Ever since the first waiver was granted, it has been something of a storm center for heated debate. It seems unlikely at this historical juncture that further discussion will change anyone's opinion about the justification for, or the wisdom of, granting waivers of medical requirements for psychoanalytic training. The issue has become sufficiently polarized that further arguments seem only to harden previous positions. On one side are those who believe that the introduction of the waiver has in no way benefitted American psychoanalysis and that those who apply as research students do so as a deliberate subterfuge in order ultimately to enter private practice. Anyone who gives a moment's thought to the fact that most institute training still averages about ten years of study will see that there are easier and faster ways of entering clinical work and that anyone willing to endure the financial and psychological hazards of psychoanalytic training must have loftier motives than gaining access to the clinical marketplace. Those opposed to granting waivers must come up with a more convincing argument.
On the other side are those who can see in the waiver an opportunity for cultural and scientific cross-fertilization that has already paid dividends in the number and quality of books, articles, research projects, and ingenious innovations in applied psychoanalysis. Fortunately for the psychoanalytic movement, Erik Erikson and Anna Freud lived in a community not blinded by the medical model, and were able to attain training without benefit of a waiver even before their work secured them established reputations.
On another front, it is also true that several of the older institutes have appointed Ph.D. clinical psychologists as training analysts, thus providing nonmedical teachers and supervisors as mentors and models to a largely medical student body. These people have been remarkably productive, and the educational gold of psychoanalysis has in no way been debased by their presence.
The acceptance of waiver candidates may provide psychoanalysis with a needed infusion of new blood as a way of introducing more of a spirit of unrest into psychoanalysis, a sense of crisis as a necessary precondition for the emergence of new theories or for the advancement and progress of old ones. The history of science teaches this lesson no matter what period of history one considers—whether the Copernican revolution of the ancients or the more recent scientific tensions around splitting the atom.
What is needed is a greater research emphasis in evaluating the various paradigms that make up the science of psychoanalysis. While my own preference would be to grant waivers to diverse professional groups, it is the clinical psychologist, with his specialized training in research methodology and empirical and observational approaches who would most benefit psychoanalysis as a science and perhaps lead the way toward new scientific breakthroughs. There is no guarantee of course that any such change would occur, but it is more likely to happen if we become more relaxed about the waiver, for the best of our research psychologists have been offered no inducement to enter psychoanalytic training.
An example of our difficulties can be noted in the present debate about the place of metapsychology in psychoanalysis. If we reject this one paradigm, as so many are now advocating, and substitute no other paradigm, then we have in large part rejected the theoretical base of psychoanalysis and run the danger of removing psychoanalysis from the field of scientific research problems, allowing it to become nothing but a clinical tool.
Most of the time people in a single scientific community work from a tightly-knit set of paradigms, a fact that seems also to be true of psychoanalysis, and seldom do we have people from other scientific disciplines working in the same paradigm. Such a possibility has all kinds of advantages. To bring in research-minded clinical psychologists might have the result not only of expanding the scientific community of psychoanalysis, but of introducing what Kuhn calls the “essential tension” of scientific research.
Sydney Smith
Topeka