Life-giving. Life-taking. Crand, generative, healing yet inert, cold and uncaring. Our mountains, the great Rocky Mountains, form the visual backdrop for our lives as we love and work. They are also the metaphor expressing our triumphs and struggles. Elemental like our drives. Complex and relational like our selves. Evocative like our memories. Psychoanalysis is alive in this place.
The story of psychoanalysis in Denver goes back almost seventy years. In 1923 the Colorado Psychopathic Hospital was built and served to attract practitioners of the day, who presumably brought with them at least snippets of the psychoanalytic theory and practice then spreading through the country. By the early 1930s, Denver's population hovered around 330,000 (it is now approaching two million), and the first bona fide psychoanalyst had arrived, the Swiss-trained John Benjamin.
The Denver Psychoanalytic Institute was founded in 1969 and accredited in 1972. Before that, candidates commuted to Chicago every other weekend for classes and supervision. The Chicago Institute was a veritable melting pot then, with candidates in attendance from Denver, Cincinnati, Chicago, and St. Louis. The disruption of personal and professional lives was balanced by the stimulation offered in that environment. The first candidate class at the Denver Institute consisted of Robert Emde, John Kelly, Paul Levine, David Metcalf, Ceorge Mizner, and Samuel Wagonfeld.
In Denver as elsewhere, the years following World War II witnessed an explosion of interest in psychoanalysis, a period of unrestrained growth fueled in part by the availability of third-party payment. Perhaps inevitably, attempts were made to control this expansion through organizational structures and a certain exclusivity. As competing theories and personalities clashed, a spirit of perfectionism set in. Psychiatric residents interested in psychoanalytic theory were of course encouraged to seek a personal analysis, and referral patterns were established to take advantage of insurance benefits that would underwrite their treatment. But few could gain entry into the Institute for training, and those who succeeded had difficulty graduating. This overzealousness and psychoanalytic nitpicking not only discouraged potential analysts but angered other mental health professionals in the Denver community, many of whom went on to achieve local prominence.
With the sudden drying up of insurance benefits for psychoanalysis, the unraveling of the old “system” created great anxiety among many mature analysts still far from retirement. It soon became common to hear of analysts who once had full psychoanalytic practices applying for jobs with mental health centers, carrying beepers, and taking potential referral sources out to lunch. Although a psychopharmacology crash course was organized to bring analysts up to speed, local psychologists set up a competing psychoanalytic training program. In the Denver Institute, candidates organized a supervisor feedback process which attempted to identify strengths and weaknesses, as a result of which some training and supervising analysts were badly bruised. On top of all this came the increasingly raucous debate over the training of nonmedical candidates, the now-famous lawsuit brought by psychologists, the thorny issue of delinking certification from full membership in The American, and the growing managed care movement, which has made plain its contempt for psychoanalysis. The general atmosphere was nothing short of desperate. After a period of introspection, a new spirit of openness and cooperation prevailed, supplanting the bitterness of the “bad old days.”
But just as the psychoanalytic house was being put in order, complications were emerging in the larger psychiatric community. Prominent psychiatrists in Denver (and elsewhere) now openly encourage colleagues to avoid mentioning psychoanalysis in the same breath with psychotherapy, fearing a contamination that may lessen the chances of third-party payment for psychotherapy in the coming national health care plan. The irony is that here in Denver the psychoanalytic community has pulled together around a common goal of providing the best possible training, supervision, and treatment. Political infighting is notably reduced, and discrimination against non-M.D.s has all but ended. Enrollment at the Denver Institute is up, a child analytic training program has been added, and analysts are volunteering selflessly of their time and energies to keep their first love alive.
Many challenges and uncertainties lie ahead for all of us. In Denver we believe our commitment to excellence will enable us to promulgate psychoanalysis as the uniquely respectful and humane treatment we know it to be. We acknowledge the pressing need to define more clearly what psychoanalysis is and is not, and for whom it is an appropriate treatment. We also know we must participate constructively in efforts
to control health care costs while simultaneously insisting on an immediate end to discrimination against those who suffer from mental and emotional illness. This discrimination is a shameful feature of the current health care system.
The contributions that follow tell the Colorado story in greater detail. As you read, you will feel the energy, the enthusiasm, and the renewed hope now springing up among us. You may even begin to appreciate how, for us, the enduring power of our majestic mountains inspires us in these difficult times of change.