D. Learning or Training: The Dilemma of Psychoanalysts.

This distinction is seldom mentioned or considered in the psychoanalytic circles. It is the distinction between learning what to know about psychoanalysis and training in psychotherapy, which we are inclined to still call it psychoanalysis.  It is a distinction that is blurred- almost intentionally- by the psychoanalytic institution(s) because if it is clarified and recognized there would be some serious questions about the functions of that institution itself. 

However, let us start with another distinction that was fundamental in the development of psychoanalysis itself. It will prepare for a more comprehensive reply to our main issue. What is the difference between a profession that demands certification to practice, and a craft that only requires apprenticeship? This question is in fact fundamental, because though it is avoided by the psychoanalytic institutions it still preoccupies analysts- more unconsciously than consciously (the endless questioning of psychanalysis itself and what is it really). It arises whenever some particular issues are raised like the schools of psychoanalysis, the training systems, the scientificity of the discipline, etc. It has not gotten an answer yet!!. Without answering to that question, we should not talk about ourselves as psychoanalysts. Psychoanalysis has to prove first that it is a profession and not just a designation in other professions to call ourselves psychoanalysts.

Psychoanalysis started with a few physicians and men of knowledge, who were already influenced by the notions of the subject’s duality (German ideological metaphysics). It started with Freud proving -by using hypnosis- the coexistence of dual streams of thoughts in patients. After a short while he realized that the ordinary speech of the patient could, with some attention to its idiosyncrasy, reveals the second stream of consciousness without hypnosis. Freud and his followers embarked on a process of exploring the human subject-via his psychopathology- by just ‘analyzing’ the duality in his speech. The findings revealed that there are obscure psychodynamic processes that link the two streams of thought.  The processes were active and unconscious. Those revelations required improvising new definitions for the common vocabulary and language used to refer to them (repression, etc). Gradually some sort of theoretical framework of psychopathology emerged. The expansion of Freud’s insights and thru the contributions of his group of inquisitive colleagues a movement was created, which evolved to be what we have now: an international organization that is supervising a self-created training system that qualifies a person as psychoanalyst, if trained in one of its accredited institutes.

The reason of choosing this path to start this part of the posting is to show and underline that the onset of psychoanalysis and the objective of the first Freudian group was an interest in acquiring the skill of analyzing people’s speech, not to create a profession. Even those who sought to practice psychoanalysis as treatment of patients took more than two decades to identify-in a definite way- a psychotherapeutic attribute to psychoanalysis. Knowledge of the “unconscious” changed the curiosity, aim, and the dynamics of the group and created an ambition to practice that skill professionally… by making the unconscious conscious. With the increasing number of people who wanted to join Freud’s group the idea of systematizing training in psychoanalysis emerged and linked with the expansion and the reorganization of the IPA. Training in institutes that are governed and accredited by the IPA was found to be the sensible and a practical thing to do. However, there was no external official independent authority to certify the training and authorize practicing that type of therapy (still there is none). Certification is a precondition in the practice of any professions. Analysts, must come to their membership in the IPA already certified by their specific professional qualification to practice their training in with the public, legally.

In Freud’s discussion of the “Question of Lay Analysis” (1926) he was obviously clear in not considering psychoanalysis a profession. He stated that it is an applied psychology that requires special training but is not enough to constitute a separate and distinct profession. He also talked about psychoanalysis as knowledge which is applicable to other professions. As knowledge that could influence- positively-several other professions it could be- symbiotically- a major player in psychotherapy. As psychoanalysis proves its usefulness and functionality in several fields of the humanities it should be treated as such, and not limit it to psychotherapy and characterize it a profession of psychotherapy. A shift to that perception of psychoanalysis requires a different outlook on who is or could become a psychoanalyst?

Up till now, the graduates of only three clinical professions (Medicine, Psychology, Social Work) are accepted in the training programs of the IPA. This stance confirms that the IPA considers psychoanalysis a clinical discipline only. Since the three specialties are not clinically of similar backgrounds, and are markedly different in their clinical functions, we could safely conclude that the graduates of those three disciplines are accommodated in the IPA training in psychoanalysis because they are ‘certified’ professionals. It does not need much to say that such accommodation has nothing to do with psychoanalysis; it only increases the number of the analysts and gives the IPA more members who are certified to practice legally a health act.

 I have to repeat my previously declared view regarding training and the true nature of psychoanalysis to proceed without unnecessary distractions in futile arguments:

If psychoanalysis is a skill and not knowledge, training should-in principle- be restricted to the clinicians who are certified by their academic degrees to treat patient. Example: for a Ph.D. psychologist to be accepted in training in psychoanalysis his Ph. D has to be in clinical psychology and not in experimental psychology, so that after passing his apprenticeship training, he could join the psychoanalytic community. If psychoanalysis is knowledge, training therefore should be open to all the qualified candidates in the humanities, who seek the additional ‘depth’ psychoanalysis offers. Training that meaning should be geared toward the nonclinical aspects of the psychoanalytic discoveries. The term psychoanalyst (if used as an adjective) would then indicate a specialization within a profession.

Losses and Gains:

There are two main issues to address in regard to the membership of the psychoanalytic community: learning/training and the applicants. Psychoanalysis should lose the fixed image of a clinical discipline and being simply a psychotherapy, in order to gain the quality of being a knowledge that enriches other branches of knowledge (including psychotherapy too).  Thus, it would no longer qualify as an apprenticeship but becomes an academic subject. It will not be learned in institutes that are run and overseen by the “membership” organization of the IPA. The learning institution will be Academia which overlook all that is related to getting certifiable in the candidates’ choice of their domain of psychoanalytic interest. There would a real separation between the educational body and the membership body. Psychoanalysis become an integral part of several recognizable professions like medicine.

We lose the unsystematized and haphazard curricula and the subjective significance of the ‘training’ analyst.  We gain the respect of academic learning and the teaching faculty’s concern about its educational input in learning. We also gain that our contributions to psychoanalysis will be scrutinized by other academicians, therefore we open the self-imposed isolation and the gradual deterioration of psychoanalysis.

In regard to the candidates, we will get younger people who are going to spend more years in learning a profession that will give them a quality of credibility they will work hard to deserve and keep. It will weed out those who are not there for learning but only for quick training in doing something less credible than it was many years ago because of its novelty.