One of the keys to success in building a psychoanalytic practice, advise Karen Johnson and Steven Goldberg, is to consider all patients as candidates for psychoanalysis until it is clearly contraindicated. Johnson and Goldberg report that at the San Francisco Psychoanalytic Institute they conduct a well-attended annual colloquium for associates. Sponsored by the Institute's clinic, the colloquium this year took up the topic “Talking to Patients about Psychoanalysis.” In addition, in the first-year curriculum at San Francisco, three sessions are given on how to start an analytic case. The Institute, with seventeen new candidates this year, has been very successful in its practice development efforts.
The San Francisco experience was one of several topics discussed at the December meeting of the Committee on Psychoanalytic Practice chaired by Lee David Brauer of New Haven. It was reported that efforts to hold more local workshops on building psychoanalytic practices were slowed by uncertainty over how to address the issues of health care reform and managed care. Over the past three years, many successful workshops on the subject have been run under the energetic leadership of Joyce Root of Boston. She will be succeeded in this function by Erik Gann of San Francisco, who will survey the societies concerning their desire for further workshops.
The committee has supported the research work of Norman Doidge (Toronto) and Joseph Schachter (Pittsburgh). Doidge is studying the comorbidity, impairment, and history of environmental trauma of patients in psychoanalysis. Preliminary results are similar to those of his earlier Canadian study, in which extensive pretreatment difficulties were demonstrated. Schachter is studying the analyst's practice in relation to posttermination contact with analysands. He hopes to determine the frequency and nature of these contacts and to identify which categories of analysts are more likely to engage in them. Brauer reminded the committee to encourage use of the Society Reports distributed in 1993. These reports, based on data collected from the 1990 Statistical Survey of Psychoanalytic Practice, contain a wealth of data comparing the local society with national trends. Items covered include the age of members; hours worked; size of analytic caseload and frequency of sessions; fees and incomes of members; and participation and satisfaction vis-à-vis analytic organizations. Copies of the reports can be had from local society offices or from Brauer.
The committee also addressed particular problems, such as the estrangement analysts often feel after graduating from their institute, as important issues affecting psychoanalytic practice. The committee reaffirmed the need to help graduates maintain their analytic identity through learning, teaching, and doing psychoanalysis on a continuing basis. Both at the committee meeting and in communication afterward between Brauer and president Judith Schachter, concern was expressed for improved support for societies and individual practitioners. Schachter also noted the absence of information about child analysis in the Society Reports and elicited a promise to generate information in this area. At the December meeting, the committee also held a workshop for society representatives.
Out of this gathering came another effective communications tool. The representatives, uncertain how to cope with managed care and the many issues it raises, expressed a need for more rapid feedback about what others in The American are doing. To meet this demand, Isaiah Share (Bala Cynwyd), who chaired the workshop, will compile a newsletter to be distributed to the representatives for posting in their societies. The committee recommended that the societies send copies to the local membership, along with a request for feedback, to be conveyed to the committee by the representatives. The Central office fax-on-demand system might be a fast and easy way to distribute the newsletter. It could also be put on the Psychoanalytic Bulletin Board of CompuServe, a project of the Chicago Institute coordinated by Robert Galatzer-Levy. Currently this computer BBS has over two hundred people receiving its messages twice weekly.