In the fall of 2008 the Greater Kansas City Psychoanalytic Institute (GKCPI), at that time an APsaA provisional institute, was faced like many institutes with concerns about its small size, financial limitations, an expensive lease for its headquarters, and the isolation of psychoanalysis from other academic disciplines and institutions. To address these challenges, GKCPI embarked upon a long-range plan to establish a relationship with an institution of higher learning. Considering the practical concerns, as well as the concept that psychoanalysis is not only a clinical discipline but also an academic discipline, I shared my vision with several other members of GKCPI's Executive Committee that psychoanalysis has a great deal to offer not only to psychotherapy trainees and psychoanalytic candidates but to psychiatric residents, psychology interns, and postdoctoral trainees, as well as to the larger academic world.
Furthermore, I reasoned, GKCPI, a new and not yet fully approved institute must now become more proactive in its mission—a mission to increase the visibility of psychoanalysis and the institute itself, to create an outreach movement, and, most important, to establish an affiliation with an already well-established academic institution like a medical school department of psychiatry with a residency program and a postdoctoral program for psychologists, that could provide a pipeline for trainees to enter psychoanalytic training.
Kansas City, situated on the border of Kansas and Missouri with a metropolitan population of approximately two million, supports three medical schools: the University of Kansas School of Medicine in Kansas City, Kansas (KU); the University of Missouri Kansas City School of Medicine in Kansas City, Missouri (UMKC); and the Kansas City University of Health Sciences, an osteopathic medical college in Missouri. In addition, there are a number of private and public colleges and universities, with the main campus of the University of Kansas in Lawrence 40 miles to the west and the main campus of the University of Missouri in Columbia 125 miles east of the city. While Kansas City is rich in academic resources, these institutions have had limited psychoanalytic interest and teaching.
Historically, it was well known within GKCPI that the University of Kansas Department of Psychiatry had harbored an anti-analytic bias dating back 40 years, when a prominent analyst in Kansas City reluctantly resigned his half-time teaching position at the University of Kansas Medical School because the new chair of the Department of Psychiatry and initiator of the surge of the biological psychiatric movement at KU Med, issued a proclamation that all positions must now be full time. Following the analyst's resignation no analysts were ever again hired as teaching faculty; it was later inferred that the proclamation had most likely been a ruse, at least partially designed to purge psychoanalysts from the teaching faculty.
Interestingly, while the University of Kansas School of Medicine over the years has maintained its biological stronghold, with no analysts on its faculty, the University of Missouri Kansas City has demonstrated an eclecticism in its teaching of residents, psychology interns, and postdoctoral residents. Fortified with this history, and with the support of the GKCPI Executive Committee, I made phone calls to Salomon Alfie and Walter Ricci, training and supervising analysts and senior members of GKCPI, as well as past faculty members of the Department of Psychiatry at UMKC. Both agreed that the possibility of an affiliation was an intriguing venture that might provide a tremendous opportunity for both UMKC and GKCPI. Alfie paved the way for a meeting between Stuart Munro, the chair of psychiatry at UMKC and me, along with Bonnie Buchele, the director of the GKCPI at that time.
A series of meetings subsequently ensued between Munro and me. Importantly and fortuitously, Munro, although not an analyst, had been trained at the University of Virginia when it had a strong analytic presence, which he explained, had remained with him throughout his career as a psychiatric educator. Munro informed me about the history of psychoanalytic contributors and contributions at the Western Missouri Mental Health Center, the former name of the training hospital for residents and postdocs of the University of Missouri Kansas City, now known as the Center for Behavioral Medicine.
Initially, Munro and I were the main enthusiasts for the affiliation. Both of us saw the possibilities, and we were united in principle that psychoanalysis is a clinical discipline that should also be a fundamental tool in both understanding the structure of psychopathology and providing treatment possibilities for
Richard M. Zeitner, Ph.D. ABPP, is a training and supervising analyst at the Greater Kansas City Psychoanalytic Institute and the institute director. He is also an assistant clinical professor of the University of Missouri Kansas City School of Medicine.
all forms of mental illness and emotional suffering, whether or not medications or other psychotherapeutic strategies are employed.
We agreed that certain conditions would have to be met. One, GKCPI would remain an independent institute with its own administration, and not a department or administrative component of either UMKC or the Center for Behavioral Medicine.
Two, the institute would relocate its administrative offices into the Center for Behavioral Medicine where GKCPI would now have the opportunity to collaborate with UMKC psychiatric and psychology faculty and administrative staff. Institute classes would be taught in spacious, well-equipped, and modern classrooms within the Center for Behavioral Medicine, where we would have access to video conferencing equipment, enabling us to participate in distance education throughout the world.
…the advantages of affiliating with a medical school department of psychiatry that highly valued psychoanalysis as a discipline, a profession, and a fundamental teaching tool eventually held sway over other issues.
Three, the GKCPI library would have its own section, but housed within the psychiatric library of the Center for Behavioral Medicine.
Four, in turn, institute faculty would provide a series of lectures on psychoanalytic topics over the course of 12 to 20 weeks, one 90-minute weekly session, initially to second-year residents, and eventually to fourth-year psychiatric residents and psychology post-docs. Academic appointments at the level of clinical assistant professor would be awarded to those who taught with consistency (other criteria to be determined). GKCPI would be granted a five-year affiliation agreement with the Center for Behavioral Medicine, with no rent charged to the institute. With such an affiliation, representatives of both groups would continue to meet periodically to insure ongoing communication between the two organizations.
After three years of many discussions, including meetings held within the Center for Behavioral Medicine, the Missouri Department of Mental Health, the University of Missouri Kansas City, and the Greater Kansas City Psychoanalytic Institute, as well as meetings between the Department of Psychiatry, GKCPI, and its attorneys, in June of 2011, the organizations finalized an agreement that was eventually acceptable.
Throughout the years of negotiations, the decision for GKCPI to affiliate and move its headquarters and teaching venue into the Department of Psychiatry was not at first without internal hesitation and some tensions within and among certain members. Although most were highly enthusiastic and could foresee the benefits, some were reluctant. Many meetings were held, including an all-institute/center retreat where key concerns were raised, discussed, and eventually resolved to the point where the Education Committee of GKCPI could finally put the proposal to a vote.
During these meetings questions were raised, for example, about the implications of affiliating with one medical institution and its effect on candidate recruitment from other training facilities and universities. Others were concerned about affiliating so closely with psychiatry and the implications for psychologist, counselor, and social work candidacy recruitment. And finally, there were some who were concerned about moving the institute's home from the prestigious, albeit expensive, Country Club Plaza where the institute had been housed for several years into a medical school psychiatric facility located in an area of the city known as “hospital hill,” an area less glamorous and less logistically accessible. Nonetheless, eventually the advantages of affiliating with a medical school department of psychiatry that highly valued psychoanalysis as a discipline, a profession, and a fundamental teaching tool eventually held sway over other issues. The Education Committee finally voted overwhelmingly in favor of the affiliation and the relocation of the institute.
After a year and a half, although the affiliation is still young, both groups, the Greater Kansas City Psychoanalytic Institute, now a fully approved APsaA institute, and the Department of Psychiatry of the University of Missouri Kansas City agree that the affiliation has been working well. The financial advantage for GKCPI is significant, and the institute has established a new home that has afforded other advantages.
The institute is now poised to establish academic connections with other departments within the university system. As director of GKCPI, I have recently appointed a chairperson within the institute to establish a Committee for Medical School and University Relations for the purpose of establishing other potential routes for analytic teaching or consultation with other departments within the University of Missouri educational system, including arts and sciences, as well as the UMKC School of Law and the College of Dentistry.
Although it is too early to provide a progress report, it is noteworthy that during this past year the number of inquiries into psychoanalytic and psychotherapeutic training at GKCPI has substantially increased. Furthermore, GKCPI has admitted a new class of eight candidates, a combination of psychoanalytic and psychotherapeutic candidates in a pilot program to combine psychotherapy and psychoanalytic didactic training for the first two years. We look forward to writing a positive report after more time has passed for GKCPI to continue its evaluation of the advantages and/or disadvantages of the affiliation between a psychoanalytic institute and a medical university.