“You have a deep-rooted need to feel special. I feel, that in the drive to feel special, you have been alienating many around you. I am concerned that if you continue to be this way, you may end up dying alone.”
I made this remark to one of my control cases, 26 months into treatment. Later, they called it a “transformative statement.” At the time, though, they felt like storming out of the office.
In 2014, I was introduced to Dr. Salman Akhtar.
“This is Himanshu. He is interested in pursuing analytic training.”
“Hello, Himanshu. Nice to meet you. Let me ask you a question. Can you think of a good reason not to start analytic training?” I responded by listing many: money, time, confidence, limitations related to my practice. He nodded along, then responded in his signature style.
“I see, I see. So, let me ask you a question. Do you have a good reason not to start analytic training?” I smiled sheepishly as I pondered what he was encouraging me to be curious about.
After another 18 months of my personal psychoanalysis, I felt I had worked through my resistance, and applied for training at my beloved, idealized psychoanalytic institute in Minnesota.
In my personal statement, I recalled my rendezvous with this charismatic, commanding analyst, and added, “I am applying to psychoanalytic training because, simply put, I have run out of reasons not to.” I wrote this application seven years ago, and since then I have had some time to think about what resources were needed to take this step. Before enumerating these resources, I would like to start with a disclaimer that these resources and factors are likely different for every individual. However, the point I wish to make is that every potential candidate may have important reservations and many of these are arduous to overcome, and sometimes seem insurmountable.
Firstly, I had to receive my “terminal degree” which, in my case, was an M.B.B.S. (the equivalent of an M.D. degree) from my medical school in India. I had added six more years to my medical training, including four years in a psychiatry residency and two years as a fellow in child and adolescent psychiatry. We were all called fellows, irrespective of our gender. These additional years turned out to be both an impetus as well as an impedance to applying for psychoanalytic training. The same training that created a thirst to immerse myself in learning about the importance of childhood also left me drained when it came to taking any further steps. I gradually built up an intellectual reserve; however, it took me several years to do so.
The next resource I needed to conjure up was money. I was already in personal psychoanalysis, which was costing me a pretty penny, despite being told I had “the best insurance plan in the world.” (As I read somewhere, when Americans say “world,” they really mean “USA,” and when they say “USA,” they really mean Manhattan.) Starting analytic training meant coming up with additional money to pay for tuition, books, travel. However, the biggest financial commitment would be to bid adieu to 20 percent of my annual income for the next four years, as I committed an entire workday to didactics. In retrospect, the biggest challenge was to reconcile with the state of finances during my childhood. I grew up in New Delhi on the fringes of poverty, and my mother's entire salary went to paying her sons' private school tuitions. Little Himanshu had to work through the reality that this 20 percent he would forego each year was the equivalent of 12 years of his parents' combined incomes!
The next resource I needed to recruit was the time and the ability to tolerate volumes of readings. My father, my childhood hero, openly displayed his disdain for academia and academicians. He had successfully defended against his own bibliophobia by ridiculing bibliophiles, and it took a few more years of analysis to work through my strong identification with this part of him. It took a rare scolding from my immensely patient analyst for me to see the light. “What I'm saying is do your damn readings!” One father prevailed over the other, and I realized, much to my delight, not only could I tolerate psychoanalytic literature, but I could relish it!
The final resource I needed to start psychoanalytic training, was misery. At the time I put in my application for psychoanalytic training, I was divorced and terribly lonely. In retrospect, I believe if I had been as happy in my personal life back then as I am today, I may not have put my name into the hat.
“What does it take to become a wizard?” I once asked my analyst.
“A lifetime of suffering and the help of a few good people,” came the reply.
Nine individuals started in our psychoanalytic class. Four have made it through the coursework, earning them the nomenclature of “advanced candidate.” All nine are extraordinary human beings in their own ways. They are all highly intelligent. They are all too familiar with hard work. They all possess extra-ordinary emotional perceptibility. Yet, over half of this group has chosen to part ways with the Institute. If one individual leaves, perhaps it has something
to do with that person. If two people leave, perhaps it has something to do with that dyadic dynamic. If a whole bunch leaves, perhaps it has something to do with the system, in this case, my beloved institute in Minnesota.
Around the same time, the end of my second year of training, I too started entertaining the idea of premature termination of my psychoanalytic training. I was feeling exhausted, overwhelmed, dog-tired. I would put my toddler to bed, kiss my wife's forehead, and then disappear into the recesses of the night to do my prep work for the next class. This was the hardest thing I had done since medical school! I was feeling unappreciated, and “un-understood.” By my own subjective calculations, one out of four teachers assigned readings poorly, and one out of four teachers discussed them poorly. I am loquacious by nature, and it felt like many teachers were uninterested in my ideas and my opinions. And then there was the archaic to reckon with, for instance, the chauvinism and the homophobia, which made a noisy din amidst the awkward silences in the classroom.
It is entirely unfair to vilify my institute.
A large amount of my institutional transference had to do with my own neuroses. I noticed, for me, there were strong similarities in the middle phase of my analysis and the late-early/early-middle phase of psychoanalytic training. Amidst my regression, I was constantly angry, irritable, full of self-doubt. I was picking frequent fights at home. I hadn't even started my first control case.
I took to intellectualization and sublimation. I had been appointed the editor of the Candidate Connection national newsletter for the American Psychoanalytic Association (APsaA), and I now knew my theme for the next edition: the vicissitudes of candidacy. I created an anonymous survey and sent it to the listserv for all APsaA candidates. I wanted to know if other candidates around the nation were feeling similar difficulties.
Out of 297 members on that email list, 51 responded. Apparently, there were many others who felt the way I did. I was not alone! The other useful message I received was from advanced candidates and recent graduates: “Psychoanalytic training is hard. However, if you are able to find a way to get through the rigors, it is worth it.” This information provided the exact shot in the arm I needed—along with a very nurturing analyst, and an extraordinary person who calls me her husband.
“What is the overarching purpose of psychoanalysis?” I once asked my analyst. “Success in love, and success in work,” came the reply.
My wife, Sarah, would have gained the most had I quit my analytic training. She would have her husband back, smile and all. But she egged me on. When I interviewed her for the next edition of Candidate Connection, entitled “Unsung Heroes,” I asked her what made her push me to continue. She replied she knew she would respect me more if I persisted, but more importantly, she knew I would regret it if I quit, which in turn could affect not just our marriage but also my relationship with myself.
“What is the overarching purpose of psychoanalysis?” I once asked my analyst.
“Success in love, and success in work,” came the reply.
My analysis had borne fruit. Through internal transformation, I found this most healthy person. I had succeeded in love! Now, it was time to double down and succeed in work, the work of psychoanalytic training and developing a psychoanalytic identity. I took to my training analysis with a renewed fervor and started to recognize, and work through, the de-idealization of my institutional transference. I began to see my teachers and the leaders at the Institute as people worth admiring instead of idealizing. This allowed space for fallibility and imperfections, so I could see them and myself as human.
It would be unfair to let my institute off the hook entirely.
When I complained about the poor quality of some of the didactics, the reply was, “Well, you're never going to find a solution to that problem. There simply aren't enough teachers.” I had a potential solution: Why not have fewer classes rather than expose us to bad teachers? Years later, I realize my proposed solution was overly simplistic and ineffective. For starters, it would have meant we wouldn't be able to graduate!
Unfortunately, this solution started acting itself out organically. First one, then another, then half the class started missing lectures. In my annual review, the faculty member gave me very little positive feedback, and chided me for my attendance. I expressed surprise: “I believe I have been keeping good attendance, in accordance with the number of allowed absences per the policy.” The Progression Committee replied, “We want you to have an immersive experience. When I was a candidate we simply attended as many classes as we could—which was all of them. We found that the other stuff just kind of arranged itself around this.” The other stuff referred to my commitment to my academic institution, the place of my employment, and my patients who had crises during my classes. Or my wife and my 3-year-old son, who craved a long weekend with his father, and a mother back in India, who wished to see her son.
I remember visiting my homeland during the last term of my didactics. My best friend's father had just died. I remember staying up all night (India time), attending
my classes remotely solely because of that command to immerse myself. I would be participating by expanding on my thoughts about such-and-such concept while the widow sobbed all night in the next room. I remember thinking to myself, “What's wrong with this picture?” but couldn't quite put my finger on it then. Looking back, I do believe such faculty members might be mistaking immersion with submersion—drowning, asphyxiation. Today, when I think of such teachers (whether at psychoanalytic institutes or in medical schools across the nation), I am overcome with a sense of sadness for them. In my opinion, former students have been taught wrong and are passing on the intergenerational trauma meted out to them by their own teachers, their gods. I believe in doing so, they might be identifying with the aggressor.
As someone who has been invited to several seats at the national table, whose ideas have been listened to, I say to psychoanalytic institutes across this amazing country:
“You have a deep-rooted need to feel special. I feel that, in the drive to feel special, you have been alienating many around you. I am concerned that if you continue to be this way, you may end up dying alone.”
Having said that, I am thrilled at the head-spinning pace at which APsaA has evolved in the last decade: the inclusion of several groups that were once considered the Other, APsaA's apology for its stance on homophobia, an evolved perspective on distance analysis and training, to name a few. I look forward to seeing where it is headed. As an adopted son of my institute, as the first long-distance candidate accepted by it, as someone who fell in love with psychoanalysis and then himself because of my institute, I say to anyone struggling with psychoanalytic training: Remember this about our wonderful, neurotic clan. We are a group of well meaning, partly damaged, intelligent, clumsy, wise, foolish individuals who are trying their best with what they've got, to pass on to you a specialized, sacred craft, against the grain of societal norms and business models. Please consider not doing what I have done in the past—sitting in a corner with my arms crossed whining “Where is all my tuition going?!”
Instead, consider imbibing Heinz Kohut, getting really empathic, leaning in, going with the flow, and if possible, pitching in. It will probably be a messy, undulating whitewater-raft ride, and sometimes it might feel like your paddle has fallen into the creek. However, today, I join the ranks of those who declare it has been worth it. It's not over yet, but thanks to my psychoanalytic training so far, my marriage, my child rearing, and my clinical, teaching, and administrative practices have all turned out better than this kid from New Delhi could have ever imagined.
Himanshu Agrawal, M.B.B.S., D.F.A.P.A., is an Advanced Candidate at the Minnesota Psychoanalytic Institute. He is the outgoing editor of Candidate Connection, a candidate director-at-large, and the president-elect of the APsaA candidate council.