Psychoanalysts of the 21st century live and work in a world very different from that of only a generation ago. The world of health and mental health, particularly, has changed and continues to change rapidly. One thing, however, has not changed: “Psychoanalysis still represents the most coherent and intellectually satisfying model of the mind.” These are not our words, they are those of Eric Kandel, Nobel laureate, psychiatrist, and neuroscientist in his April 1999 article in the American Journal of Psychiatry, “Biology and the Future of Psychoanalysis: A New Intellectual Framework for Psychiatry Revisited.” Kandel is simultaneously an ardent supporter and an astute critic of psychoanalysis. Not surprisingly, Kandel's recommendations to us have nothing to do with the internal conflicts that have preoccupied our organization for the past 15 years. Rather, he directs us outside of ourselves and toward pursuits which psychoanalysts have long resisted and which take us out of our comfort zone, such as alliances with cognitive neuroscience and biology, generating collaborative research into the human mind and the development of psychopathology as well as methodologies for studying and understanding treatment outcomes. The daunting scope of Kandel's recommendations helps to make sense of why we gravitate toward the internal, relatively easy things to change. Kandel strikes a more harmonious note when he proposes that the needed research “will need to be engaged constructively by those who care for it and care for a sophisticated and realistic theory of human motivation.”
There is no doubt that no one cares more for psychoanalysis than the members of our organization; despite all of our differences, care we do. We also recognize that challenges facing the 21st century candidate are different from and more difficult than the ones we faced, and that our task includes anticipating those challenges and preparing them for the psychoanalytic world of the future. Over the past year, the Board on Professional Standards has begun to implement the changes in the revised Standards for Education and Training in Psychoanalysis. This will be a long, evolving, and collaborative process which will take many years. As important as this task is, we know that it is a necessary but insufficient focus. The health of psychoanalysis will not be restored by merely changing our own internal standards. Rather, the highest BOPS priority is that of finding ways to assist all 31 of our training facilities in their struggle to recruit, educate, and professionally develop psychoanalysts who will be fully equipped to thrive in a 21st century environment.
With this in mind, we have begun to develop three initiatives which should bring us one step closer to some of these more global and future goals. The first project is to study ourselves under the general rubric of the Psychoanalytic Development Project. We intend to identify specific points of entry during a psychoanalytic career and tease out both implicit and explicit criteria typically used to mark psychoanalytic competence at that stage of development. The new standards require this kind of study, but they also provide us with some natural and somewhat uniform points of inquiry, and possibly more than one perspective at the same stage of development. For example, the Certification Examination Committee's Pilot Project, which begins the initial stage of the certification process during candidacy, provides a window into the advanced candidate's psychoanalytic competence; this data could be utilized by progression committees to compare with the data from the mid-phase or pre-graduation colloquia which are required by all Developmental Pathway Institutes, but will be encouraged in all institutes. At this stage of development, institutes will also have data from the supervisory reports and faculty evaluations which together can provide Progression Committees more uniform evaluation data by which to make training, progression, and graduation decisions. You will hear much more about this project in the coming year.
The second initiative is the Task Force on University and Medical Center Initiatives. Our goals for this task force are multifaceted. First, we plan to bring university and medical center affiliated institutes together, to share both their unique challenges and their unique opportunities. Academic and medical communities have recruitment, research, and collaborative potential not available to freestanding institutes. An academic and research environment provides the context in which the kinds of interdisciplinary collaboration proposed by Eric Kandel is really possible. University counseling centers and clinics in medical centers are a natural source of training cases for candidates, as well as opportunities to provide the next generation of mental health providers early exposure to the richness and value of a psychoanalytic perspective.
The third initiative, only now being conceptualized, is a new Task Force on Child and Adolescent Training. Underestimating the dangers of current trends in psychiatry and psychology to the existence of child and adolescent psychoanalysis will have permanent consequences for both our profession and for young people of the future. This task force will have three committees: one to identify the most critical threats to child and adolescent training and practice, a second to develop a completely integrated curriculum of adult-adolescent-child psychoanalysis which will be made available to institutes, and a third to focus on prevention and early intervention of child and adolescent psychopathology. Each committee has been asked to provide a report to BOPS with specific findings and recommendations by June 2013. Collectively, we hope that this task force will ignite a spark of greater interest into child and adolescent treatment and breathe new life into our child and adolescent training programs.
We look forward to keeping you apprised of these activities and always welcome your comments and suggestions in our shared commitment to psychoanalysis.
Colleen L. Carney, Ph.D., is chair of the Board on Professional Standards, and Lee I. Ascherman, M.D., is secretary.