As chair of the Department of Psychoanalytic Education (DPE) Section of The Psychoanalyst in the Community, I appreciate this opportunity to “talk” through TAP with the APsaA membership. Our Section (Steering Committee, Advisory Committee, and task forces) includes broad representation from 15 APsaA institutes. We would welcome members from additional institutes to join our Advisory Committee so we can closely collaborate and develop plans and initiatives that will address the needs and priorities of institutes.
Historically, this link between the education and training functions of institutes and the knowledge and experience of psychoanalysts in the community has not been so obvious. In fact, there has been and still is understandable anxiety about losing focus on the internal world of unconscious processes in the clinical dyad (the pure gold of psychoanalysis), and alloying it with consideration of social realities such as gender, race, class, culture, and the multiple groups and communities to which we belong and in which we are embedded. Nevertheless, as psychoanalytic theory continues to evolve, we are becoming less prone to dichotomizing and more open to thinking about the dynamic interplay and mutual influencing of internal and external realities. The psychoanalyst in the community is clearly positioned at the interface of those realities.
The first initiative of our section was to conduct a survey of 900 APsaA members and candidates on the listserv. The response rate was 25 percent (227 individuals) and reflects a sampling bias of those who are on the listserv and those who are more likely to participate in various ways in the community. With those caveats in mind, our findings indicate that members and candidates apply their psychoanalytic knowledge and skills in a wide range of community settings including hospitals, clinics, counseling centers, community mental health centers (serving marginalized patient populations facing daunting internal and external challenges), non-profit organizations, foundations, think tanks, corporations, governmental agencies, police departments, courts, schools, colleges, and more. Their roles also show considerable variability including clinical practice, teaching, supervision, writing, strategy, and public policy, organizational consultation, management, administration, and leadership. Ninety-one percent of the respondents ranked the application of their psychoanalytic knowledge and skill in the community as professionally important or highly important. They indicated that, on average, they spent about one-third of their professional time (both paid and unpaid) in these activities. Eighty-three percent of respondents indicated the applications of their psychoanalytic knowledge and skill in the community were integral or highly integral to their identities as psychoanalysts. Ninety-four percent agreed or strongly agreed with the statement that the work of the psychoanalyst in the community is vital to the survival and growth of psychoanalysis as a whole, but nearly half of the respondents felt there was insufficient attention or even active resistance in institutes and societies to incorporating the knowledge and experience of psychoanalysts in the community into the institute’s educational/training mission.
In addition to analyzing the results of the section survey of APsaA members, we also discussed the results of the APsaA survey of institutes earlier this year, and thought about how our section’s activities can help address the identified challenges confronting institutes and psychoanalysis as a whole.
Challenge: Lack of public awareness and perceived relevance of psychoanalysis
Responses: Fostering collaboration with various organizations in the community raises public awareness of the relevance of psychoanalysis; developing APsaA symposia and discussion groups focused on the applications of psychoanalysis in the community will raise awareness within APsaA and in the public domain; developing videos/podcasts featuring psychoanalysts who are working in various community settings and organizations will highlight the many faces of psychoanalysis in the community.
Challenge: Fewer patients, lack of affordability of psychoanalysis
Responses: Preparing trainees to work in a broader range of community settings increases access to psychoanalysis for more marginalized communities. It also increases the range of professional roles that trainees can occupy; meeting folks where they live and work in the community may increase their receptivity to psychoanalytic/psychodynamic treatments.
Challenge: Fewer candidates
Responses: Integrating thinking about community-based applications of psychoanalysis into institutes’ training and educational programs will help institutes attract candidates who may previously have thought psychoanalytic training is not relevant to their interests; meeting providers who work in the community may foster their interest in psychoanalytic training.
Challenge: Increasing diversity
Responses: Thinking about the role of the psychoanalyst in the community requires deepening our understanding of the community, including diversities of identity and experience and the impact of oppression and marginalization; building the capacity of institutes to think and talk about these issues, in turn, will make our institutes more welcoming and relevant to trainees from more diverse backgrounds.
Challenge: Low morale
Responses: Supporting institutes to teach and think about the broad impact psychoanalysis can have on our communities, beyond the individual patient in the consulting room, and strengthening their community partnerships will instill hope in the future of psychoanalysis as a vibrant, relevant, and important field.
In response to the findings of the surveys, we articulated the following goals:
Increase recognition and support within our institutes, societies, and APsaA of the various ways our members are applying their psychoanalytic/psychodynamic knowledge and skill in the community and of the value of their activities;
Capture the rich learning resulting from those activities and incorporate that learning into seminars, programs, and other educational activities in our institutes, societies, and APsaA;
Foster open dialogue and active questioning about our evolving theories, practices, and psychoanalytic identities with respect to the activities of psychoanalysts in the community;
Enhance the effectiveness of psychoanalysts working in various community settings by creating opportunities in institutes for members to learn about psychoanalytic and systems perspectives on group/organizational dynamics.
We formed subcommittees/task forces to implement these goals. I will cite a few examples of programs that have emerged out of these subcommittees.
Collaboration with the APsaA Committee on Psychoanalysis in the Community, chaired by Jeff Taxman; developed a symposium, with presentations by Gil Noam and Steven Marans for the winter meeting in NYC: “Linking Psychoanalytic Models with Community Organizations to Achieve Scale in Responding to Trauma, and Promoting Resilience in Children and Adolescents.”
Candidates in the Community, chaired by Jane Keat, developed a mentorship program that paired two candidates working in community settings with senior analyst mentors, and provided small stipends to support their work. The first recipients are Joe Wise, whose mentor is Ken Reich, and Elizabeth Schmick, whose mentor is Deborah Choate. Joe, a former army psychiatrist, is a candidate at the St. Louis Psychoanalytic Institute and is
working with soldiers and veterans. Elizabeth is a candidate at the Oregon Psychoanalytic Institute, and is working with marginalized communities in a transitional housing program. Joe summarized his experience:
For me, it was a great opportunity to work, in a mentor relationship, with an experienced analyst who has been successful working in the community. From a theoretical perspective, we discussed the overlap and boundaries between clinical and community work. From a practical perspective, we discussed approaches to working with community organizations, advocating for resources, promoting social change, and treating patients from a population not usually engaged with psychoanalytically informed clinicians.
Elizabeth commented:
During the last year, my mentor has been helping me reshape the way I listen to and experience the patients I work with in the community. I used to focus on symptoms, medication, and diagnosis; now, through her help, I am listening for the psychic reality of patients and thinking about the many meanings of the material they bring into the room. She helps me listen for and think about the underlying forces and challenges of race, class, gender, and power in the clinical setting. Through my mentor’s careful listening to me and my experience, she helps me begin to imagine how relatedness, intuition, emotional receptivity, and empathy can generate new possibilities and growth even when I find myself in a small, windowless office in the basement of a housing complex.
Both candidates will share their reflections with faculty and candidates at the February 2019 APsaA meeting.
Organizational Dynamics that I chair is developing a program in Leadership and Organizational Dynamics at the Boston Psychoanalytic Society and Institute. We are grounding the program in the theoretical framework of systems psychodynamics. The seminars are open to candidates, faculty, and community members. As we continue to learn from our experiences, we will be available to consult to other institutes interested in developing similar programs.
Institute and Academic Cooperation, chaired by Murray Schwartz, builds bridges between institutes and academic institutions. A recent accomplishment is the creation of a minor in psychoanalytic studies and cultural criticism at Emerson College. To avoid organizational redundancy and to have greater impact, this subcommittee/task force is joining with the APsaA Committee on Psychoanalysis and the Academy chaired by Peter Rudnytsky. At the February APsaA meeting, Murray and Peter will discuss a joint proposal for expanding cooperation between colleges or universities and psychoanalytic institutes.
Community-Based Psychoanalysis, chaired by Neil Altman, is developing educational resources for institutes, including syllabi for courses that include discussion of the various settings in which psychoanalytic perspectives have been shown to be useful, the political and other processes involved in establishing links and collaborating with communities, and the history of community-based work in psychoanalysis.
Psychoanalysts Working with Service Members and Veterans, chaired by Joe Wise, is focused on linking the knowledge and experience of working with traumatized service members and veterans to curricula, syllabi, and workshops in institute.
Psychoanalysts working in or consulting to various organizations in the community frequently engage in interdisciplinary collaborative relationships to which they have much to contribute and from which they have much to learn. For many community members, these face-to-face interactions with psychoanalysts enhance awareness of what psychoanalytic/psychodynamic practitioners and perspectives have to offer outside of the consulting room, dispel negative stereotypes, and help create an ecology in which psychoanalysis can survive and flourish.