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Dear Editor
Nigel Burch (BJP 30[3]) is right to call for a long-term strategy for our profession, where psychoanalytic understanding of human relations ranks alongside economics in the formulation of public policy.
At the famous 1918 Budapest conference, Freud and the early pioneers laid out their vision for the profession, seeing it as having three key components: research, training and subsidized clinics. It would seem to me that we have succeeded in just one of those activities, training, and even then only partially. Whilst our psychoanalytic/ Jungian/psychodynamic trainings are all intellectually robust and underpinned by impressive academic credentials, they have tended to develop in a fragmented and hierarchical manner. They are not particularly economically or socially accessible and have tended to place intensive individual work at the apex of a complex hierarchical structure.
We are now faced with the reality of our history, with a high concentration of relatively small competing training institutions, often geographically concentrated in fashionable suburbs of north London, with an implicit orientation towards training to work in private practice.
Why does this matter? Well it matters because it makes our profession inaccessible for many people: financially, geographically, socially and culturally, resulting in a professional demographic that does not reflect wider society. In this slightly rarefied climate, innovation has often been driven from an intellectual locus without regard to the changing external environment. The profession is often poorly understood, and viewed by society at large as anachronistic and marginal to contemporary healthcare and wider public policy development.
This must change if the profession, and our training institutions, are to survive as anything other than being of interest only to a small number of well educated, relatively affluent people; either as trainees or patients.
But the profession does have something quite profound to o