It is increasingly clear that there is again a rising interest among the young people of this country in psychoanalysis and in psychoanalytic training. I have seen this recently in Milwaukee, Miami, Michigan, and other cities. These young people are every bit as bright, idealistic, and talented as in the so-called golden period of expansion in earlier decades. They are different only in that a majority are now women, they are more racially and ethnically diverse, and they come from a broader range of professional backgrounds.
The number of candidates is also rising. Since the 1980s' low point, candidate enrollment has been gradually increasing. As of September 1997, we reached a new high of 995 candidates. The number of residents, students, and candidates who attend our national meetings has also increased. How can we understand this phenomenon?
Residents, psychology and social work graduate students, and nurse practitioners; a wide range of students in the other mental health professions, humanities, and social sciences; and medical students are increasingly receptive to our science and profession because they sense the explanatory power of psychoanalysis to provide both a deeper form of help for patients and a means to enhance their understanding of cultural and social phenomena. Together with a growing percentage of the general public, students in the health-care professions have been disappointed with the minimal results allowed by medication and brief supportive psychotherapy, and they are demanding more psychodynamic teaching by psychoanalysts. How can we encourage this trend among America's brightest and most idealistic young people?
At the last annual meeting in San Diego, we addressed this issue by voting for the formation of a new category of affiliation: student associates. We anticipate that hundreds of students will have joined this year and that in subsequent years the group may grow to thousands. A new student associates brochure will shortly be ready for distribution to all societies. The new arrangement for students will structurally parallel our candidates' national affiliate membership and their local membership in candidate groups.
A new committee, the Ad Hoc Committee on Student Associates, chaired by Jerry Melchiode, is prepared to reach out to societies and help them organize local student associations affiliated with our local societies; it will also promote the APsaA student associate membership among students nationwide. Local committees consisting of analysts and students will organize this outreach to students and will help develop extramural educational experiences.
While The American will continue vigorously to increase its presence in the intermural educational programs of students, we must now also attend to establishing extensive extramural programming. This is necessary because with few exceptions the educational experiences of these students no longer provide sufficient teaching and clinical experience in psychoanalytic psychotherapy. The students will tell us what topics they wish to study; then we must provide them with the educational opportunities that will supplement their inadequate training.
Personal contact with established analysts is vital if the student associates program is to have maximal impact. In some societies, students are being provided with mentors as well as supervisors and teachers. At the local level, student associates could also meet with our visiting professors. They should be helped to prepare for such discussions with prior reading and discussion of that speaker's work. The students also need extramural opportunities to present clinical material in case conferences that focus on diagnosis and treatment process. Clearly this is our strongest suit.
Students should be placed on local mailing lists; those who also join as national student associates will receive TAP and be offered a discounted subscription to JAPA. It is to be hoped that a large percentage of those who join our local student associations will also become national student associates. Local and national dues will be minimal. Many students who will not immediately choose to join local student associations or become national student associates may nevertheless attend local and national meetings. As they become more interested in psychoanalytic thinking, they may then join the student groups. All should be warmly welcomed; a carefully monitored mentoring program should be available.
This program will not succeed through simply distributing a brochure. Students are drawn to us typically because their psychoanalysts or candidate teachers and supervisors have helped them, shown a deep personal interest in them, and stood as caring, committed professionals central to their educational development. The mentoring should be active, continuous, and nurturing. Mentors should help students enhance their educational development both in their training program and at local and national meetings.
The majority of students who will join the new student affiliations will not become candidates and psychoanalysts after completion of their training. However, they will become more secure in their identity and practice of psychoanalytic psychotherapy. We hope they will continue their interest in psychoanalysis and, after graduation from their programs, become psychotherapy associates of The American. If not, many will remain involved in the psychoanalytic community in other ways, e.g., attending our scientific meetings, participating in our foundations, seeking supervision or participating in study groups, or enrolling in extension division classes.
Many students are already interested in becoming candidates in our institutes. However, if we are to have the opportunity to train them we must consider the values and realities of today's young adults. For the most part, they are not able or willing to make sacrifices that seriously interfere with family life. This should be viewed positively rather than as resistance and/or lack of motivation. These students usually come from two-professional families and share child-rearing responsibilities to a greater extent than was the case for older generations of analysts. They are finding it more difficult to develop private practices and do not typically earn incomes that allow one or two members of a family to be in analysis.
They may be single parents or single unmarrieds who consider their private lives as their highest priority. They need time both for child-rearing and a private social life as single people. As a consequence, this generation has a much higher percentage of potential candidates who require drastically reduced fees (even 50 percent at the onset) for both analysis and supervision.
Potential candidates in new training sites are also not as willing or able to travel to distant cities for classes. We must begin to fly in faculty to these sites rather than require the candidates to fly somewhere to attend training. Teleconferencing is another teaching aide that should be more routinely employed. Finally, we need to advertise regularly to encourage colleagues to move to new areas, especially those who are training analysts or eligible to become training analysts. If we are to fly in faculty, we will need to find significant new streams of financial support, hence the need for support of local and national foundations. It is also time that we tap the idealism and dedication of older colleagues to undertake such educational assignments.
The American is now beginning to rethink our strategies to develop new sites; our traditional strategies did not fully address the need to educate the general public and the local mental health community, nor to develop the infrastructure of our contemporary society, including a supportive foundation. This is now being undertaken by the newly established Committee on New Psychoanalytic Centers (CNPC), chaired by Lee Shershow and cochaired by Richard Ruzumna and Alan Sugarman. The CNPC will support the development of new study groups and societies and will work collaboratively with the Committee on New Training Facilities when the time arrives to establish new training programs. If some new sites have no training analysts, then we will have to be prepared to grant waivers for condensed analyses of candidates who must fly elsewhere for training.
This is not to ignore the “young in heart” older potential candidates, particularly those who are non-medical and did not have access to training in institutes of The American in the past. Many in their late 40s through late 50s have taken our extension courses for years and have been supervised and analyzed by our colleagues. They should be encouraged to seek training; on an individual basis, they should be advised whether they need to begin a second analysis before matriculation, at the beginning of matriculation, or when they begin their control work. This degree of flexibility is compatible with the principle of being in analysis during a significant part of one's training.
At the same time, we might encourage some young people who are still in residency training or in graduate education to apply for training. If they have had didactic and clinical experiences sufficient to begin analytic training, why not overlap their remaining pre-professional and psychoanalytic training? These would have to be residents and students are highly recommended by our colleagues who have been their teachers and supervisors. This path has already been well marked out by our NYU Institute for residents. This degree of flexibility is consistent with the traditions of the Board on Professional Standards.
Finally, we have to face the frequently voiced complaints of young people that our curriculum is too traditional, our teaching methods infantilizing, and our institutes too hierarchical. Most of these criticisms are no longer applicable, thanks to the extensive changes brought about in most of our institutes during the past eight years. However, to the extent that these complaints are still true, they are off-putting to the younger generation. We still have a way to go in democratizing our institutes and involving our candidates as colleagues.
They must be regarded at the beginning of training as the competent, qualified professionals that they are, and not have to experience the attitude from some of our faculty that they must unlearn their psychotherapeutic skills and be retrained as psychoanalysts, as if their previous training is of no worth. They want to experience psychoanalytic training as an enhancement of their valuable prior professional training. It is also demeaning to discover that in some institutes they are thought incapable of selecting their own supervisors or of participating in the committee life of our societies, institutes, and foundations. Some candidates are experienced educators who are in fact already qualified to teach extension division courses in their special areas of expertise from the time they are admitted for training.
The training offered in the institutes of The American is still, in my view, by and large, among the best in the world. It is also true that our institutes have both facilitated and encouraged changes that enhance the high quality of our training. Our training programs have in fact been sought out by young people because of their high standards, dedicated teachers, and stimulating curricula. Our societies have been equally forthcoming in welcoming and attracting young people through their recent openness and breadth of scientific programming. It should also be acknowledged that the trend of our foundations and societies to establish and support programs that directly affect our communities — working with parents, teachers, judges, police officers, etc. — appeals to the idealism of young people. We must continue in these directions. We must also continue to rethink our approach to the new generation and act now to engage their enthusiasm and flexibly address their readiness for commitment. We can do better, and they deserve the best.