Psychoanalytically informed clinical psychologists who work predominantly in academic settings face a number of challenges to their professional identity. In 1991 I joined an academic psychology department, in part because I was determined to share my unshakable conviction that the set of ideas we refer to as “psychoanalytic” hold the greatest hope for the alleviation of human psychological suffering. Having completed two years' postdoctoral work at Menninger, I wanted to share my new knowledge with the next generation of clinical psychologists.
I will describe two struggles here, the first as a clinical psychology graduate student and the second as an assistant professor in an academic psychology department, with those who would like to discredit psychoanalytic views.
Perhaps it was youth that enabled me to enter the battlefield without first considering carefully the strength of the opposition. When I was a graduate student, the faculty were explicit about wanting to train clinical researchers, not clinicians. The prevailing view was that anyone could do clinical work. The best and the brightest psychologists aimed for the prestige granted those who chose research careers.
Those of us who believed that psychoanalytic theories had something to offer fought, at times bitterly, with our director of clinical training. We wanted her to invite a clinician from the community to teach us psychoanalytic theory. Under pressure from the American Psychological Association, or so the rumor went, the training director succumbed and we had our seminar. It was a wonderful experience. I am embarrassed to admit that toward the end of the semester I commented that the most useful part of the course was learning that there are still clinicians who practice from a psychoanalytic perspective. In 1987 I believed that psychoanalytic theory had been discredited and that the field had long since moved on to behavioral, cognitive-behavioral, biological, and family perspectives. When I naively raised my hand and shared this bit of “insight,” the class and the instructor laughed. I realized that I had internalized the views of the faculty in more ways than I cared to admit.
Now, after pre- and postdoctoral training in psychoanalytically oriented programs, I have come full circle. Once again I find myself in an academic department that does not value or even understand psychoanalytic concepts. My colleagues view psychoanalysis as an outdated enterprise that has changed little since 1905. What's worse, I am now confronted with graduate students who are discouraged from thinking analytically. The director of our training clinic declared in an open meeting that psychoanalysis is out and managed care is in. The students in my advanced seminar on psychoanalytic concepts thought I was leading them astray.
My analytic orientation sometimes complicates, rather than enhances, supervision. A clinical psychology student was convinced that psychoanalytic thinking focused on the “dark” side of human nature. Convinced I would see her as neurotic or worse, she feared and eventually hated me. For my part, I saw her as a bright young woman with a tremendous capacity for empathy and a tolerance for difficult and emotionally evocative clinical material. How did we so mistake each other? Why did someone who would make an excellent analytically oriented clinician seem so violently opposed to me and my commitment to analytic concepts?
The supervisory struggle was embedded in an educational context that made it difficult, if not impossible, for such a talented student to embrace analytic ideas. My dual role as a clinical supervisor and a faculty member made our work confusing. She saw me as someone who held the key to her entrance into the world of professional psychology. She could not trust that things discussed in the context of clinical supervision would not spill over into my evaluation of her academic worth.
When the final assault came, it was overwhelming. A departmental review for contract renewal was a nightmare. Students and faculty alike were revolting against my psychoanalytic viewpoint. They insisted that I was teaching and supervising from a long-discredited perspective. The graduate students believed that no data existed to support the viewpoints I was espousing. How, they asked, could the analysis of transference be of any value? How could one work toward a full understanding of the patient in an era of managed care? What empirical studies demonstrated that psychoanalytic theories are useful?
My contract was renewed, but I was so demoralized that I resigned. Following my resignation, I told my analyst that I felt like a wounded scout returning from the front. I had set out from Menninger to spread the word about psychoanalytic treatment. I left Topeka feeling that I had learned something incredibly valuable. There experienced clinicians, working in the trenches where chaos and predictability meet, had taught me how to work with people with borderline personality organizations, multiple personality disorder, and other self-destructive illnesses. I believed I had learned the secret of working effectively with this group of patients and that it was my duty to spread the word to the next generation of clinicians. I did the best I could.
The award of the 1995–1996 APsaA Fellowship is a tremendous honor and could not have come at a better time. I have returned from battle, wounded but still alive. Barely able to walk, I reached my commander-in-chief and collapsed. Catching me before I hit the ground, he gave me a small drink of water. “Be careful” I whispered, “and plan wisely. I've seen the enemy and they are very powerful.”
By now I have recovered from my wounds and am pursuing full-time clinical work as a supervising psychologist in a busy mental health facility. I am happy to be back in the trenches with my colleagues.
Reggie Matias Jr., Ph.D., a 1995–1996 APsaA Fellow, is an assistant professor of psychology at DePaul University.