The psychoanalytic student's formal education, which is provided for in the well-known tri-partite system—the personal analysis, seminars, and the control cases—is usually referred to as one's “training.” Although we speak of it as such without much thought, this fact is not without importance. For psychoanalytic education is essentially a “training,” in that the candidate is for the most part being taught to do analysis (with the exeception of the research candidate, whose explicit emphasis may be to learn the essentials in order to focus on doing research in the field).
Looked at from one perspective, “training” is comprised of the learning of the technical skills to conduct an analysis and the acquisition of necessary controls and the development of essential abilities in order to employ these skills effectively. There is certainly something of the medical model of training in this, and that in turn is derived from the model of the apprenticeship. Although this model is based upon individual contact of the student with the teacher, it is taken for granted that the institute is the center for such teaching. The institute, qua institution and also to some
degree as representative of the American Psychoanalytic Association, becomes the focal point in place and persons for one's education. From a purely practical standpoint it is the institute, through its education and progression committees, that makes the decisions that crucially affect the individual candidate's status along the course of requirements, stages and finally graduation.
Institutes, their programs and policies, vary somewhat from one to another: some administer examinations, others do not; some assign training analysts, others do not; some have training analysts report, and others, not at all. By and large such differences are probably of equivocal influence, save perhaps that too much control and authority on the part of the institution tend to infantilize the candidate even more in an already regressive situation.
Of greater significance undoubtedly are the potential effects of the assumption of pivotal roles of power within the institute by important figures with theoretical differences or, in the extreme, from differing “schools of psychoanalysis” (Greenson, 1969). Herein lie the seeds either of an important diversity in approach and insight which should be a stimulus for progress in thought or of political strife in the name of differing educational points of view. For the student, alliances and identifications with various teachers are inevitable and, in fact, intrinsic to the formation of a professional identity. It is essential that these identifications be made as little as possible either on the basis of individual neurotic needs or from forced alliances, whether tacit or explicit, resulting from rivalries among the figures in-power. Meaningful debate in the institute can serve the student so that he not be overcome with any one point of view about the alleged “truth.” However, misdirected arguments can become the focus of divisiveness, playing upon the candidate's as yet unresolved neurotic conflicts rooted in his own family experiences or upon a tenuous inner struggle of the trainee needing to appeal in various ways to authority figures who themselves are battling. Hopefully, the institutes, under the aegis of the Association, can regulate their own functioning to prevent such divisiveness as much as possible.
On the other hand, an equally disquieting possibility derives from the specter of over-regulation, either on the part of the institute or that of the Association. This may become manifest in a number of ways; e.g., the attempt of the institute to decide who can be analyzed by whom or the overseeing of the candidate's cases to the point of an implicit dissuasion of one's undertaking any psychoanalytic treatment that might not serve as an official control case. But it is also evident that any field which has no standards has no quality either. Every candidate must appreciate that the institute with the Association behind it serves the integral function of establishing standards and maintaining them from the selection of candidates and faculty to determining graduates and training analysts and what is to be expected from whom.
The major tension in this realm for the student stems, I think, from the clash between the need to meet institutional requirements and the aggressive element involved in creative thinking. One is the demand of training; and the other, the basis of successful learning. To what extent may the pressures and anxieties inherent in psychoanalytic training contradict or even inhibit the development of psychoanalytic education? Or put in another way, is the emphasis on graduating reliable psychoanalytic technicians obstructing the process of evolving psychoanalytic thinkers?
These concerns are not new. Greenson (1969) writes, “Above all, I have been impressed and depressed by the observation that applicants for training often seem to be more creative than the psychoanalysts who graduate from our training institutes. Perhaps our method for selecting candidates is faulty, but in all candor, we must also face the possibility that our training programmes and the atmosphere of our institutes may stultify the creative imagination of our students.” Psychoanalytic institutes, although composed of and run by individuals who are expert in and sensitive to the unconscious workings of the mind, are nonetheless subject to the group processes inherent in any organization. One wonders to what extent candidates are selected in the image of those who are selecting and/or how many candidates are selected on the basis of a generally compliant obsessive-compulsive character structure. There is also the question raised by Eissler (1969) to be contended with as to the long-term effect on the field in what might be decreased excellence of training analyses because of less strict criteria by which an increased number of training analysts are selected. Many authors have taken up the issue of the questionable therapeutic results of many training analyses (and one would ask about the didactic results as well); and as far back as Glover's original textbook on technique, the student is warned of the difficulties in the neophyte's tendency to overidealize or even to imitate the training analyst or some image of the “ideal analyst.” To some extent these conditions and tendencies are inevitable and not unique to psychoanalysis. For the individual it is a crucial task of one's own treatment to analyze such trends; and for organized psychoanalysis it is equally necessary to keep tabs on the over-rigidification of the process.
I think there are three major problems in psychoanalytic education today: 1) the situation alluded to above involving the confrontation between “training” and “learning”; 2) various real and practical demands on the candidate that are part of this training situation; and 3) questions concerning the future of psychoanalysis itself and the role of analysts and therefore analytic teachers today in contributing to its potential demise, whether witingly or not.
To begin with the first of these, it is clear that as candidates we must gain control of various competitive and narcissistic needs in such a way that our oedipal strivings lead us neither to have to kill off our parents and teachers nor to be compelled to maintain a totally passive or submissive stance. I think there is a certain regressiveness intrinsic to the experience of being a trainee of any sort, and this in turn creates either a compliance that may be comfortable for student and teacher alike or the opposite, a rebelliousness, either one resulting in more rather than fewer controls being maintained over the student. Clearly both students and teachers should be aware of these processes and the constriction on thinking that ensues.
The second category encompasses the complaints offered most vociferously by candidates, and indeed these are often the most immediate. Psychoanalytic training is extraordinarily long and costly from several standpoints. No other training has graduates that are older. The expense of a personal analysis and not infrequently that of one's spouse, usually begun while one is still in residency or post-doctoral training and/or at the beginning of psychiatric practice, is immense, especially when the candidate is simultaneously confronted with low-fee cases and supervisory fees. In the United States this is subject to slight geographical and other variations, but it is now in this country a formidable financial undertaking, given in addition the time that must be devoted to analytic sessions, seminars, and supervisory hours. The candidate
is faced essentially with a non-paying half-time job. To be sure, if analytic training is one of the foremost of one's priorities, the compromises are part of one's choice. But the candidate is nonetheless attempting to establish himself as a professional practitioner or often has already been a practicing psychiatrist or psychologist for a number of years, when faced with the contradiction in self-image of being a student concomitantly and experiencing the regressive pull that that entails. The attempts to cope with these difficulties by trying to graduate as quickly as possible or prolonging one's candidacy by not taking on more analytic cases may both have detrimental effects on one's education.
However, in my opinion it is the third consideration that poses the gravest threat to psychoanalysis and to us who will be the analysts of the future. There are two sub-issues at stake here—the future of analysis as a therapeutic modality and the future of psychoanalytic theory—which I believe are inextricably entwined. In keeping with the times, more analysts are devoting their time and energy to other pursuits and other treatments, psychoanalytic psychotherapy included. Parallelled by increasing preoccupations with allying analysis more with psychiatry and medicine for allegedly economic reasons, I think this shift is symptomatic of wishes to “psychiatrize” psychoanalysis, attempting to make it more palatable for those outside the field and perhaps for too many within it. Another facet of this increasing emphasis may also be represented by the chorus of theoreticians who look to fields outside analysis for new ideas or further developments within the theory.
I would like to emphasize that I am not in any way advocating an ivory tower attitude nor one that espouses eschewing anything outside the realm of analysis. If one agrees with Eissler that the “paradigms” possibly derivable from the psychoanalytic situation and method itself have been exhausted by Freud, then indeed one has no other choice but to practice analysis with an eye on extra-analytic studies to provide the final understanding of human psychological functioning. These studies and other fields are no less valuable and cannot be ignored, as Holt (1978) and many others have stressed. But I believe that relying on extra-analytic solutions to the puzzles of the mind that confront us still, insofar as they are approachable at all with our method, is a resistance within analysts themselves to the experience of intrapsychic conflict and its vicissitudes. The net result will inevitably be the further elaboration and promulgation of a seemingly refined theory, clinical and metapsychological, that will lead to teaching in institutes by analysts who are more and more directed towards practice and thinking that is informed less and less by the immediate psychoanalytic experience.
I am aware that there are many who will take issue or even dismiss one or all of these opinions. In addition, I have omitted presenting much testimony to the fact that despite the causes for concern, we who are candidates are privy to an impressive heritage and an educational system that is constantly being examined and re-thought, viz., this very series in The Newsletter. It is my hope that the opinions expressed here will provide another small push towards progress in that very re-examination and re-thinking of what it means to become a psychoanalyst and how that objective can best be achieved.
Erik Gann
San Francisco