You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Our field is in crisis. The amount of psychoanalysis practiced in the United States has declined dramatically. Institutes can't attract new candidates and candidates can't find new cases. Our reputation has sunk, from idealized to denigrated. And much analysis today occurs over phone or video, which some consider a pale imitation of the in-office experience.
How can we address these problems? Are they even worth solving? The behavior of many analysts indicates a belief that they are not. Most graduate analysts see, on average, one analytic case a week, and many do not practice analysis at all (Kaplan et al. 2009). It seems that we are voting with our feet, and our feet have given up.
In Psychoanalysis from the Inside Out, Lena Ehrlich uses technique and theory that are at once revolutionary and traditional to address our dilemma. She looks not to economics or neuroscience, but rather to our own field, to deepen existential questions about analysis and propose ways of addressing them. Above all, Ehrlich seeks to understand the issues by analyzing them. Though she acknowledges external barriers to analysis—time commitment, expense, unfavorable cultural climate—she redirects our attention toward internal obstructions. Ehrlich then employs the concept of the frame to suggest practical solutions, particularly
maintaining high-frequency analysis for both our patients and ourselves and expanding the tripartite model to encourage reanalysis, consultation, and peer study throughout our careers.
Ehrlich's work falls within the two-person psychology tradition. Before the 1980s, the one-person model prevailed, and literature focused more on the patient's analyzability than on the analyst's reluctance. Ehrlich provides an overview of the evolution toward a two-person model. Theodore Jacobs (1988) was among the first to acknowledge that internal factors, particularly the analyst's ambivalence toward recommending analysis, “seem to be as important as such external conditions as th