Training of psychoanalysts
Psychoanalytic training is the process that enables a student to be recognized as a psychoanalyst by the psychoanalytic community and serves as a prelude to psychoanalytic practice. Many attempts have been made to define the optimum conditions for training since the early years of psychoanalysis. Following the creation of the Berlin Institute for Psychoanalysis in 1920, there came into being a number of organizations designed to provide training based initially on individual psychoanalysis.
At present there is no official degree or certification for psychoanalysts. Because of the excesses and pretenses that have inevitably accompanied the success of psychoanalysis, the issue often arises of the need to protect not only patients but also properly trained psychoanalysts, and ultimately psychoanalysis itself. However, the private institutions that represent psychoanalysis do not want the certification they provide to be part of any official legislation. There is a fundamental reason for this. Psychoanalytic training involves, first and foremost, personal experience of the analytic situation, and this experience is valid only if it is a subjective adventure freely undertaken. How could analysts in training reveal the most intimate aspects of their beings if the experience served as a means of obtaining a state-authorized degree or certificate?
Freud himself was aware of the problem early in his career. In a 1926 article (1926e), Freud argued against the idea of restricting analytic practice to medical doctors alone and pointed out the near impossibility of defining criteria for the "illegal practice" of psychoanalysis. His wish was that psychoanalysis be "neither permitted nor forbidden," and thereby be free of government regulation. At the same time, he felt that organizations like the association he had created could regulate psychoanalysis and thereby resolve, to the extent possible, the problem of integrating psychoanalysis into society. Such an institution could establish methods of training and procedures for certification. In spite of various crises and criticisms, this model and its variants appears to have remained the most pertinent.
It is easier to describe the tripartite model that is generally a part of an analyst's training than to summarize the contradictions that have arisen with the question of accreditation. There are three components to training, all of which are necessary. In the United States the analyst in training undertakes the three parts of training concomitantly. It is considered essential that a candidate undergo analytic treatment while conducting a supervised analysis so that problems that arise through the counter-transference can be analyzed.
The first component of training is the analysis of the candidate. In France, this requires a commitment to analysis prior to training and ensures that the analysis, when it occurs, calls into question the unconscious sources of the desire to be an analyst. If the candidate is not committed, or is incompletely committed, the candidate should draw the appropriate conclusion and withdraw from the field. Experience shows that this does not always happen, and in such cases the position assumed by the analyst is rarely compatible with the analyst's performance. It is appropriate to refer such cases to a third party—an organization, for example—for adjudication. The personal experience of analysis is so important that it has been referred to as the second fundamental rule. This requirement follows from the demands made on the analyst in practice: evenly suspended attention, benevolent neutrality, the ability to analyze one's own mental responses to the patient, identification and de-identification with the patient, and so on.
The conclusion of analysis and the criteria for success have been the subject of much spirited debate within the psychoanalytic community. Originally, the analysand was involved in only an aspect of the full potential of psychoanalysis: acknowledging the existence of the unconscious, which provides the subject with greater understanding and conviction. But with advances in the technique of analysis and the emergence of the concept of counter-transference, training analysis moved in the direction of the most complete analysis possible, with each of the major theoretical trends proposing a definition of a satisfactory conclusion in terms of its own criteria. The paradox is that defined criteria of a satisfactory conclusion engenders a normative reference that contradicts the very spirit of the analytic process. It is important to stress, therefore, that the analysis of the candidate has a greater chance of success if its didactic dimension is ignored, if the ever-present real or imaginary requirements of the collective ideal are abandoned, and if the analysis finds its own modus operandi. The process requires only—but this is already asking quite a bit—that candidates, starting from an adequate intellectual base, engage in self-analysis and be able to identify and make use of the effects of counter-transference on themselves. As can be imagined, such a process of analysis exceeds the scope of training. Because of the risks associated with practice of the profession, the analyst should be prepared to undertake additional therapy when needed: one's own analysis being, by definition, open-ended.
The second component of training involves supervised analysis. The novice analyst speaks to a more experienced colleague on a regular basis about a current patient in analysis. This report can assume various forms and involve different kinds of comments and exchanges. What is essential is that the junior analyst talk about what takes place between his patient and himself in terms of transference and counter-transference. When he does so, he will necessarily reveal the unconscious counter-transference, which then can be pointed out and elaborated. One of the goals of supervision is to enable the beginning analyst to transcend identification with his own analyst and develop his own style.
The supervisory situation, typically involving two people, can also be conducted in small groups, in which case it resembles a seminar for clinical discussion. The controlled environment that supervision affords is so vital that all analysts should make use of it whenever problems occur in their practices. Supervision must therefore be considered a separate form of analysis, a process that occurs alongside therapy and serves as the basis for analyzing oneself while analyzing the patient.
The third component involves training in analytic knowledge and metapsychology. Naturally, it is desirable that the analyst be familiar with the key texts in psychoanalysis and be as well educated as possible. Study groups and seminars requiring the trainee's active participation and interaction with older colleagues will contribute to the trainee's education. Below are some additional points about education:
* Possessing knowledge is of limited value for practical competence. For the analyst, knowledge assumes value when a given concept, author, or clinical description arouses his interest, mobilizes his defenses, and encourages his identifications, allowing him to access the truth at a given moment. And this process is entirely subjective. A theoretical overview intersects with the insights of self-analysis. Because psychoanalysis seeks knowledge of the unconscious, everyone must follow the road of Freudian discovery for himself. * Studying Freud is a central part of training. This study is justified not only because Freud originated modern psychoanalysis and his depth and scope form an intellectual matrix for the discipline, but also because identification with the inventor of psychoanalysis shifts over time as a result of rejections and contradictions and multiple models. Critical study can weed out defensive adherence to a dogmatic and closed theoretical model. Finally, in view of the pluralism of post-Freudian thought, shared knowledge of Freud's work can be used to identify areas where differences, divisions, and revision occur. A century after Freud's discovery, an analyst's metapsychological grounding must involve some historical awareness, which is indispensable for orienting oneself within the immense body of psychoanalytic writing. * Training in psychoanalysis also involves initiation into a range of fields opened up by the extension of psychoanalysis (child, psychosomatic, family, group psychoanalysis) and its application (care institutions, education). In all of these fields, what is important is that psychotherapeutic practices more or less follow the analytic model. * In the ideal program of a psychoanalytic institute, Freud included the teaching of fields that he felt were essential for analytic thinking: anthropology, prehistory, mythology, history of religion, biology, linguistics, as well as others that have been added since, such as the arts. For the well-trained analyst, nothing human is foreign. In pursuit of this ideal the well-trained analyst will undergo continuous education. * In a more immediately practical sense, the question of appropriate prior training has often been discussed. It is advisable that the analyst have at least a college education, have adequate experience of living and working, and have seen something of human suffering. In the early twenty-first century, the great majority of analysts came from the fields of medicine, especially psychiatry, and psychology, and indeed, knowledge of serious psychopathology is indispensable in modern psychoanalytic practice. For these professionals, the encounter with their unconscious and access to metapsychological ways of thinking will still call their training into question, but it is not a bad thing if analytic training is primarily conceived as a form of undoing.
To ensure that a psychoanalytic body is responsible in certifying its members, it must explicitly define the principles on which training is based and the regulatory procedures to which trainers and trainees are subject. The most difficult aspect of this process is ensuring quality analysis of the psychoanalytic candidate while respecting the candidate's extrainstitutional space and time. For this reason and for purposes of maintaining confidentiality, every institutional discussion or decision concerning a candidate must explicitly exclude any interference by his analyst.
Interactions between applicants and institutions (such as offers of employment) reflect the options available and the views held by the various parties regarding the ethics of training and certification. Models range from selection prior to any commitment to analysis (as in the United States), a model that requires a highly organized course of study at an institution, all the way to certification after the fact, which makes candidate analysts fully responsible for the various aspects of their training. In intermediate models, supervised analysis serves as an introduction to the institution and thus as a preliminary form of certification. Logically, candidates' requests to move from couch to chair should coincide with affirmation of their desire to make the move. However, this connection cannot be made a requirement even though the institution requires it, because the affirmation ultimately lies with the subject.
In France, evaluation of a request for admission to a society generally takes place over the course of three meetings with three analysts assigned by the institution. In these meetings the candidate speaks about himself and his analysis. This is an awkward situation, for the candidate needs to transpose, in a conversation with an analyst who is also an examiner, what has until then been his intimate and private experience of the analytic situation. What the examining analysts seek in the candidate is not greater benefits from the analytic work but a display of the necessary distance that reflects the self-analytic ability required of an analyst. In successful interviews, the candidate clarifies the truth of the dialogue of the meetings, and the examining analysts can consider whether the candidate is qualified for the work of analysis. From the personal nature of these meetings, it is easy to see that they require absolute confidentiality. The outcome of the meetings should be a collective response made on behalf of the institution. Ultimately, the most difficult problem is that of rejecting the candidate.
Further training and certification can assume very different forms. New analysts can be further evaluated in supervised analysis and seminars. Since an institution is defined as much by those it accepts as those it rejects, the problem of rejecting candidates remains. Flexible and controlled modulation of where to draw the line between admission and rejection makes for internal dynamism in scientific exchange, fertile tension between the individual and the group, as well as conflict between generations. Institutional certification acquires meaning only in relation to the duration of training, when supported by older colleagues, and in seeking the transmission of knowledge from one generation to the next.
- American Psychoanalytic Association
- Berliner Psychoanalytische Poliklinik
- Development of Psycho-Analysis
- Lehrinstitut der Wiener psychoanalytischen Vereinigung
- New York Psychoanalytic Institute
- "Recommendations to Physicians Practicing Psychoanalysis"
- Splits in psychoanalysis
- Supervised analysis (control case)
- Technique with adults, psychoanalytic
- Technique with children, psychoanalytic
- Training analysis