Candidates have always been our future. They are our legacy. However, there is little in our literature that might help younger clinicians reflect upon what it means to be a psychoanalytic candidate and its role in the professional life they are about to enter. In a first-of-kind book, I attempted to speak to these issues by inviting senior psychoanalysts from around the world to write personal letters to candidates that include memories of their own training, what it was like to become a psychoanalyst, and what they would like most to convey to the candidate of today.
The request to write something for this book was met with great enthusiasm, and it shows. In these rich letters one finds insights that can help analysts in training and those recently entering the profession reflect upon what it means to be a psychoanalytic candidate and what it's like to begin a life as a psychoanalyst. Sharing their own experiences, these analysts demonstrate a vital commitment to psychoanalysis and give lively descriptions of how each became and remained a psychoanalyst. They write candidly about the enduring satisfactions of being an analyst and about the anxieties, ambiguities, and the complications they faced in training and entering the profession. Many offer ways to think about dealing with these hurdles. Some suggest it is useful to realize one is always in the process of becoming a psychoanalyst. To do so is to be open to a life-long process of learning and testing one's ideas.
Below are edited excerpts from these letters that give an idea of the authors' joys and disappointments they've experienced in analytic training and the profession. Although the difficulties of their training have not been forgotten, these senior analysts have, for the most part, worked through these issues without losing their enthusiasm for being analysts. They offer ways of thinking about training to help candidates deal with their own experiences. For most, the conclusion is: It was worth it.
As much as I have felt the need at various points to reflect on my analytic training, to revisit its valuable teachings, I have also had to work through experiences of disillusionment.
I also understand better now why analysts work well into their old age and sometimes through it. There is the excitement in being an analyst—the capacity to help people deeply, to inch them toward deeper change, to learn what has been previously unknowable, all the while further refining one's analytic capacity that continues to grow. It is hard for me to imagine giving this up as long as there are patients willing and eager to work with me and profit from what we as a group of committed clinicians have to offer.
A suggestion to you: Try to participate in the meetings of your institute and society, dare to ask questions and make comments at the seminars, don't accept anything without raising your doubts when it's the case. If you think a concept is strange, unjustifiable, or even ridiculous, share your ideas and ask for clarification.
Your analytic education is an exercise in uncertainty—and in learning to tolerate that “not knowing.” Not knowing what your analyst really thinks of you. Not knowing how you will pay off your educational loans. Not knowing whether you will have an analytic practice after so much effort, an effort that leaves you wondering if you should be at home with your family instead of at seminars. Uncertainty is the rule of candidacy. Competing psychoanalytic theories can also confuse as much as they clarify. And how about the lack of clarity as a beginner in how to analyze? How does one even get to do analysis, find a patient who is willing to undergo intensive treatment?
This leads me to the question of anxiety in psychoanalytic education. I think anxiety is unavoidable. Of course, I was also anxious about how I and my psychoanalytic work would be assessed by my supervisors and my fellow candidates. And I was also worried if I could understand my patients well enough. I still have this worry every day. But I would like to distinguish between anxiety as a helpful signal of never being too sure and anxiety as a fear of disapproval and exclusion. The latter paralyzes one's own feelings and thoughts. So, I would like to encourage you to be anxious in a caring sense but not anxious in the form of submission. Be open to your teachers but do not follow them blindly. Rather, dare to discuss difficult analytical processes with them and hopefully find common solutions instead of either submitting or superficially agreeing and then doing something else. This includes dealing with mistakes.
The other day, you told me euphorically that one of the assessors of your clinical report said: “Your text is perfect. I have no questions to ask and nothing to add.” You were proud, and I know that you wanted to share your happiness with me. You found it strange that I didn't seem pleased, and since we have a close relationship you asked me, “What was the matter?” I am initiating this dialogue in writing, but I am sure that we will address this in greater depth when we meet.
Your perception was correct. I felt affected and ill-at-ease and was unable, at that point in time, to put my thoughts into words. I shall explain: A “perfect” work of psychoanalysis, one which doesn't raise any questions or problems, cannot be good work. Flawless analytical sessions and texts do not exist. I have encountered situations before when I have thought that the presenter has glossed over their own interventions. This gloss conceals, yet it also reveals. The psychoanalytically trained listener doubts the truthfulness of the account.
When I was a candidate, my friends and I used to play a game that goes like this: Imagine that the entire psychoanalytic literature is destroyed tomorrow. Psychoanalysis vanishes, but you can bury a time capsule to be dug up after a few hundred years. Into that capsule you can put some papers—a handful of short works, or excerpts from longer works, ten or twelve brief pieces at most that people of the future might use to reconstruct psychoanalysis.
What do you put in the imaginary capsule?
In the process of creating and re-creating your capsule, you are not only tracking your own development as a psychoanalyst, you are also preserving the discipline. Perhaps most important, you are writing a letter you would send to future generations of aspiring psychoanalytic students, in this way connecting you to past and to future. I think here of Freud's melodic sentence in “Creative Writers and Day-Dreaming” about phantasy, or daydreams, and the function of a child's play. “Thus past, present and future are strung together, as it were,” Freud writes, “on the thread of the wish that runs through them” .
Not knowing you only permits me to answer some of the many questions you may have at this point and to be cautious about unsolicited advice. To begin: It is well worth it to become a psychoanalyst at this time when psychoanalysis is widely being questioned and criticized—sometimes with good reason. Psychoanalysis, I believe is the most profound and comprehensive theory about the functions, structure, development, and pathology of the human mind. It also provides a spectrum of psychoanalytically based psychotherapies, including the classical or standard psychoanalytic treatment and several derived, empirically validated psychotherapies. And it is a unique potential instrument for research on the mind.
Which other profession would allow you to linger on dreams, to look at their intricate layers of meaning, and enjoy the beauty, wit, and even the archaic bluntness of their imagery?
You've made a great choice when you decide to go for psychoanalytic training! To work with the human mind is endlessly fascinating. No two patients are the same, even if they carry the same diagnosis. To trace the particular defense strategies of your patient's ego when faced with challenge and opportunity, and to experience the emergence of their unconscious fantasies and infantile theories, will always reward you with awe and amazement. As much suffering as a patient may put on your couch or chair, to eventually access and resolve together the unconscious core-conflicts and beliefs that are at its root will enlighten both of you with pleasure. And not to forget: Which other profession would allow you to linger on dreams, to look at their intricate layers of meaning, and enjoy the beauty, wit, and even the archaic bluntness of their imagery? Since this complexity is what makes psychoanalysis such an intriguing profession, it is obviously a daunting task to study it.
In short, if I compare my early situation as a candidate with yours, I would say we had probably more grandiose, idealizing illusions (such as being somehow “pioneers,” easily recruiting needy patients asking to be rescued via classical treatment, dealing with a univocal, indisputable, all-explaining theory, etc.) to be progressively reduced and realistically proportioned by experience; while you can have today more consistent and refined analytic instruments, a more advanced professional community, and a different awareness of the contemporary psychoanalyst on how the human mentality uses interior organization and availability to invest are rapidly changing in the relational attitude of the subject toward the object.
What instead remains substantially unchanged, in my opinion, is that analysts are, in fact, the only owners of the keys to the door to the unconscious, and the only possible guides for patients needing deep and stable changes in their lives.
Isn't this enough for motivating you to become such a specialist?
And then there's the central importance of your own analysis in this process. I firmly believe, based on experience, that in order to be deeply interested as an analyst in someone else's story, someone else has to have been deeply interested in you. Some of us have had parents who were interested in us, and others haven't. For those of us who haven't, in particular, the analyst's interest is crucial. And by “deeply interested,” I don't mean just liking; I mean being interested in raising the wreck—getting to the bottom of it. This is the job description for being an analyst. It is a form of commitment unlike any other. It is a process that is never complete, but having some idea that it's possible, and how to do it, is essential. Your own experience in analysis is crucial to becoming an analyst yourself, with supervision a close second. It has been said that every supervision is the chance for another analysis. The presence of the supervisor as a third term in your work with patients, and often in your own analysis, is vital.
The combination of analysis and supervision offers (or should offer) infinite ways of refracting your own experience of being a person and an analyst, something that just doesn't happen in “real life.” If you read the psychoanalytic literature carefully, you'll find that the trajectory of any one analyst's writing—in addition to its subject—maps the course of that analyst's personal development. It is also helpful to go back into analysis with another as needed. You are never done, and there is always more to learn. I've always found this point to be uniquely reassuring. I think it's safe to say that my interest in psychoanalysis could be described as a love affair. It has to start with an other but, with luck, it will continue privately for the rest of your life.
Training is not easy. It is time intensive. It is financially difficult. It is emotionally demanding. It is self-confronting. It helps if you want it very badly, if your interest is compelling, if you love patient care, if you need to think deeply about the mind. In training, you learn difficult theory, treat challenging patients, are supervised in uncomfortably personal ways, and read an exciting but seemingly endless and dense literature. Because the study is so personally demanding, you meet many puffed up egos, one adaptation to the humbling of grandiosity. Ignore the ego aggrandizement. The field is riven theoretically, as all growing fields tend to be, and you see many heated arguments. Enjoy the show and don't confuse truth with the theoretical sturm und drang. Do not click on the emotional click bait of pedagogy. Focus on your learning. Learn from all.
…to be an analyst, as I see it, is not to seek the best ways toward symptom relief but to be part of a search for the deepest integration of the patient's unconscious mind, of the truths with which at bottom he struggles.
Integrating theory and developing your clinical working style are lifelong developments.
What begins in candidacy will hopefully grow into a career-long project to develop your capacity to work with unconscious material and appreciate the life of the psyche. Yet, this will invariably test your ability to tolerate uncertainty, confusion, insecurity, and intense feelings, often in ways that entail considerable vulnerability. Additionally, particularly through helpful supervisory experiences and your personal analysis, you must reckon with your ability to tolerate disappointment, responsibility, and manage narcissistic investment in your work, often in great inner solitude. Despite the intimacy within analytic space, we are unutterably alone in the deepest and most important aspects of our work. Your solitude as an analyst must become an anchor where you can eventually find your way, often amid turbulent and unfamiliar conditions that candidacy can help you learn to accept and even bear with curiosity. One way of maintaining its vitality is, in my opinion, to encourage ourselves to rethink, to question each and every one of its concepts in light of the epochal changes as well as contributions from other disciplines.
While psychoanalysis offers an understanding of the person that falls into the field of psychology and a practice that could be considered a form of therapy, the unique nature of the psychological understanding and therapeutic practice that it offers also shapes a profound ethical vision. We can and should, in my view, be motivated by this vision. I consider this vision to be one regarding the power of truth and of love. It proposes that failure to know oneself, one's inner truths, is what lies at the foundation of psychic disorder, and analytic cure is to allow the patient to come to know these previously unknown, unconscious truths. Coming to know truth in this context is not simply an intellectual matter but rather involves the integration of parts of ourselves; it means a lived experience of these parts. And it is also a motivated act, as is the failure to come to know. That is, we in a sense “choose” to know and “choose” to deny, and in this sense we are also responsible for our psychic
suffering and the suffering we cause others as a result.
In other words, what I'm emphasizing here is that psychoanalysis provides the person with a way to know and be oneself—to choose to live truthfully, to take responsibility for who one is and what one does. This is an ethical aim, and to become an analyst is to embrace it. Therapeutic relief through analysis, in this context, is only a derivative of striving toward this analytic aim—one of its important benefits. That is, to be an analyst, as I see it, is not to seek the best ways toward symptom relief but to be part of a search for the deepest integration of the patient's unconscious mind, of the truths with which at bottom he struggles.
Just one personal point: I started to attend local, regional, and international scientific meetings early on, and this opened up my mind in a way that only recently, in the position that I now occupy in the IPA, I realize was the start of the journey that brought me to where I am today.
I don't want to give an idealized picture of my training, however. Again, I say that there was a lot of effort and dedication in those years, and time scraped from wherever possible, especially family life. I had excellent teachers, and some not so. I had wonderful supervisors who were as generous as they were demanding. My colleagues said that I chose the most difficult ones, but from them I learned during my clinical experience so much about psychoanalysis. Above all, however, and being faithful to Bion, I learned through experience what it is to be dedicated to a task and to have a passion for psychoanalysis.
Psychoanalysis is an approach to thinking and education that emphasizes reflection and understanding. It becomes a contradiction in terms when rules regarding the psychoanalytic training model take on an absolutist quality. The preservation of a certain model rather than the establishment of policies and procedures that reflect attention to individual training and clinical needs is inconsistent with fundamental psychoanalytic principles.
The allure of rules is that they offer a sense of security and stability, especially during times of rapid change. At best, rules promote healthy functioning and improve output. They make us better. At worst, rules become a bastion against important new thinking like an orthodoxy that can only perpetuate itself. Somewhere in between seems right. Quality control is essential, but we have a potent, well-tested analytic method and ways of understanding human nature that merit organizational confidence. In my view, flexibility in the face of shifting technological and cultural change is not a specific risk to psychoanalysis or a harbinger of a slippery slope. Flexibility, as I see it, is an approach reflecting an overall attitude of curiosity, discovery, and openness to new thinking and willingness to face challenges without excessive fear.
Dear Candidate, we need your help in exploring the pros and cons of flexibility in the goals and standards for analytic training. Please be an active participant in the conversations at your institute while you live through the process! Also, participate in the national and international conversations, now so much easier thanks to communication technology. An open and transparent educational system promises to allow greater emphasis on scholarship, research, and collaborative thinking, all good for the future of psychoanalysis.
It is important that you find an analyst with whom you feel comfortable being brutally honest about the workings of your mind as well as the ways you work with your patients. Unfortunately, this does not always happen in one's training analysis. If it doesn't, seek another analysis when you can. For me, my third analysis, when I was already an established analyst, is the one that truly helped me to know and master my deepest conflicts. As expected, my clinical work improved remarkably. For this reason, my parting words will be to remember Freud's suggestion that we all be reanalyzed periodically. Do not shy away from another analysis if you find you are getting in your own way at any point in your analytic career.
While this book is geared toward candidates and those entering the profession, analysts at all levels might be inspired to think, once again, about this impossible but fascinating profession. Dear Candidate: Analysts from Around the World Offer Personal Reflections on Psychoanalytic Training, Education and the Profession was published by Routledge, November 2020.
Fred Busch, Ph.D., is a Training and Supervising Analyst at the Boston Psychoanalytic Institute. He has published over 70 articles in the psychoanalytic literature and five books, primarily on the method and theory of treatment.