I first came to Denver in 1970. About six months before I actually moved, I began to receive phone calls from people interested in starting analysis. It seemed there were not enough analysts to go around in Colorado, and indeed there was a surplus of patients just waiting to get started. When I arrived in June, my practice was full. It was simply a matter of meeting those who had contacted me and deciding whether analysis was the treatment of choice, and whether there was a good match between us.
It seemed analysis was in its heyday, and all the senior analysts had full schedules. The mental health professionals who sought analysis felt that to be an analyst was the pinnacle of success. Psychoanalysts had a great deal of prestige, occupied key positions in the Department of Psychiatry, and were considered the best trained and most qualified clinicians. It was an exciting time in the Denver Institute, where everyone talked, breathed, and lived psychoanalysis.
Eventually, though, things began to change. While I became very fond of individuals in our group, I became increasingly uncomfortable with some of the things I was hearing and found myself a part of. Unfortunately, I remained silent far too long. I remember Selection Committee meetings in which remarks like “he will be just an ablebodied seaman,” or “an average or slightly below average analyst,” were made. This of course implied that we were all superior and above average. I felt increasingly alienated from this kind of arrogance, while at the same time I was becoming more attached to individual analysts who were my close friends. I can remember Selection Committee meetings where the criteria used to evaluate an applicant were so unrealistic that I thought I would never have been accepted at this institute. Rifts and divisiveness also began to emerge among the faculty, and these were often displaced onto candidates. I can remember arguments over whether oedipal or preoedipal material was more important. In retrospect, though, I think these theoretical disagreements were manifestations of the personality quirks, and sometimes the outright “craziness,” of some of our faculty members, and had rather little to do with the theory and practice of psychoanalysis.
Eventually we came to be seen, accurately I am sorry to say, as a group of narcissists often dismissed with the quip, “No one is good enough to get in or get put.” All this came to a head in the late 1970s and early 1980s. We seemed suddenly to be faced with no applicants and no new graduates, and I think that some of us began to realize that we were witnessing the demise of the Institute. The younger members of the faculty began to speak up, and several senior members began to catch on. I well remember Herb Gaskill's comments at one faculty meeting. That perhaps was the turning point, enabling us to take a hard look at how we were behaving.
We began at that point to try to turn things around and undo the reputation we had earned, but by then psychologists had formed a new institute in Denver and the economics of psychiatric care delivery started to hit home. As analytic practices dwindled, few analysts could boast the waiting lists we had once been accustomed to.
The psychologists' lawsuit against The American hastened changes in admissions requirements, and soon we were accepting nonmedical candidates in greater numbers. I was pleased that Denver took a leading role in this, both by endorsing the change and by the fact that Herb Gaskill's advisory committee to Board and Council had offered a viable proposal effecting it. Our institute also started to reach out to the local community, however belatedly, and found to our relief that it was not too late. Today we offer the best training in Denver, both for those who want to become analysts and—a new program—for those who want to improve their skills in psychotherapy. The two programs, psychoanalytic training and psychotherapy training, complement each other well, and allow us a responsiveness to the needs of mental health professionals in the community, so necessary if we are to remain viable.
In September 1975, having undergone the ritualized “double interview” (once for acceptance, then again two years later for readiness to matriculate), I began my analytic training at the Denver Institute. My class consisted of four eager and competent psychiatrists with many years of clinical and teaching experience behind them. Our initial enthusiasm for classes was quickly dampened, however, by rumors that people, for reasons that were unclear, were not graduating and that talented friends and colleagues were being rejected
for training. We became increasingly aware of a subtle attitude of blame that crept into the supervision whenever our cases were going badly. We were made to feel that we were mishandling the analyses and were told directly that “countertransference problems” were causing our difficulty. Never did it seem that the case might be inappropriate for analysis or that some modification of technique might be necessary.
I had a powerful experience with my first case, a woman who presented a history of multiple early trauma—including a clitorectomy “for excessive masturbation”—which led me to realize that a traditional Freudian analysis and precise interpretation of conflict did not seem to be helping her. As I struggled to find what was helpful, I discovered that my experience as a child psychiatrist and mother was most useful in understanding my patients developmental dilemmas. But when I chose to help this patient regulate her disturbing affect instead of providing a correct interpretation, which in any case would not penetrate her narcissistic defenses, I was told to stop behaving “like a social worker.”
Correct interpretation was exalted above all other analytic tools as “the cause of meaningful change.” All of my patients seemed to have suffered significant early parental loss, trauma, or abusive or narcissistic injury, which rendered such a simplistic notion relatively useless. I found much of my analytic work focusing on developing a treatment alliance, trying to understand how these early traumas impaired my patients' ability to trust or work with me, and conveying to them how their lives were currently affected by these issues. Some of my teachers and supervisors were supportive of my work, but often I felt that I was not really doing analysis, even though my four cases showed growth and change and went on to successful termination.
As some of my classmates began to have problems with cases, one by one they began to disappear from the program. Over the course of six years as a candidate, I joined many advanced classes only to experience once again the surprising and unexplained disappearance of fellow students. Hushed whispers after the fact suggested that candidates had been asked to leave. At times it felt as though I were in a surrealistic movie where people vanished and it was “poor form” to ask why. The implied fantasy that traditional psychoanalysis could help all patients, with no adaptation to specific developmental needs or ego distortions, set an impossible and unrealistic standard for us as candidates.
The faculty itself represented another major obstacle to learning. One teacher was known to call candidates “idiots” whenever they voiced dissent. Another was frequently aggressive and personally attacking. Still another was noticeably confused. Having a faculty that was at times attacking, intrusive, or oblivious was difficult. What was absolutely confounding and disastrous was that a conspiracy of silence, an epidemic of denial, and a cult of elder worship had set in. There was no acknowledgment by the faculty of these lapses, and no willingness to confront the perpetrators. Teachers seemed oblivious to the possibility that such dysfunctional behavior might have an impact on candidates. As a result, the anxiety level in the classroom often ran high, despite the presence of empathic teachers and supervisors who in individual situations seemed supportive.
It was with great relief, then, that in 1981 I found myself able to graduate. Still, 1 was aware of an ambivalent response in myself to having completed my training. 1 was angry that the training had seemed unnecessarily painful and that my enthusiasm had dwindled greatly. Out of my original class, only two of us completed training. Other classes showed an even greater “disappearance” rate, a later class graduating only one of six original candidates.
In 1982, when I attended my first faculty retreat at the Broadmoor Hotel in Colorado
Springs, I realized I had grave doubts about joining this group. As attention focused on once again polishing already brilliant classes, several of us spoke up about problems in the Institute that were being ignored. Ishared my sense that while many of my teachers and supervisors were warm and caring people individually, as a group they seemed insensitive, perfectionistic, and cruel, creating an illusion that only the most talented could become analysts. At that point, a significant shift occurred in the discussion. Many were able to talk about personal doubts concerning the atmosphere at the Institute and what it conveyed to candidates. During this retreat and at succeeding ones, the faculty was able to look at these unrealistic standards and appreciate why the reputation of the Denver Institute had become tarnished in a community that was critical of elitism and that had seen many of its psychiatric leaders treated badly. Soon changes began to occur, including a painful look at the supervisory process that to many had been so hurtful.
Eventually, a collegial sharing of ideas with talented candidates became the standard for supervision. It may be asked why the Denver Institute had to experience such a difficult period. Perhaps the deepening of our understanding of narcissistic and self issues, and of how severe trauma alters personality development, has helped all of us to appreciate the importance of a positive and supportive learning environment.
I had the good fortune to train at the Denver Institute at a time when it was well into the process of reinventing itself. I began my training in 1988 as a member of a candidate class that was one of the first to reflect the new demographics ushered in by the Gaskill amendment. We were three: a child psychiatrist, a clinical nurse specialist, and myself, a psychologist. As an applicant, I had been aware that the Institute was in the midst of a significant change in character. Apparently, a perfectionistic set of attitudes toward theory, technique, and training was rapidly yielding to a new ethic of open-mindednes's.
I was initially fearful that behind the new open-mindedness might lurk a veiled resentment at having felt forced by the Division 39 lawsuit to open training to nonmedical candidates. Yet, hard as I looked, I could detect not a single instance of resentment, elitism, or narrow-mindedness. Instead, a genuinely welcoming and accepting attitude prevailed, greatly enriching the training experience. We felt free to be ourselves.
This positive learning environment, however, may have been purchased at a cost. First, at its extreme the ethic of open-mindedness seemed to translate into a subtle group prohibition against clarifying the ways in which we might disagree with one another. At times, I think, we chose to maintain a warm sense of group consensus when vigorous debate or clear disagreement might have done more to help us formulate our thoughts.
There were also some complications associated with being taught by teachers and supervisors who had experienced tyranny in the name of Freud. It seemed difficult to get anything but a perfunctory nod in his direction. Freud seemed so identified with the “period of oppression” that it was difficult to discuss him with the open-mindedness and respect accorded other authors.
Finally, I have wondered if being trained by teachers who felt tyrannized in their own training may have complicated for their students the amorphous process of consolidating an analytic identity. Many recent graduates seem to be struggling to establish a healthy sense of themselves as psychoanalysts, one not built on the toxic foundation of elitism. Could part of our problem be that we have had as role models teachers and supervisors who, as a necessary part of their own liberation, needed strongly to disidentify with those who had taught them?