Crisis in the Therapist

Despite a long personal analysis and presumptive self-understanding, a practitioner has no guarantee (why should he?) that he will remain confident and stable in the years ahead. Indeed, sometime after the end of their formal training, a number are compelled to return for additional therapy. Why this happens is surely complicated. Before tackling the question, however, let us sketch the early period of a psychotherapist's professional life.

Upon completion of his M.D. or Ph.D., plus an internship, the young psychiatrist or psychologist characteristically takes a staff position in a mental hospital or clinic. For him these are exciting days. He deals with actual people, having grave emotional problems, and so has the first real chance to use his knowledge and skills on his own. In case conferences and team meetings he and colleagues evaluate and discuss their patients. Periodically, to stimulate and inform the professional staff, visiting experts lecture on analytic theory or discuss the handling of specific clinical problems. For personal and didactic reasons, the therapist may during this period of his career begin his own analysis.

After a few years of service in institutions he ponders his own goals, motivation, prospects, and the time and money involved should he undertake intensive training in psychoanalysis. Eventual full-time private practice is a tempting kind of professional life and well within reach if he has the credentials.

Let us say that our therapist makes application to a training institute and is accepted. To be sure, there are many psychiatrists, psychologists, social workers and others in part or full time private practice who have not sought formal psychoanalytic training, or were not admitted by the institutes to which they applied. Some have undergone