Analytic training under the best of circumstances is arduous. Analytic training when one commutes long distances often necessitates creative solutions on the part of both institutes and candidates. Psychoanalysis continues to struggle with how to attract quality applicants and how to widen the geographic scope of psychoanalysis beyond major metropolitan centers. Although there is a long history of commuting for psychoanalytic training, the difficulties in pursuing psychoanalytic training today seem to have increased. Reasons for this include (1) the lack of insurance reimbursement for one's personal analysis, (2) the decreased availability of psychoanalytic patients, (3) increase in financial debt from prolonged postgraduate training, (4) the demands of two-career couples with young children, and (5) the decreased value placed on psychoanalytic training by patients and employers. Nevertheless, many institutes are thriving and are beginning to address these concerns on both individual and national levels.
The Cincinnati Psychoanalytic Institute serves as a regional institute for Ohio, Indiana, and Kentucky. Of the current third-year candidate class, three of seven candidates are commuters. One candidate commutes an hour each way from Dayton, Ohio, and two candidates commute nearly two hours each way from Lexington, Ky. One senior candidate commutes two hours each way from Columbus, Ohio. Here are some ideas developed out of the institute's success in attracting regional applicants.
Reach out to regional universities, training programs, and mental health communities. Institutes can offer grand rounds and case conferences and publicize courses for mental health professionals at neighboring training programs, mental health societies, and regional universities. Trainees in these communities have frequently not been exposed to psychoanalytic thinking or clinical work and are enthusiastic about hearing a detailed case presentation or a psychoanalytic perspective on an issue of clinical practice that they have been exposed to from other viewpoints. For example, analysts from Cincinnati gave presentations at the University of Kentucky on trauma and play therapy and presented a summary of a successful psychotherapy experience.
Most trainees wonder what relevance psychoanalytic training may have to their ultimate career goals and practices. Developing a presentation that illustrates the benefits of psychoanalytic training for the way one works can be extremely helpful, as can an open-ended question-and-answer session with trainees about psychoanalysis. There may be misperceptions about “what psychoanalysts are really like”; building in some informal contact with visiting analysts may be helpful.
Sponsor a psychotherapy award at regional programs. Sponsoring an award for excellence in psychotherapy enhances the importance of psychotherapy skills and gives the institute a presence at the program where the award is presented. The award itself can lead to increased contact with the institute. The Cincinnati Psychoanalytic Institute sponsors an award at the University of Kentucky that offers the recipient a choice of experiences including ongoing supervision with an analyst at the institute, a reduction in or waiver of tuition for a course at the institute, free attendance at an educational event sponsored by the institute, or a mentorship opportunity.
Offer informational seminars or clinical case conferences to interested applicants. An informal get-together to present information about analytic training and to allow attendees to meet members of the institute will provide practical information to potential applicants. A clinical case conference for potential candidates allows them to get a sense of the richness and excitement involved in psychotherapeutic work as supervised by analysts.
Extend personal invitations to commuters for institute events, and maintain an active mailing list. It can be daunting to attend a psychoanalytic event. A personal invitation from a faculty mentor or senior candidate who can accompany a commuter to an institute event can be helpful. Once regional applicants have expressed an interest in analytic training, put them on a active mailing list for all open institute events and other educational opportunities.
Provide admissions advisors. Because commuters are isolated from the analytic community, it is extremely helpful to assign a senior candidate and/or faculty mentor once interest has been expressed in analytic training. This person can answer questions about the application process, address personal or logistic issues relevant to commuters, and provide information about what analytic training is actually like that may be difficult to obtain in admissions interviews.
Offer telemedicine capability. Relatively inexpensive telemedicine systems enable analytic institutes to establish audio/video connections with other sites using standard telephone lines. This technology can be extraordinarily helpful in offering lectures given at analytic institutes to neighboring training programs, providing face-to-face supervision, allowing candidates to attend classes on days when weather prohibits travel, and offering ongoing psychotherapy teaching at regional programs.
Debra A. Katz, M.D., is a third-year commuting candidate at the Cincinnati Psychoanalytic Institute and the director of general and child and adolescent psychiatry training at the University of Kentucky. Jacob D. Lindy, M.D., is a training and supervising analyst at the Cincinnati Psychoanalytic Institute, of which he is a former director.
The University of Kentucky Psychiatry Residency Training Program has conducted a two-year psychotherapy course for residents using telemedicine technology, taught by analysts from the Cincinnati and New York Psychoanalytic Institutes. To date, the course has been very well received.
Design the schedule with commuting candidates in mind. When scheduling classes for a group of candidates that includes one or several commuters, an institute needs to plan well in advance. Because of travel time, traffic patterns, and conflicts with work and home responsibilities, the schedule of classes and institute activities assumes major importance for commuters. The Cincinnati institute arranged a separate tutorial for two commuting first-year candidates who were unable to attend one class at its regularly scheduled time. The candidate group was then asked to come up with a workable schedule for the second year that everyone would be able to commit to. This involved some major changes to the institute's traditional teaching schedule. Because of the difficulty in arranging two sessions per week for classes, the class with four commuters meets from 8:00 a.m. to 1:30 p.m. on Friday. This schedule is expected to remain in place for the duration of training.
Since a round trip to the institute for a commuting candidate can involve a minimum of four hours, special events or changes in the schedule need to be communicated with sufficient advance notice. Institute faculty need to be understanding about the scheduling constraints of commuters in arranging supervisory times or scheduling special meetings with candidates.
Establish a commuter committee. Invite a commuter from each regional site to meet with a group of interested faculty to address commuter issues. This committee can address a number of concerns, both large and small, for commuters. Larger issues addressed by the Cincinnati Institute's Commuter Committee have included the consideration of scholarships for commuters, how to increase the presence of psychoanalysis in local communities, and ways to facilitate analytic referrals. Other issues can greatly affect the day-to-day lives of commuters: adequate parking, an area in which to work or read between appointments, the use of a phone to communicate with distant work and/or home sites. The commuter committee can also educate the institute's faculty on particular issues for commuters, such as the importance of advanced scheduling and consideration of traffic and weather issues when scheduling guest speakers.