The Committee on Psychoanalytic Education (COPE) study groups are dedicated to understanding important areas in psychoanalytic education. Our Study Group on Reanalysis (Beverly Betz, Dan Brener, Stan Coen, John Hayes, Mel Lansky, Richard Lightbody, Gunther Perdigao, Christine Ury, Joan Wexler, and I as chairman) is interested in taking advantage of the laboratory of reanalysis to better understand analytic process and considers reanalysis as one of the most significant personal, and therefore educational, experiences an analyst can have.
Two or more analyses are not rare. Data indicate that about two-thirds of analysts have had more than one analysis, as summarized in my article printed in JAPA in 2007. It appears that about half of the group with more than one analysis (one-third of the total) was analyzed prior to beginning training, so that the additional analytic exposure was in a sense preparatory, and the other half was reanalyzed after the completion of training. We have been especially intrigued by the latter group of post-training reanalyses.
In fact, Freud suggested that analysts be periodically reanalyzed, noting that even a good, completed analysis cannot necessarily be expected to endure…
Such reanalyses are interesting because candidate analysands are selected as suitable, exposed extensively to the analytic method, analyzed by a peer reviewed training analyst in a setting emphasizing thoroughness, and motivated strongly to do well. On those bases, one might assume that post-graduate reanalyses would be matters of adjusting fine points but, in fact, such reanalyses tend to be intense, with more primitive and powerful affects, previously unknown levels of anxiety, revitalization of earliest object representations, and subtle but pervasive identifications with those objects. Reanalysis, in short, puts meat on the bones of prior work. It also establishes an “experimental” condition for observing durable unconscious issues over time, in training and after. We have begun to examine whether certain identifications, as durable unconscious issues, are particularly difficult to deal with in training.
The fact that analytic candidates are required to engage in the field's most powerful treatment method is unique in clinical education but necessitated in our “impossible profession” by the need for the analyst to be not only the agent but also the instrument of change. Beginning with Freud's “Analysis Terminable and Interminable,” however, it was recognized that a training analysis might be insufficient to accomplish those ends. In fact, Freud suggested that analysts be periodically reanalyzed, noting that even a good, completed analysis cannot necessarily be expected to endure because of ongoing resistances, passages in life, evolution of experience, and changes in the balance of sublimations–not to mention the “dangers” of stirring up the analyst's own conflicts by regular immersion in patients' material. Beyond reanalyses motivated by neurotic, maturational, or career changes, however, there is at least a question of whether some characteristics of training analyses may potentiate the need for further analysis. In particular, we have wondered whether training analysis may reinforce resistances to the exploration of some kinds of identifications.
The concept of identification is a fluid one that covers a lot of territory. An identification, as we use the term, is not only a product of object relations—in which we speak of an “identification with”—but also a process of “mentalizing” the interactions and relationships in one's environment and becomes, almost preoperationally and procedurally, part of who one is. In development, identifications are the background against which more obvious developmental steps occur. In a parallel fashion, identifications are particularly likely to show up in analysis as rivers of subtle behaviors and moods, the silent partners of more obvious eddies of conflicts.
As silent partners of more obvious conflicts, identifications are difficult to engage in any event, but our question is whether they are more difficult during training because their expressions can find cover in the defensive use of psychoanalytic training itself. For example, while any patient entering psychoanalysis comes into a strange new world, the candidate is not only entering a new world but also acquiring a new identity in that world. That new identity may gloss over older ones.
Jon K. Meyer, M.D., past-president of APsaA, is training and supervising analyst, Washington Psychoanalytic Institute; teaching analyst, Baltimore Washington Psychoanalytic Institute; professor of psychiatry and psychoanalysis, emeritus, Medical College of Wisconsin.
We have also noted that before coming to training, candidates have often been narcissistic objects for their parents and have dealt with their identifications as such by pursuing academic and professional success. Since a training analysis is not pursued for analytic purposes alone but also for career development, those same defenses are readily deployed in analytic training and strengthened by the success dividend of graduation. Such defenses may also be aided and abetted by the fact that training analysts can have agendas for gratifying their own hard won analytic identities through the success of their candidates.
In particular, we have wondered whether training analysis may reinforce resistances to the exploration of some kinds of identifications.
An identification as a narcissistic extension of parents—or idealized analysts—can lead to a sense of falseness at the core of who one is, compromising the capacities for empathy as well as satisfaction in post-training analytic work. Coming to terms with such identifications may be helped by reanalyses that are more private, non-institutional, do not facilitate mobilization of success defenses, do not have a graduation, elicit less narcissistic identifications of the analyst with analysand (or vice versa), and provide an opportunity for a long look at the subtle projections and introjections of identifications.
Our thoughts are speculative and an examination of the issues is just beginning. We hope consideration of reciprocal identifications, and especially narcissistic ones, will provide food for thought in selection and training of candidates as well as training analyst preparation. We welcome critiques, comments, or suggestions.