Editor's Note: Recently I had the pleasure of reconnecting with a former psychotherapy student. She was living in a new city on the West Coast, setting up a hybrid remote and in-person practice, and beginning analytic training. I asked if I could interview her for the next TAP. I'm delighted she said yes!
I received my M.S.W. from New York University in 2005 and immediately began working in high-acuity settings—inpatient psychiatric/addictions admissions, adolescent partial hospitalization and intensive outpatient programs, and an inpatient dual diagnosis unit. In all of those settings, there was a common denominator: I saw individuals and families suffering immensely, who, with few exceptions, hadn't had the opportunity to engage in depth-oriented psychotherapy.
I was fortunate that my graduate program was deeply rooted in psychoanalytic theory and practice. Most of my professors were psychoanalysts who were in private practice. We were encouraged early on to think about which institute we would join after completing the program. Imagine my surprise when I finished my degree and entered the above workplace settings!
I completed the two-year psychoanalytic psychotherapy program (PPP) at the Oregon Psychoanalytic Center. It was an incredibly rich experience with weekly classes, personal analysis—or a minimum of twice-weekly therapy—and presentation of two cases from our practices to faculty members. We also did a final case formulation paper that demonstrated our knowledge of psychoanalytic psychotherapy theories as applied to one of our supervised cases.
That most patients actually want more connection and to know themselves more deeply! And the better equipped I am to explain the unique benefits of depth-oriented therapy, the better I am able to help patients choose to engage with me in treatment that occurs multiple days per week. Another takeaway was that I wanted more of the training I had already received. I wanted to engage more deeply in the same way I wanted my patients to.
I think the best aspect for me was the sense of community I had during the Psychoanalytic Psychotherapy Program (PPP). I loved getting to know my classmates, personally and professionally, and getting to know the faculty members as well. As I'm sure many of us can understand, private practice can be isolating and finding a like-minded community was very powerful for me.
My time as a candidate has been similar to my time as a PPP student—which is a great thing, because I loved my PPP experience. I am engaged in a personal analysis, I take weekly classes, and I am in the process of converting current psychotherapy cases to analytic cases in my supervision. Once again, the feeling of community and shared love of learning, both from my fellow candidates and teachers, has been delightful and nourishing.
My most recent favorite book is the Psychoanalytic Diagnostic Manual. We used it during my time in the PPP in Oregon, so I was familiar with it. We are using it as a primary text in a current class. It really delves into the patient and clinician experience of certain diagnostic categories. It's helping me understand some of my own cases differently.
I would encourage them to look up their local institute and just reach out! Explain that you're interested in analytic ideas and concepts and ask if a current member—student/candidate and/or faculty—would be able to speak with you. My main advice is not to be shy. Most of us doing this work absolutely love to share how enriching, wonderful, and relevant practicing analytic work is.
I have gained so much! Initially I was a psychotherapy associate and was able to present at two APsaA conferences. It was amazing to meet members from all over the country and to present my work to people I have admired from afar through reading their books. As a candidate I have
been able to become even more involved on a national level through joining a candidate committee. I personally believe that psychotherapy and candidate members, by and large, share many more similarities than differences. I actually would have welcomed being more involved as a psychotherapy member, but there were not as many opportunities at that level.
I hope that psychoanalysis becomes more accepted as a standard treatment, and that both prospective patients and insurance companies recognize the value of more intensive work. When patients are invited to connect with themselves, and with us, in a spirit of respect and curiosity, amazing changes can happen. I do wish the general public knew the difference between a treatment that is solely targeting symptoms and a treatment that is designed to take the whole person into account in the way that psychoanalysis does.
My main advice is not to be shy. Most of us doing this work absolutely love to share how enriching, wonderful, and relevant practicing analytic work is.
In terms of training, in the future I hope there will be less distinction made in some institutes between psychoanalysis and psychoanalytic psychotherapy. What I have observed is that most of us are attracted to this specific area because we are thirsty for knowledge, both about ourselves and about our patients. Psychotherapy students may more readily convert into analytic candidates if they are not trained in two completely separate programs. There is so much overlap, yet often so many barriers to becoming a candidate. If we want psychoanalysis to truly become a gold standard treatment, we need to train enough psychoanalysts to meet that demand. That can be more easily accomplished if clinicians of all types and educational backgrounds are welcomed into analytic training of any kind. And we need to make it easier to transition from psychotherapy student to candidate, if that's what people want to do.
Zoe Crawford, LCSW, is in private practice in San Diego. She specializes in working with people who haven't had success with previous therapy and/or brief treatment. She also reserves a portion of her practice for short-term addiction consultation and referrals.