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Many major changes in the requirements for admission to training in psychoanalysis and in the education of those admitted have occurred in the last fifty years. These changes have greatly increased both the number of members of the psychoanalytic profession and the opportunities available to them to practice.
It is a fact that becoming a psychoanalyst in the United States when I entered the profession meant that I was a medical doctor who was seeking advanced training in a subspecialty of psychiatry. We were learning how to do clinical psychoanalysis as a therapeutic tool to cure certain mental illnesses, mainly the psychoneuroses. We were expected to master the tools of our trade by undergoing a traditional analysis ourselves at a frequency of four or five times per week for at least three years. In addition, we were expected to take didactic courses and have supervision on our own cases where we applied the psychoanalytic method to neurotic patients. We were enrolled in a “trade school”—like those of other medical specialties—that would enable us to practice special skills. We were authorized to train other doctors in our area of expertise. This system can be described as analyzed neurotics training neurotics to treat neurotics. In addition, analysts trained non-doctors to do psychoanalytic psychotherapy, which was believed to require less specialized skills. Psychoanalysts unable to fill their practice