Evolution, Change, and Training in Psychoanalysis

In recent exchanges among members of the American Psychoanalytic Associations there is soul searching about matters related to training and its discontents. They are coming in different forms of memories, hesitations, conflicts about maintaining the old and the necessity of giving it up. It also shows that we all have a difficult time for another more serious reason: recently we discovered that some of the ‘unquestionable’ fundamentals of psychoanalysis- as we knew it and practiced for mor than a century- are dogma that we did not know the logic behind them. We adopted the psychoanalytic protocols regarding practice (# of sessions, the couch, silence, distance, etc.), training (Eitington’s model), and some theoretical dogma (free association) without any rational effort to-at least- know what decided their import in the first place. Eitington’s model of training was firstly decided because the practice of analysis at that time had to be learned in a modality of apprenticeship (there was little to teach and more to learn). The number of sessions was also dictated by the need for quick training and more trainers who were to return to their countries to create training facilities. All that had to be done in a short period of time as a result of the novelty of psychoanalysis and its fast expansion. Free association was and still is a cognitive impossibility (transcendence of consciousness and consciousness of consciousness). I do not have to say more; just try free associating and see what will come out of it. But, if we go back to the immediate phase after abandoning hypnotism, we could clearly see that Freud meant by free association just talking freely or talk first and then see what you wanted to say (talk to know not about what you know). Free association is not what Carl Young attempted in his ‘word test’.  

The tripartite protocol was a very intuitive clinical gesture, like the intuition about Wild Analysis, (Freud, 1910). It was a stroke of ‘genius’ in which Freud condensed in that protocol the whole gamut of the distinctions that latter made ‘psychoanalyzing’ different from any current or future psychotherapies. However, there is very little, in the literature, that explains their significance (as far as I know in English and French literature). Psychoanalysis was an identifiable entity till the early fifties of last century.  The ‘controversies’ in the British Society, and the troubles between Nacht and the rebels in France around the same time, revealed that psychoanalysis is not one definable matter, but a field of an evolving and developing epistemology that could give birth to conflicting points of view. Furthermore, psychoanalysis could not stop its own evolution, and its natural process of changing, thus it is unsettled on one stable, definable connotation, especially in the area of its practice. Therefore, the term psychoanalysis does not mean the same to all of us. Our loyalty to psychoanalysis (adhering to tradition) should be to it as a term and symbol not as a fixed connotation of somethings analytical, because it is clear and obvious that most of us use the terminology of psychoanalysis as the tool to explain psychical matters, while they are- as fact- issues that require explanations based on what we understand now, which is better than the ones who coined that vocabulary. 

What was there before the controversies of the British Society was not psychoanalysis but a new understanding of us (humans) that was called ‘psychoanalysis’. However, that understanding was an understanding that initiated further understandings and different ones.  The controversies revealed that the field of understanding, and misunderstanding is open for points of view, which revealed diversities and many personal conflicts.  In other words psychoanalysis stopped being psychoanalysis from the time the controversies created two groups, then one more, declaring the opening of the gates. It was never one psychoanalysis since then. As such, any assertion of something about psychoanalysis that is not relative to what is relevant to furthering its discoveries is a false loyalty. In a more comprehensive sentence: the discovery of the person in his psychical condition started a theory that is in continually progressing and evolving, and also facing relentless resistance to those necessary changes, which result from its evolution. A good example to this sentence is the emergence of the schools of psychoanalysis in the eighties and nineties of last century: they were not new discoveries in the theory of man or in the field of the tripartite protocol of practice; they were attempts at replacing psychoanalysis without any substantive evidence of its inadequacy, or of a substantive evidence to the adequacy of the new proposed protocols.

The Evolution of Psychoanalysts and the Stagnating Training:

I will discuss three issues concerning training because all the training institutions of psychoanalysis irrespectively share the interest in those three issues: The Training Analyst, the Psychoanalytic Setup, Personal Analysis.

1.The Training Analyst:

 After over a hundred years since the establishment of the first training institute of psychoanalysis in Berlin we find ourselves, still stuck with the apprenticeship modality of training: knowledge owned by someone (or more), and one can only acquire it by personal contact with that person or persons. Regardless of all what happened to psychoanalysis and the psychoanalysts over those hundred years, the IPA -as the legitimate voice of psychoanalysis- still does not acknowledge that we have gained a wealth of knowledge about the human subject that exists independently of the training analyst, and beyond the capacity of one ‘training’ analyst to deliver. Worse, creating the status of “training analyst”, which suited apprenticeship training, ignored that the contemporary psychoanalyst needs to learn more than the limited literature of psychoanalysis, which training analysts do not have. For an example, the disappearance of the diagnosis of hysteria, nowadays, is a result of basic changes in the sexual attitudes of societies, the place of metaphor\metonymy in everyday life speech, the evolution of the identity of females. Training analysts are not expert enough to lecture or train in those areas, which are vital to keep psychoanalysis a viable theory and stop its stagnation. Previously, the training analyst knew more about what the candidate needed to know, but now what the candidate needs to know is the functions of a whole educational system and institution. Furthermore, previously training was limited to practicing psychoanalysis in psychotherapy. This is not possible anymore, if not because limiting training to that task would not appeal to the eager candidate, it will be because it limits training to dealing with problem that do not exist anymore.

Candidates do not need someone to train them in psychoanalysis; they can learn it directly and from each other. A good syllabus and a god academic team of thinkers could do a much better job than few training analysts put together. The reason is that psychoanalysis is in continuous process of evolving while analyst seem to prefer stagnation. Thus, eliminating the status of the training analyst is long overdue and should be replaced by ‘educationists’ in certain areas of the humanities because as the human subject is changing the theory about him must have changed also. Yet, there is an aspect in the “formation” of the analyst that requires the input of a good well informed and skilled psychoanalyst, not necessarily a training analyst. It is personal analysis.

2. Personal Analysis:

Eitington’s model of training reflected the situation of psychoanalysis at that time, a hundred years ago: new and simplistic, theoretically very tentative, and provisional, and lacking clear guidance to how it is done. It was in demand by unorganized groups of people of different backgrounds and inclinations. Personal analysis- the third requirement in training- was an important way of qualifying the new commers, because there were no tested ideas about the method or the theory of practice to present to the new seekers of psychoanalysi. The candidate had to go through the experience of analysis as a patient to learn how to do it with patients. Naturally and unfortunately the objective and meaning of that part of training got distorted and confusing: is it therapeutic or didactic? Is it therapeutic because analysts are expected to be psychologically healthy, or is it didactic, which means that going through the process is a learning experience that could not be properly explained to teach and learn from the literature? Although we now have a clearer idea of the workings of the psychoanalytic processes, we still do not agree on most of their connotations, because we do not know the logic behind them. We obviously prefer the familiar because it is safe and looks sure. That is why we want to stay with a psychoanalysis that is outdated, and out of synchrony.

Another serious matter in training is what and when to interpret, and what and when to reconstruct the material interpreted? Why not answer a question by the patient when he is clearly expecting a response etc.? Maybe, this should be left to the personal skill of the analyst. Nevertheless, the difficulty in that issue sheds light on the issue of a training analyst. Only in personal analysis do we encounter those situations and witness the analyst style in dealing with them (style but not reason). This point leads directly to the issue of the didactic analyst (not the training analyst) and his ways of conducting the personal analysis of candidates. There is no way, method, or teaching guide that could introduce a candidate to the practice of psychoanalysis but going through it personally. But this statement has to be qualified. The analyst has to know what he is doing and not doing, not just intuited in his doings, i.e. able to explain verbally what he does. The analyst has to also have in mind how his work is effecting in the patient, thus has a responsibility of knowing beforehand what to be said decide how to say it. Better, personal analysis is the cornerstone of training if done by a special kind of analyst that has nothing to do with whether he is Training Analyst or not.  It is obvious that this part of personal analysis has a therapeutic value in addition to its didactic value, and the analyst who does that is de facto a training analyst (his analytic work teaches the candidate\patient something). Nevertheless, selecting the proper candidates for training should not be linked to the issue of personal analysis.

I hope that my emphasis on the lack of need for training analysts and our dependency on good analysts highlights the gap between formal and informal training.

3.The Analytic Setup.

The basis of Freud’s ingenious intuition in the psychoanalytic protocol, particularly regarding transference extended to the setup of practicing the psychoanalytic act itself. He proffered a setup to be applied with all patients; thus the differences in outcome could be referred to the patients and not considered reactions to the circumstance but of practice.

When I gained confidence in my understanding and my practice of psychoanalysis (26 years) I decided to actively use that change ((three more years). I put to the patients the issue of selecting what suit them best in terms of the setup of their analysis, with the understanding that there will be no changes at a later time, or as they wish. The choices were the couch or the seat, three or four sessions per week, vacations, cancellations, payments, termination, length of sessions (mine were 45 minutes). My view was to eliminate using projection, at a later time, as means to manipulate the analytic setup. I did not emulate my two previous analysts in doing that, and I was also aware that I was breaking what seemed like an absolute tenets of psychoanalysis, when there were actually none (Freud improvised the couch position because He felt less stressed when the patients were not looking at him sitting during the sessions).

This point requires some elucidation because it will likely be misconceived by most. Since the original setup of the analytic situation was not decided based on any psychoanalytical principles or requirements, thus the analyst along with the patient should decide and stick to their decision about what is more convenient for both. This could be done with the proviso that there are requirement, limitations, consistency, and mutual understanding that the analytic set up and observing it is part of the process itself. Requesting changes to the original setup was subjected to analyzing and material for examination and analysis. The other aspect in the managing of the setup was what the protocol of practice is emphasizing. The analyst’s neutrality, anonymity, and abstinence, if strictly observed in his reactions to the patient’s attempt to use them in his relationship with him he would be preserving the place of transference in interpreting the patient’s material. If the patient has a factual issue about the analyst and the analyst does not confirm it or deny it the transference material will eventually reveal itself.

Evolution of Psychoanalysis and Training Change:

The endeavor to carrying on with leftovers of old psychoanalysis (vocabulary) is useless, if not detrimental. The most it could do is giving a skeleton for a poor system of psychotherapy. In other terms, the vocabulary of psychoanalysis that is currently used, and in most cases considered the theory of psychoanalysis, is just terminology of no specificities. Therefore, most of the leftover vocabulary of the old psychoanalysis was-or should be- a stop gap until we understand what things are. As an example: identification, in the original usage of the term, meant a process of self-definition based on assuming an identity that goes beyond the subject’s own authenticity: “identified with his father or the aggressor”. However, after decades of dealing with the subject in more than one capacity, we amassed a vast knowledge about identification that could (should) clarify that psychical process in a different and clear way. We learned few things about narcissism, projection, love\hate relations, interpersonal and intrapsychic structures. We cannot or should not understand identification in the same old meaning because it is not a simple process of introjection. We would be doing ourselves a great favor if we examine the human subject’s Grief reaction to loosing an object of identification.

Psychoanalysis has evolved to get closer to understanding its subject matter; the human being, but that is not clear to the naked eye because its training is stagnant at a backward point. Its training has to match that progress and not keep recycling the old. It has to because the humanities are modernized and have commensurate systems of learning and training, and we need to join them. We still in owe of our forefathers… or are we?! A possible answer to that question: no we are not. It is just that we have no analyst with vision to see, prepare, and work on moving forward to let our forefather rest in peace.