Extensions

Extensions, which makes its debut in this issue, is an occasional column that will report the activities undertaken by institutes and societies to reach out to the nonanalytic community and promote the field of psychoanalysis. An outgrowth of The American's Committee on Extension Divisions—Eugene Goldberg, chair—it is meant to serve as a clearinghouse for information on extension division activities (and activities of a similar nature, whatever their official sponsorship) throughout the country. Each column will focus on a particular type of activity, with examples of successful programs in different areas of the country.

This first column will focus on the most widespread and traditional form of extension division activity: course offerings designed for mental health professionals. The Michigan Psychoanalytic Institute and the New York Psychoanalytic Society provide examples of active programs that have grown and flourished over the last several years—and have served to promote analysis as a field of knowledge, a form of treatment, and a profession worth pursuing.

The Michigan Psychoanalytic Institute was founded in 1962; its Extension Division in 1973. A variety of seminars are offered each year in three locations (Southfield, Ann Arbor, and Grand Rapids), mostly in the evening. The typical course involves 8 to 12 weekly sessions; topics have included A Clinical Case Seminar on Transference and Resistance, Object Relations Theory and the Treatment of the Borderline and Narcissistic Patient, and The Early Phase of Psychotherapy with Children. Longer seminars are offered as well, including a two-year seminar for beginning therapists (24 sessions each on psychopathology and psychotherapy), and a year-long seminar for psychiatrists who have recently completed residency training. The latter has reinforced several participants' interest in pursuing analytic training. MPI also arranges study groups focused on a topic of the members' choice; several such groups have continued through a series of topics and instructors.

Registration has risen from approximately 40 students a few years ago to around 100 most recently. This is a sizable number for a society that itself has only about 80 members. MPI's outreach extends to including interested community members, who suggest topics and help publicize courses on its Extension Division committee. Nonetheless, it remains difficult to anticipate appeal; frequently there will be sufficient enrollment to proceed with a course in one location but not in another, or in one year but not the next. MPI charges each student $20 per 90-minute class and pays instructors (it should be noted that a stipend is unusual, as most societies do not pay Extension Division faculty). A minimum size of 8 for each class is set to prevent the Institute from losing money.

These course offerings accomplish outreach to the larger mental health community, involve members in the Institute's work, and offer financial rewards to the instructors (who include candidates authorized by the Institute).

MPI is also actively involved with mental health professional training programs. A joint committee of the Institute and Society works with the directors of the three major psychiatric residency programs in the area, as well as with clinical psychology and social work programs. A coordinator acts as liaison to each program, reviewing the core curriculum, suggesting courses and faculty, and recommending supervisors suitable for particular trainees. This initiative has been strengthened and expanded over the last few years and is well received. As a result, analytic input and an analytic perspective are now welcome at programs which had previously been ambivalent or negative.

MPI also runs a program in the public school system for teachers and mental health professionals, as well as a program for parents, which will be described in a future column. Other outreach activities are organized by the Society, which sponsors a variety of programs open to the public, including an annual symposium that attracts approximately 300 people each year; the Association for the Advancement of Psychoanalysis, which has over 200 members and sponsors lectures and a film series; and a lay foundation, which is active in fundraising, sponsors symposia, and supports the Extension Division by contributing to the cost of secretarial help. These various activities are publicized in the newsletter of the Institute and Society. The Extension Division also maintains a mailing list and sends out an annual brochure.

Another effective initiative is the Visiting Professor of Psychoanalysis Program. Each year an analyst from out of town is invited for a week to visit and talk to the Society, the AAP, several training programs, and community groups. The cost of this cosponsored activity is shared among participating groups and the lay foundation.

A 1990 survey of psychoanalytic practice showed that members of the MPS had more patients in analysis than did members of other societies; doubtless these ongoing community outreach programs contribute to this outcome. Anyone desiring more information on these programs should contact Harvey Falit, Chair of the Extension Division, at (313) 662-1668 or Don Spivak, Liaison Coordinator to training programs and Co-chair of the Visiting Professor Program, at (313) 440-7775.

Since its founding in 1931, the New York Psychoanalytic Society has offered, through an Extension Committee, a variety of lectures and seminars to the nonanalytic community. In 1991 the Community Education and Outreach Division chaired by Arnold Richards was reorganized into three subcommittees: the Public Information Committee, the Extramural Relations Committee, and the Extension Committee. The Extension Committee offers seminars for mental health professionals and trainees, in addition to sponsoring several interdisciplinary colloquia and an annual Fall symposium. These programs are not intended to provide clinical training but to demonstrate the usefulness of psychoanalytic theory for understanding the human mind, and to enlarge the population who might seek psychoanalytic referral for themselves, their families, or their clients. In contrast to the MPI, which offers longer, more intensive courses, the New York Extension Committee has designed a variety of brief courses intended to appeal to both students and instructors without the expectation of covering their subject matter in rigorous depth and breadth. Another difference from MPI is that instructors are not paid; brief courses have the advantage of requiring less commitment from a volunteer faculty.

The Special Seminar Series presents a variety of evening seminars, which meet for three sessions, generally in the instructor's home or office. The number of seminars offered has steadily increased, from 6 in 1989-90, to 17 in 1990-91, to 31 in the current year. Only seminars with sufficient enrollment are actually given; each instructor sets a minimum, typically five or six students. Over the past two years, approximately 12% of the offerings failed to meet this minimum. Enrollment increased from 69 in 1990-91 to 112 in 1991-92, with many individuals taking more than one seminar. This year seminars were grouped into series of related topics, to encourage individuals to take a sequence. Offerings include Freud's case studies; the contributions of Phyllis Greenacre, Edith Jacobson, Annie Reich, and Margaret Mahler; masochism; psychopharmacology; and various topics in applied analysis. The majority are designed for mental health professionals, but they are open to others with

the permission of the instructor. Generally, the fee for each three-session seminar is $100, with discounts for enrolling in a series. The instructors represent a mixture of institute faculty, Society members, and invited non-members, but not candidates. Participants are asked to fill out a questionnaire providing feedback; however, for the most part participants' verbal comments have proved more useful. Suggestions for new courses are solicited from both Society members and seminar participants.

Fall symposia in 1990 and 1991 were warmly received and so well subscribed that they have outgrown the Society's 200-seat auditorium. While in the past the costs of administering and advertising extension programs were underwritten by the Institute or the Society, and by a $10,000 gift of seed money in 1989, it appears that these symposia and the Special Seminar Series may generate enough profit not only to pay for themselves but to subsidize a variety of free programs, including free courses and study groups for trainees.

Since 1987 the New York Psychoanalytic Society has offered free evening courses specifically designed for psychiatric residents, doctoral students in psychology and social work, and medical students. Introductory courses are held at the Society building in the hope that trainees, experiencing the Society as open and welcoming, will go on to attend Scientific Meetings and to use the Society's library and bookstore. In 1991-92, there were 71 students from 26 local programs (60% residents, 5% medical students, and 15% each psychology and social work students). Over time the format has evolved from eight monthly sessions to eight weekly sessions, with four basic courses being offered: Introduction to Selected Psychoanalytic Clinical Concepts, The Psychoanalytic Principles of Psychotherapy, The Mind in Conflict, and The Psychoanalytic Approach to the Sicker Patient. Each session consists of a one-hour lecture followed by small group discussion. Six advanced study groups were offered this year as well; these meet at the instructor's home or office. Where once there had been a pattern of high initial enrollment followed by a high dropout rate, recently the program has attracted a smaller number of more motivated students. The courses are publicized through mailings, as well as by visits by Society members to the various training programs.

Through its Extramural Relations Committee, the New York Society is engaged in an additional type of outreach to these programs, arranging on-site teaching including monthly clinical case conferences, psychodynamic grand rounds, and a variety of lectures. Many training programs, including some which in the past had a strong psychoanalytic orientation, appear eager for more psychodynamic teaching. The committee works with each program to determine specific interests and needs. Participation is not restricted to members of the Society; members of other New York societies have been invited to lecture as part of this outreach effort. The Extramural Relations Committee is involved also in training chaplains at several hospitals. It plans to expand its direct services to medical, mental health, and allied professionals.

The Extension Committee also sponsors a number of ongoing interdisciplinary colloquia free of charge, involving a dozen or so individuals from different disciplines meeting once monthly on topics such as Psychoanalysis and Literature, Psychoanalytic Theory and Family Process, and The Effect of the Holocaust on the Second Generation. Many of these colloquia are now in their second decade. In addition, there are a number of programs related to child and adolescent analysis, including a new Parent-Child Center; (See Box).

Programs are promoted through a combination of both purchased and in-house mailing lists, brochures distributed at local professional meetings, advertisements in professional newsletters, and personal contact. In addition, a first class mailing is sent to all those who have paid to attend courses in previous years. The Society also underwrites the cost of sending first class mailings concerning Scientific Meetings to a list of over 1,000 individuals.

Anyone desiring more information on these programs should contact Sandra Kopit Cohen, Chair of the Extension Committee, at (212) 744-2182; Carl Kleban, coordinator of the Special Seminar Series, at (212) 876-4153; or M. Philip Luber, Chair of the Extramural Relations Committee and coordinator of the courses for trainees, at (212) 249-4499.

Future columns will deal with courses and programs specifically focused on child and adolescent work, including school consultation programs, and those designed to reach out to the lay community, both the general public and professional groups outside the field of mental health. We would also like to report on specific public information efforts undertaken by institutes and societies. Please send information about your local programs to Cecile Bassen, c/o TAP.