I have just returned from the 29th Congress of the Latin American Psychoanalytic Group held in Sao Paulo, Brazil. It was a remarkable meeting and I will write more about it in my next column. What I would like to focus on here is that the International Psychoanalytical Association seems to have been able to accomplish something that we in our Association thus far have been unable to do. That is, to consider and discuss a central idea, an idea that is at the core of our philosophy, without reaching for lawyers or threatening to split.
The title of this column is taken (with permission) from a remarkable book of the same name, published in 2010, written by Douglas Kirsner, an Australian professor of philosophy and psychoanalytic studies at Deakin University.
The book is based on a series of interviews with faculty members of four institutes, New York, Boston, Chicago, and Los Angeles, and describes in riveting fashion the bitter internecine political struggles, marked by intolerance and polarization and often resulting in splits. This book is a “must read” for anyone involved in psychoanalytic administration or education.
Kirsner's conclusions are clear and compelling: Each of the institutes he studied was divided by conflicts over power and authority. The most impassioned and damaging of these conflicts were animated by perceived inequities in the TA system.
As many of you know, the PPP (Perlman-Pyles-Procci) Proposal was introduced in September of 2011. This has sparked an ongoing discussion, which culminated in our last meeting with the Executive Council passing a resolution that the selection of training analysts should be based on objective criteria. Naturally, this has created a tremendous amount of confusion, consternation, and misunderstanding about the meaning of the Executive Council's action and the meaning of the PPP Proposal.
Although this was simply a proposal put forward for the purpose of discussion and consideration, it would seem that there is something in the very nature of our group that prevents us from being able to tolerate actually discussing these ideas without feeling a kind of annihilatory anxiety.
The most impassioned and damaging of these conflicts were animated by perceived inequities in the TA system.
At the heart of this discussion is the question of authority: Who has it and what place it has in a psychoanalytic education system. The Presidential Plenary at the January 2013 National Meeting, which will be given by pastpresident, Warren Procci, will focus on one aspect of this issue in his address, “The Second Century for Psychoanalysis and for APsaA: Their Fates May Differ.” Otto T. Kernberg will take up the TA system directly in an address, “The Twilight of the Training Analyst System.”
We might very well look to the example of the IPA a few years ago when they were faced with a similar crisis. The flashpoint of the issue was that of frequency, three versus four-to-five times a week as a minimum training standard. Former IPA president, Daniel Widlocher, put me in charge of a committee to try to resolve the conflict.
Up to this point, the IPA had always formally recognized only a single system of education, the Eitingon, based on the original model of the Berlin Institute, though others were known to exist “under the radar,” similar to our own situation.
One of the wonderful achievements that the IPA was able to accomplish was to get away from the narrow legalistic way of thinking, and focus on the larger educational picture and the larger issues. Up to that point, the IPA was focused, as we are now, on a very legalistic way of thinking that was highly polarizing and problematic.
My committee hit upon the idea of surveying the training practices in all of the societies around the world and came up with the concept of “models of education.” The willingness of the committee to collect and assess objective data was key in breaking the impasse. Then by moving to the concept of models, we were able to rise above narrow issues and look at educational systems in their entirety. For quite some time, the controversy was focused on the single issue of frequency. As long as each side maintained and hardened its position, the anger and bitterness became so pronounced that the IPA was in serious danger of splitting.
By moving the discussion to the higher plane of educational systems, we were able to consider each element, such as frequency, training analyst system, and so forth in a context.
Bob Pyles, M.D., is president of the American Psychoanalytic Association.
The three models that we were able to identify (the Eitingon, the French, and the Uruguayan) were carefully considered and discussed by the IPA Board. Each of these systems had been in existence for decades and had a proven track record of producing graduates of high quality. By looking at the total educational system, we were able to evaluate the quality and nature of each of them. The IPA Board came to the conclusion that, while each of the three had real differences, all three depended on the tripartite model (course-work, personal analysis, and supervised control cases), at least in spirit, if not in letter.
For example, the French system does not have the title “training analyst,” and analysis is not mentioned in its description of the requirements for training, because the analysis is considered to be entirely outside of the educational process, a completely independent function between the candidate and analyst. However, in general the French have a tradition of long analyses. There is considerable evidence to show that length of an analysis, rather than the frequency of sessions, is in many ways more important in terms of producing growth. Consequently, in the French system, absence of the formal title of training analyst was accepted by the IPA and grandfathered as a perfectly acceptable way of treating candidates.
There is a similar situation within the Uruguayan model in which the actual title of training analyst is not used because of the country's political history of people suffering under fascist authoritarian regimes. Consequently, the structure of the educational process is much more democratic, with the candidates' full participation in their education and in the affairs of the institute right from the start. On this basis, this was also considered to be a variation of the tripartite system.
What the IPA should be congratulated for is being flexible enough to recognize and accommodate these rather differing systems of education. In our situation the first action of BOPS was to create a Reference Committee, which was designed to look at the legality of the PPP Proposal. At no point have we been able to discuss the nature of the TA system and what the cost or benefit of such a system is.
Interestingly, two of the three officially recognized models do not utilize a training analyst system. It seems to me that the French and Uruguayan systems, by focusing on the analysis as a clinical issue rather than an educational one, are on much more solid ground.
However, the main issue is that we cannot seem to be able to discuss these things in any sort of civilized or “analytic” manner. It was my deep wish when this discussion began that we could finally come to some sort of resolution of our disagreements over the training analyst system and certification, so that we could move on to do the things we need to do to promote and save psychoanalysis.
Kirsner interviewed me for his book in 1992, partly because I had been president of the Candidates' Council when the Boston split occurred. He asked if I thought the split could have been averted. I said I thought the split was entirely avoidable, but there was a major failure of leadership and “major differences in how an institute should be run and its involvement in the community.”
So the conflict points over power and authority don't seem to change very much over time. What remains to be seen is whether we have changed enough to come together for the sake of our patients and our profession.
Conflicts over the TA system cannot be resolved by ideological arguments, parliamentary maneuvers, or narrow debates about procedural details. We cannot transcend these conflicts by fetishistic attachments to habitual, taken-for-granted assumptions, or by concrete thinking that throttles creativity by obstructing abstract thought. We need to think more freely, more abstractly, and with a wider field of vision. If we do not transcend the narrow confinement of our current habits of thought, we will be perpetually locked in futile and exhausting exercises of power politics and stale rhetoric. All this and more, and all the while our numbers dwindle, our energies dissipate, and our profession declines.
We must break this impasse before it breaks us. The three-model solution adopted by the IPA is a paradigm for creative problem solving.