Re-Centering Psychoanalysis: Toward a Socio-Centric Psychoanalysis

Today it is still necessary and useful to deal with the empirical foundations and cultural dimensions of a discipline such as psychoanalysis that has played a vital role in shaping the contemporary world, on both sociocultural and clinical levels. This study aimed to describe and summarize the perspectives of experienced psychoanalysts on important aspects of psychoanalysis today. Semistructured interviews were conducted with 62 psychoanalysts. The interview data were processed using a theory-informed thematic analysis. There were 12 macro-themes: important aspects of psychoanalysis, important authors in psychoanalysis today, “contemporary psychoanalysis,” the proliferation of psychoanalytic “schools,” psychoanalytic identity and psychotherapy, psychoanalytic training, the Oedipus complex, dreams, the relationship between psychoanalytic theory and outcome and process research, the relationship between psychoanalysis and research in the neurosciences, empirically validated psychoanalytic concepts, and the marginalization of psychoanalysis. Our study revealed the image of a pluralistic psychoanalysis that the participants interviewed show they have, with various schools/definitions/sources, where Freud and the classical model are contested by numerous other approaches.

Psychoanalytic education in the United States faces multiple challenges as we enter the last decade of this century. (1) Changing interest and career path patterns for psychiatrists have resulted in fewer medical applications for psychoanalytic training. (2) Increased opportunities for full psychoanalytic training of nonphysicians have resulted in increased applications from highly skilled clinicians who often have more clinical experience than their medical colleagues. (3) Increased enrollment of women candidates has required rethinking of progression requirements, in light of their combined careers as professionals and mothers. (4) Independent institutes not accredited by the American Psychoanalytic Association compete for applicants while maintaining training standards that require less time and immersion in psychoanalytic theory and practice. (5) Economic factors increasingly influence the desirability of prolonged psychoanalytic training and the availability of suitable analysands for control analyses. (6) Evolution of theory and practice and the emergence of "new schools" of psychoanalytic thought have rendered the previous psychoanalytic landscape dominated by drive theory and ego psychology more multifaceted and less uniform. The American Psychoanalytic Association and its institutes attempt to understand these changing patterns and take them into consideration in the design and implementation of psychoanalytic training programs. Only one aspect of this complex situation will be described in this work, the current state of psychoanalytic training in the 28 institutes accredited by the American Psychoanalytic Association. Although the data available at this time leave unanswered many important questions about the philosophies that organize the content and emphases of the curriculum in different institutes, much has been learned about the overall structure of psychoanalytic training programs.

Contents: Part I: M. Meisels, Introduction: The Colorful Background of the Clark Conference. E. R. Shapiro, Helen Block Lewis, In Memoriam: Her Vision of the Clark Conference on Psychoanalytic Training for Psychologists. H. B. Lewis, Some Thoughts on Becoming a Psychoanalyst: Anno 1985. H. B. Lewis, Psychoanalysis as Therapy Today. Part II: E. R. Shapir, Keynote Address: Introduction. A. M. Sandler, Comments on Varieties of Psychoanalytic Training in Europe. Part III: E. R. Shapiro, Institute and Alternative Training Models: Introduction. C. Spezzano, A History of Psychoanalytic Training for Psychologists in the United States. M. Hyman, Alternative Training and Its Alternatives. A.M. Antonovsky, Institute Training. M. Horowitz, Alternative Training Models: A Response. S. Gourevitch, Discussion of Marvin Hyman's Paper: Institute Training and Its Alternatives. Part IV: E. R. Shapiro, Components of Psychoanalytic Training: Personal Analysis and Supervison: Introduction. M. Miesels, The Personal Analysis. J.E. Gedo, Position Statement on the Training Analysis Question. S. Basescu, Personal Analysis. H. J. Schlesinger, Supervision and the Training Analysis: Repetition or Collaboration. A.L. Siegler, Finding One's Voice in the Analytic Chorus: Some Thoughts About Psychoanalytic Education. Part V: E.R. Shapiro, Becoming a Psychoanalyst of One Persuasion or Another: Introduction. S. A. Appelbaum, Reflections on the Role of Theory in Psychoanalysis. M. Bilmes, N. Adler, Becoming a Psychoanalyst: An Example From an Integrative Program. Part VI: E.R. Shapiro, The Psychoanalyst's Identity Vis-a-Vis Other Therapies and the Discipline of Psychology: Introduction. P.L. Wachtel, Should Psychoanalytic Training be Training to be a Psychoanalyst? G. Silberschatz, Psychology's Contribution to the Future of Psychoanalysis: A Scientific Attitude. E.R. Shapiro, The Relationship Between the Division of Psychoanalysis and Local Chapter Training Programs. F. Pine, The Relationship Between the Division and Local Chapters (Abstract). J.H. Slavin, Authority and Identity in the Establishment of Psychoanalytic Training. R. Kainer, Superego, Ego Ideal, and Transitional Phenomena in Issues of Regional Training. E.R. Shapiro, Summary of Audience Discussion. Part VII: E.R. Shapiro, Implications of New Information for Psychoanalytic Training: Introduction. Part VIII: G. Stechler, The Integration of Psychoanalysis and Family Systems. J.B. Miller, Psychonalysis and the Psychology of Women. L.E.A. Walker, Feminist Scholarship and the Training of Psychoanalytic Psychologists. D. Mendell, A Model for Integrating New Ideas From the Psychology Era of Women Into Training Programs. Part IX: E.R. Shapiro, Workshop Reports. E.R. Shapiro, The Future of Psychoanalytic Education: Intergenerational Conflict and the Balance of Tradition and Innovation. Clark Conference Program. Clark Conference Faculty. Clark Conference Planning Committee. Author Index. Subject Index.

The author summarizes parts of two papers that appeared in Italian and were presented at International meetings (Galli, 2006, 2009). The following topics, among others, are discussed: the history of psychoanalytic theory of technique with a critique to some aspects of contemporary psychoanalysis; intersubjectivity; the concept of analytic neutrality; the relationship between psychoanalysis and psychotherapy; technical spontaneity; the identity of psychoanalysis and therapeutic identity; interdisciplinarity and the relationship between psychoanalysis and other disciplines; psychoanalytic training; the concept of “continuous interpretative activity”; self-disclosure in analysis; the relationship between theory and technique in psychoanalysis; psychiatric diagnosis and psychoanalytic diagnosis; the relationship between the person of the analyst and therapeutic technique.

This paper discusses the role of clinical supervision in psychoanalytic training. It also discusses the impact of training modes on the psychoanalytic organisations that use these different models of training. The paper argues that psychoanalytic training consists of a unique combination of personal analysis, study of psychoanalytic theory and research and clinical supervision. Given the variation of these three components and their possible interactions, an overly prescriptive view of training can be detrimental and counterproductive. The effectiveness of psychoanalytic supervision is to a significant degree dependent upon a trainee being engaged in personal analysis. Clinical competency requires extensive clinical experience obtained in a variety of settings and with a broad exposure to patient groups. The detrimental implications of restrictive and reductive views on psychoanalytic training that seek to specify quantitative criteria rather than clearly articulate clinical competencies are discussed.

The term institute is used inclusively here to refer to different organizational structures such as psychoanalytic societies and centers. Those organizations have primary tasks such as providing education and training in psychoanalysis and psychoanalytic psychotherapy. Existential threats covers a range of factors, both internal and external to an organization, that may seriously impair or destroy its capacity to carry out its primary tasks and to survive as a functioning entity. Perceptions and responses relating to those threats are dynamic processes within the organization that shift and evolve over time. This case study explores one institute's use of organizational self-inquiry and external consultation to strengthen its capacity to perceive, make meaning of, and respond adaptively to those threats. The qualitative research for this case study is based on a series of semistructured individual interviews with a representative sample of participants in the consultation, close attention to the intersubjective experiences of interviewees and interviewers, and careful thematic analysis of the interview data. Interviewees shared their understanding of what led up to the consultation, their experience of the consultation, and their perception of its immediate and ongoing impact. Many interviewees felt that the consultation helped strengthen the institute's organizational capacity for resilience and innovation, expressed the desire for additional consultation to ensure the institute's survival and ongoing health, recommended that the institute include the study of organizational dynamics in its curriculum, and thought it should develop its internal capacity for organizational self-inquiry.

This book provides an intimate portrait of a clinician’s psychoanalytic approach to working in the public health sector with people suffering from acute and chronic emotional pain. Drawing on three central psychoanalytic concepts of countertransference, projective identification, and the destructive superego, Paul Terry weaves together a unique and distinctive psychoanalytically-based approach to psychotherapeutic work. He illustrates this approach in detailed, almost moment-by-moment case studies of his work with people suffering from depression, psychosis, dependency, loneliness, dementia, and terminal illness. He also shows how his approach helps him to understand social and political issues of war, the holocaust, entitlement, and sexual identity. For readers unfamiliar with psychoanalytic theory, the book concludes with an appendix in which there is a summary of some Kleinian psychoanalytic concepts and psychoanalytic studies of psychosis. This informative, compelling, and moving book will act as a valuable resource for students training in psychoanalysis and to work in public settings along with career psychologists and mental health professionals seeking to better understand their clients and experiences.

This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book is a singular attempt to form a theory of how interpersonal dynamics structure the human mind and, in turn, how that governs the functioning of the body, within the mid-century French psychoanalytic tradition. When Françoise Dolto was training in psychoanalysis and beginning to practice it in the 1930s and 1940s, there was little psychoanalytic theory available in translation in France. The book puts the complex nature of interpersonal interactions squarely in the centre of French psychoanalytic theory, where it had been missing. Dolto clarifies how the distinction between desire and need arises at the earliest stage of infancy.

Transference and countertransference and the unconscious are critical concepts from psychoanalytic theory that are central to social work education and training about the therapeutic process. However, assessment and treatment of diverse populations requires the incorporation of new theories and concepts for understanding the intersection of clinicians' and clients' racial and ethnic identities. Intersubjectivity, ethnocultural transference and countertransference and racial enactments are three key concepts that deepen psychoanalytic and psychodynamic work with racial and ethnic populations. These concepts are described and illustrated by a case example. This article supports the incorporation of this knowledge in the supervision, teaching and training of psychoanalysts, professional social workers, and other mental health professionals. Professional social workers in the American Psychoanalytic Association are encouraged to take a leadership role in supporting the inclusion of this knowledge in psychoanalytic training.

The Psychoanalytic Model of the Mindby Elizabeth L. Auchincloss, M.D. Washington, D.C., American Psychiatric Association Publishing, 2015, 332 pp., $59.00 (paperback).

The psychiatrist with psychoanalytic training and experience is enabled thereby to bring special contributions to nonclinical work in community mental health programs. Specific reference is made to social planning, catalysis of social change, and negotiation. No point-by-point translation from psychoanalytic thinking to community situations is intended, but rather a flexible translation whereby psychoanalytic theory in general, and certain psychoanalytic concepts in particular, provide useful bridges from traditional practice to nonclinical community work. A psychoanalytic backbround is notseen as essential in the community field; nevertheless the effectiveness of psychoanalysts now practicing there warrants efforts to recruit others.

The author addresses how privileging of dyadic learning structures (supervision and personal analysis) in psychoanalytic institutes contributes to a paucity of attention to group processes in psychoanalytic training. Because groups resist development that disrupts the established order, this is a controversial article, for it questions traditional assumptions regarding the ways in which psychoanalytic theory is taught. Following a historical trajectory, the author discusses five examples of analysts' lack of attention to group dynamics. The group processes occurring in these situations are analyzed from the perspective of Bion's (1961) theory of groups, which shows how primitive anxieties emerging in groups encourage dependency on. particular theories and analysts, fighting between those of different theoretical persuasions, and the development of a psychoanalytic aristocracy (an “in-group” of training analysts). This detracts from critical thinking, and undermines efforts to find new solutions to the problems psychoanalysts face in today's world.

<i>The authors consider the influence that a sense of geographical and cultural ties of candidates from different regions has on their theoretical interests. They question the way that this is taken into consideration in psychoanalytic training. The function of theory, both in terms of its transmission and the creation of new knowledge, is explored from this perspective. The results of an Internet survey are presented. The candidate sample for this survey</i> (N = <i>250</i>) <i>was drawn from Europe, Latin America and North America, and candidates were asked to indicate their degree of interest for each of the 55 authors in a given list. The results showed that there were significant differences in the areas of theoretical interest of the candidates depending on the geographical region. Furthermore, what is also significant is how these differences in areas of theoretical interest were linked to those authors who had developed their work in the same geographical region as the candidates. These differences are shown to be connected to the candidates' sense of regional belonging. Data are also presented about which authors have the greatest impact in a given region, along with the influence values of the authors in relation to each one of the regions. Finally, the candidates' interest in each of the authors is specified in terms of a general mean rank and a regional mean rank, thus showing which authors candidates find most interesting in each of the regions. The study concludes by arguing that the results of the investigation enable us to question how psychoanalytic theory is transmitted, and, more specifically, how it is transmitted within institutions at a regional level. It is also suggested that the means be found to uncover the inconsistencies linked to cultural ties. It is proposed that further research be conducted to look more deeply into how cultural differences play a part in the different theoretical languages in the training of psychoanalysts.</i>

There has been a historical shift in psychoanalysis from an earlier time of certainty to our present state of uncertainty with the coexistence of multiple theories competing for our attention. We realize retrospectively how entrenched groups ruled our institutions by maintaining faith in their authority as the keepers of “pure” psychoanalysis. Despite struggles between competing ideologies, there has been progress in integrating clinical theories. As no psychoanalytic theory or technique has been proved superior, we advocate an inclusive approach with all psychoanalysts keeping an open mind about the value of competing theories. This integration of disparate theories has led to a resurgence of interest in psychoanalytic training. Examples are given of some of the difficulties encountered when competing ideas are introduced in psychoanalytic groups.

SUMMARY This paper describes the attitudes of British Psychoanalysis toward homosexuality, starting from the time of Ernest Jones to the present day. It traces the development of psychoanalytic theory from its total pathologising of all expressions of homosexuality towards a more questioning and non-pathologising formulation. The article illustrates how changes in psychoanalytic theory and practice both mirror and are influenced by the changing legal and societal status of homosexuality in the United Kingdom. Although openly gay and lesbian candidates are beginning to be accepted into psychoanalytic training, the continued existence of antihomosexual prejudice and bias suggest an ongoing need for continuing education and concern.