The Place of Psychoanalysis in Academic Psychiatry: A Debate

When Dr. Joel Paris's The Fall of an Icon: Psychoanalysis and Academic Psychiatry (2005) was published, I was eager to read it. As an upper-year psychiatry resident at McGill university, I have been training in a milieu that has a long history in psychodynamic teaching. Of the resident training programs in Canada, McGill enjoys a reputation for paying more than lip service to the “softer side” of psychiatry. Much of our teaching, supervision, and academic seminars are given by analytically trained psychiatrists. Yet under the chairmanship of Dr. Paris, our teaching on the psychodynamic aspects of the therapist–patient encounter has noticeably taken a back seat to emerging biological research, non-analytic psychotherapies, and psycho-pharmaceutical treatments. Somewhat in answer to the top-down decision making that has lessened our exposure to teaching by analysts in our core teaching blocks, the Canadian Psychoanalytic Society (Quebec English Branch) has opened its doors to the residents in psychiatry. Once a month, we meet on their premises and discuss academic articles, watch videotaped sessions, and review transcripts from the caseloads of academic psychiatrists who are also psychoanalysts. Meetings have up to six psychiatrist-analysts and fifteen residents (which is about half of our program). These evenings have been a great success, judging by resident turnout and enthusiasm.

The Fall of an Icon is a history of the “hegemony,” “challenge,” and “decline” of psychoanalysis, within academic psychiatry and in the (mainly North American) cultural ethos. Many of the statements of the book are fact-like: how