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Wallerstein (1990), in his cogent and thorough review of psychiatric education over the past 30 years, laments the decrease of formal teaching of individual dynamic psychotherapy. When he began his survey shortly after World War II, approximately 300 hours over the course of the psychiatric residency were devoted to individual dynamic psychotherapy. Currently, individual dynamic psychotherapy is allotted approximately 50 hours. For a number of reasons, Wallerstein argues against this trend and seeks a restoration of focus on individual dynamic psychotherapy as a major part of psychiatric residency training. While accepting and admiring the scholarly aspect and exactitude of his presentation, many psychiatric educators, including myself, feel quite differently about the facts he presents. We are delighted that our field has progressed so rapidly.
Thirty years ago about all we really had to offer psychiatric residents were the nuances of psychoanalytic theory and therapy. Advances in many other aspects of our field have created a far more sophisticated understanding of the forces that impinge on our patients, and we welcome the advances in genetics, molecular biology, psychopharmacology, imaging, and neurophysiology which we can now employ. Nevertheless, the major aspect of Wallerstein's (1990) view, that we are producing residents who graduate without the necessary level of experience in and knowledge of psychodynamic psychotherapy, is, in many cases, accurate and needs to be addressed. It is here that Dr. Frosch's magnum opus may have its greatest utility. I strongly believe that every graduating resident, especially those trained in programs that are relatively deficient in psychodynamic and psychoanalytic emphasis, should have a copy of this work. It is an excellent reference to be consulted and perused.