At last Decembers meeting of The American, the COPE Workshop on Issues for Women in Psychoanalytic Education selected Muriel Laskin and Brenda Solomon to succeed Helen Meyers and Barbara Deutsch as co-leaders. The latter pair had served in that capacity since the workshop's inception fourteen years ago.
In 1979 Samuel Abrams, then chair of The American's Committee on Psychoanalytic Education (COPE), asked Meyers and Deutsch to chair a feasibility committee. The charge of this group, which convened in San Francisco in 1980 for the first time, was to identify any issues in psychoanalytic education that were specific to women and that might warrant the formation of a full COPE workshop. It was recognized that psychoanalysis had always been a discipline in which men and women contributed on an equal basis. It was recognized also that many of the vicissitudes of training were the same for both male and female candidates. Nevertheless, it did seem that there would be issues which concerned women uniquely.
Enthusiastic participation in the workshop over the years attests the accuracy of that hypothesis. The feasibility committee evolved into a full workshop, which, in a departure from the standard COPE model, has no fixed membership. From the beginning, meetings have been attended by both regulars and new people, all sharing a common interest in the concerns of women.
Although the request that institutes send representatives contained no gender stipulation, the original group consisted entirely of women. Over the years, however, a few stalwart men have joined and have provided invaluable help. The workshop roster has included at least a hundred participants, spanning the analytic generations and including representatives from every institute. Early on, a number of areas were identified for intensive study. These continue to serve as guiding topics.
Assignment and referrals to women. How does the fact of being a woman affect referral for analysis and self-referral for analysis and supervision? Are referrals made to women because they are women? If so, what factors inform this choice?
Selection and progression. Are special criteria used in considering women in selection, progression, promotion, etc.?
Attitudes of classmates, faculty, and public. Do women experience sexism in the conscious or unconscious attitudes of those with whom they come in contact during training or in later professional life?
Psychology of women. When and how are the issues of female psychology introduced and taught in institute curricula? Is an effort made to incorporate modern contributions in this area?
The timing of training for women with respect to family. How do family vs. career choices, part-time training, interruptions, etc. affect psychoanalytic education?
Self-image. How does a woman's experience affect her self-image, and how does this self-image affect her experience during her psychoanalytic career?
Transference-countertransference. With respect to the analytic experience per se, are there issues of transference and countertransference that are unique for women either during training or after graduation?
Role models. What is the impact on women in psychoanalytic education of female supervisors, training analysts, teachers, and administrators? The paucity of such female role models was noted.
Creativity. Do women express their creativity through theoretical and clinical contributions to the field of psychoanalysis?
The first project undertaken by the group was a survey of The American's institutes. A subcommittee consisting of Deutsch, Laskin, Meyers, Barbara Rosenfeld, and Sara Vogel developed a questionnaire to gather relevant information with respect to admissions, teaching, administration, supervision, training analysis, and the teaching of female psychology. In 1982 the survey was sent to the institutes. Responses were received from twenty-three (over 75%). Lee Brauer, by then a workshop member, generously contributed his time to a computer analysis of the data. It was striking that women were represented in most activities in proportion to their numbers among analysts, at that time 11%.
This figure showed up repeatedly in the data—in the percentage of women graduates, teachers, supervisors, and training analysts. The data suggested that problems arose from the small percentage of women in the profession, rather than as a result of unfair practices within it. Because of the small numbers involved, it was possible that candidates might have little or no contact with women as teachers, supervisors, or analysts.
Unfortunately, the study did not provide precise information about how female psychology was being taught in institute curricula. While the answers to other questions in the survey were clear and helpful, concerning this subject they were uniformly vague. As a result it was decided to compile a comprehensive reading list for distribution to the institutes. Intended to demonstrate the existence of a significant literature on female psychology, eminently worthy of inclusion in institute curricula, this project grew exponentially. Eleanor Schuker and Nadine Levinson, who co-chaired the subcommittee undertaking this task, soon became coeditors, as their dedicated efforts and those of other workshop members eventuated in Female Psychology: An Annotated Bibliography, published by Analytic Press in 1991. The bibliography lists and annotates over two thousand psychoanalytic books and articles on the subject. This is an encyclopedic text, outlining psychoanalytic views of female psychology from Freud to the present. In addition, Schuker and Levinson provide a series of model courses.
The volume is the product of many individuals, both men and women. Some furnished a few annotations; others prepared annotations of their own work; still others collaborated on chapters or wrote complete chapters of their own. In all, more than sixty analysts from the workshop and from institutes worldwide have contributed. The bibliography, described by Arlene Richards as “overall an awesome piece of work, a contribution without parallel in the psychoanalytic literature” (Bulletin of the Association for Psychoanalytic Medicine, Vol. 31), has been distributed by The American to the institutes, thereby realizing the workshop's original goal.
While the survey found no evidence of overt discrimination, the workshop probed for more subtle manifestations of sexism in psychoanalytic education. This extended exploration gave rise to two major projects: one, undertaken by Elizabeth Lloyd Mayer, on referral practices; and another, by Dorothy Holmes, on gender bias.
Mayer's study was based on a concern that women candidates who had difficulty obtaining male patients faced discrimination in that regard. In an attempt to document this, she conducted a study of gender-related patterns of referral using workshop members to gather data. She tested the hypothesis that women analysts receive a disproportionately small share of male referrals. Although she found, contrary to popular opinion, that men and women analysts are referred approximately the same number of patients, it did appear that female analysts are
referred a significantly higher percentage of female patients (80% female, 20% male); male analysts, by contrast, are referred male and female patients in approximately equal proportions. This discrepancy could be explained only in part by the fact that female patients often request female analysts. In addition, male analysts tended in their referrals to match patients and analysts of the same sex. This seems to reflect an attitude about the treatment of male patients by female analysts which, though common in the general population, is surprising to identify in psychoanalysts. The impression that it is more difficult for female analysts than for male analysts to obtain patients of the opposite sex was statistically supported by the data. This difficulty clearly has its effect on training, as analytic experience with both sexes is an important requirement.
Mayer's study, entitled “When Theory and Practice Diverge: Gender-Related Patterns of Referral to Psychoanalysts,” appeared in JAPA in 1992. For it, Mayer was awarded the Menninger Prize. Although the study examines one important aspect of gender and referral, a number of intriguing questions remain. Why are fewer men referred to women? What types of men are so referred? How important is the sex of the analyst to the referring doctor or to the patient, and why is it important?
Dorothy Holmes's project was a study of gender bias and relevance in relation to psychoanalytic theory, training, and practice. Beginning in 1984, candidates, analysts, and training analysts were sent a survey with questions relating to attitudes about gender relevance and gender bias. Asked to rate the items on a Likert Scale, respondents were also requested to give anecdotes, which were then rated along several dimensions. Respondents came from seven institutes, four of which had no female training analysts. Holmes's hypotheses were (1) that women would see more saliency in gender-related issues than would men; (2) that the saliency of gender-related issues would decrease as the institute status of the respondent increased; and (3) that gender would be seen as more salient in institutes which had women in training analyst positions.
In this study women, more than any other category of subject, tended to perceive gender as relevant in psychoanalytic theory, practice, and training. They also were more likely than any other group to perceive gender as a source of bias. Methodological problems with the questionnaire made it impossible to verify these impressions with precision, but they were supported by the anecdotal data.
In her final report Holmes wondered how institutes might make use of her findings that females, across status levels, perceive more gender relevance and gender bias than do their male counterparts; that they experience gender bias more often, reporting more anecdotes on the survey; that they register their experiences more personally; and that they see more subtle and more recent evidence of gender bias. Does the disparity between the sexes in the perception of gender bias and relevance contribute to, or result from, certain gender-linked practice phenomena such as the tendency of male patients to be referred to male analysts?
The subject of candidacy and motherhood has been a special concern of the workshop. The desirability and feasibility of a more flexible curriculum is an issue of increasing relevance as greater numbers of young women enter psychoanalytic training.
In this regard, Elizabeth Mayer has organized another project, entitled “Motherhood and Psychoanalytic Training.” Using workshop members as local contacts, she collected anecdotal material reflecting the experience of women in institutes of The American. Her aim was to provide candidates and potential candidates
a compendium of personal experiences with the vicissitudes of pregnancy and child rearing before, during, and after training. Much of this material has been read in the workshop, where it has engendered lively discussion. It is currently being prepared for publication.
Another research project was brought to the workshop by Rona Knight and Judith Huizenga. Their paper, entitled “Analytic Training and Motherhood: The Development of a Dual Identity,” reported research involving both questionnaires and personal interviews. They began with a breakdown of their data by decades, from 1940 through 1990, noting that the number of women candidates has steadily increased, along with the number of women graduates. Their training, however, has lengthened considerably, now covering more of the childbearing and child rearing years. The good news here was that all of the candidates who were mothers felt that motherhood enhanced their analytic skills. But they also felt the need for greater flexibility in analytic training in order to manage the often conflicting demands of motherhood and profession.
Another issue addressed by the workshop was the “glass ceiling” phenomenon. Although women were represented everywhere in The American at the time this discussion began, there were still no women chairing major committees, many institutes still lacked women training analysts and supervisors, and, even where there were women in these roles, they did, not often hold powerful leadership positions. In 1990 a subcommittee was formed to explore how women might be advanced within The American and how successful female leaders might be defined. Chaired by Beth Seelig, the subcommittee includes Barbara Deutsch, Ruth Fischer, Sybil Ginsburg, Marianne Goldberger, Nancy Kulish, Malkah Notman, and Jackie Zilbach.
In workshop and subcommittee discussions it was noted that one problem for women in attaining leadership roles was a perceived lack of mentors. A real need existed for senior and mid-level female analysts who could serve as role models or mentors for junior female colleagues. This need has been expressed repeatedly by female candidates and recent graduates. The lack of opportunity to discuss clinical and theoretical analytic issues, as well as life issues, with senior women colleagues is felt particularly in institutes where few women are found in the training analyst or faculty ranks. With the current increase in female analytic candidates, this need has been exacerbated. To address this concern, the workshop has instituted a two-pronged Women's Mentorship Program.
The individual mentor program. A list of senior women analysts is available for free consultation during meetings of The American. Mentors will meet with individuals or with groups of female candidates who so request.
The traveling mentor program. A list has been compiled of senior women analysts willing to travel to institutes upon request. The mentor might offer a lecture, clinical case presentation, consultation, or supervision, depending on the need and desire of the institute and its candidates, and on the expertise and interests of the mentor.
The program is just now getting under way. In response to a letter informing institutes of the program and inviting participation, several candidates availed themselves of the opportunity at the recent May meeting.
Workshop discussions have been held on many issues of concern. Eleanor Schuker presented a paper on creativity in women, addressing the issue of why so few women write and publish in psychoanalytic journals; it was subsequently published in Journal of the American Academy of Psychoanalysis (Vol. 13, 1985). In 1984 Helen Meyers presented a paper in San Diego on transference and countertransference issues involving women as analytic patients and in supervision. Currently a discussion group is being planned on countertransference issues for women analysts. To be held at a future meeting of The American, it will be chaired by Nancy Kulish and Ruth Fischer. Ethical issues of concern for women have been highlighted in the workshop by Margaret Keenan.
The workshop has kept abreast of changes with respect to the numbers of women in psychoanalytic education. Rima Brauer has presented a report on women from The Americans 1990 Survey of Practice. These findings raised many more questions than they answered. She reported that in 1990 there were more younger women and more women overall in The American than there were in 1976. Women work fewer hours than men, do more volunteer work, and have currently three times the amount of personal analysis as have men. Women earn less money than do men from their analytic careers.
Asked about their plans for the future of the workshop, Laskin and Solomon mentioned several follow-up studies to be undertaken. One will review institute curricula to determine how female and male psychology is currently being taught. Another will reexamine gender bias in order to assess changes since Holmes's original study. Further exploration of issues concerning gender and referral is also planned. The Mentorship Program will be a priority, and ethics issues will continue to be discussed. An important new area of concern is the impact of the health care reforms as they affect women as patients and as analysts. In that regard, Barbara Wolfe has begun a project to collect anecdotal material concerning analytic practice and managed care.
In the past thirteen years things have changed for women in psychoanalytic training. Although the number of women in psychiatric residencies and institute classes is rapidly increasing, there are still relatively few women in positions of power in the institutes. And with the increase in women candidates come new problems. In the past the special educational needs of a woman who was pregnant, or who had small children, were considered on an individual basis. As the numbers increase, however, with many more women of childbearing age becoming candidates, a broader outlook and the establishment of more flexible curricula become essential.
The workshop will continue to track these crucial issues for women in psychoanalytic education.