Faculty and Candidates Take on Issues of Progression

A candidate in his sixth year of training has three cases underway when, 11 months into analysis, his third and only female patient—a single mother of two, who commutes over one hour each way for her analytic appointments—explains that she can no longer make the trip four times a week. She strongly wants to continue in analysis, but she can only make three weekly sessions.

The patient, the candidate, and the supervisor all see the treatment as healthy and valuable, and wish to continue it at the greatest possible frequency. The supervisor, however, notes that the progression committee will give credit only for a case conducted four or five times weekly, for a minimum of 24 months. Now the candidate has paid a significant amount in supervision fees and finds himself committed to a low-fee case that will no longer “count” toward graduation.

And we wonder why it is taking some candidates 10 to 15 years to graduate!

This story was adapted from a presentation at a unique Round Table forum at the January APsaA meeting in New York. The Round Table featured candidates and faculty from different institutes who met on equal footing for a frank dialogue about questions, issues, and fantasies related to the progression process in APsaA institutes.

The meeting was very well attended and an audience from around the country participated in a lively discussion with faculty Ellen Rees, Stan Bone, Deborah Cabaniss, Sid Phillips, Marvin Wasserman and candidates Justin Richardson, Stuart Rostant, and the authors of this article.

This forum grew out of the pioneering efforts of the late Larry Chalfin and the Project 2000 committee, in collaboration with Nancy Blieden, then-president of the Affiliate Council, as a means to foster participation of candidates in national level discussions about training in APsaA institutes.

The meeting was organized in two parts. The first part focused on specific policies pertaining to progression and graduation: What factors go into deciding whether a candidate's control case should count toward graduation? When, if ever, should a committee override the judgment of the person supervising the control case, and why? What information is relevant to the decision about a candidate's academic and clinical work?

The second part took on more thorny problems related to institute politics and culture, and to the dynamics of the committee process itself. What factors give rise to candidate anxiety and mistrust, and how can these be ameliorated? Issues discussed included conflicts of roles and interests, organizational factionalism, snowballing or runaway committee dynamics, miscommunication, what should be held confidential, and what disclosed to the committee.

Some suggestions raised in the course of the Round Table may merit further discussion at institutes, for example, the need for explicit, clear criteria upon which candidates' clinical and academic work will be evaluated; having the candidate participate in the committee's evaluation of his or her work; and having a candidate representative serve as a working member of the progression committee.

The Round Table was received with enthusiasm and general acknowledgment of the importance of such educational issues in psychoanalytic training today. The planners hope to have more such faculty-candidate round table discussions in the future.