Letter to the Editor

Editor:

The discussions of psychoanalysis as a profession in a recent issue of this journal (Eisold, 2003a, b, and the five accompanying discussions by Bose, Cooper, Lionells, Meyer, and Newirth) seem to reflect a conflict between two competing views: Should psychoanalysis be a healthcare profession with independent verification of its results, or should psychoanalysis be a humanistic discipline that deconstructs the very concept of results? Rather than enter the debate as to what sort of profession psychoanalysis should be and become, it is important to recognize that there are serious obstacles to succeeding in either approach. It seems that psychoanalysis has drifted into becoming a small humanistic discipline by default as economic opportunities in mental health have declined. Without large-scale outcome studies to establish the efficacy of long-term and intensive treatments, it is difficult to convince others to view psychoanalysis as a healthcare profession.

Though it may be intellectually stimulating to continue as a humanistic discipline without scientific credentials, that choice carries serious socioeconomic consequences. The older generation of analysts may continue to make a comfortable living into retirement, but there is a growing segment of the younger generation whose “living” is not so “comfortable.” As a consequence, many psychoanalytic candidates no longer expect to make a living in private practice. They keep their salaried day jobs, depend on spouses with more lucrative careers, have family money, or perhaps continue to live quasi-graduate-student lifestyles with substantial debt well into middle age. I believe that, increasingly, we are becoming a field of part-time practitioners. It is certainly not death for the profession, but it may not exactly be life either. This version of psychoanalysis is not so much a profession as it is an extremely meaningful spiritual mission, like saving the rainforests, primarily engaged in by dedicated, idealistic