Interim report of the EPF WPE March 2005

INTERIM REPORT OF THE WORKING

PARTY ON PSYCHOANALYTIC EDUCATION[1]

March 2005

compiled by Gabriele Junkers

I.Intention

The aim of the EPF Working Party on Education[2] is to create a space for reflection on the principles of psychoanalytic training in Europe. In order to find out more about how these are conceived and applied in the different European Societies, interested training analysts of Europe are meeting to exchange information and opinions about how we work as training analysts. The specific aim is to have a closer look at how we see our training system and at what we are actually doing. Thus we want to reach a clearer understanding of how we actually conceive psychoanalysis and if our present practice actually meets the aims we are pursuing. Clarified aspects of current training will establish the evidence for our thinking on these topics (See European Scientific Initiative (ESI, 4. & 5.).

This includes both the gathering of information on how psychoanalytic training is conceived of and carried out in the Societies within the EPF, and organizing opportunities to meet and to think in the company of others who have a shared commitment about what the systems of training can tell us about how we actually understand analysis.

Instead of advocating change or devising any model of common training the WPE would like to look more closely at the implications of the great variety of methods of training applied in Europe, in order to reach a better understanding of the underlying assumptions.

The focus should be wide, only narrowing in on detail where this seems to illuminate the underlying theoretical orientation, educational approach and implicit models of analytic work within the different Societies.

We are doing this in a variety of ways: by thinking as a group about what the major issues seem to be, by gathering information, and by establishing ways of including many colleagues involved in training, in a variety of groups, for deeper discussion of underlying principles and how these relate to practice.

When set up in 2000 the Working Party on Education was first chaired by Mary Target until June 2003. At the Council meeting November 2003, following the proposal of the EPF Executive, Gabriele Junkers was nominated as acting chair of the WPE. This report tries to give an overview over the aim of this WP, the development of the work from the beginning up to now, the projects formulated, events offered, outreach activities presented and interim results.

II. Background reflections

What is required to train a psychoanalyst is something that has rightly been of concern since the early days, and that has been written about and discussed extensively by those involved in psychoanalytic education. The Working Party wishes to take these earlier contributions into account, and draw on this already extensive work, while giving ourselves at least two additional tasks. The first is to consider the issues of psychoanalytic training specifically in the European context. The second is to stand back and think as freely and openly as we can about training and education in general, as we are beginning the new century. That is, we would like to broaden our horizons beyond the framework of the restricted psychoanalytic tradition, and to consider also what we may know about how people learn new ideas and skills, and a new professional identity.

The second of these tasks involves a deeper consideration of the purpose(s) of the training and how we know whether these are being achieved. For example, it could be said that a major purpose of psychoanalytic training is to produce competent psychoanalysts. Another aim might be to teach in ways that stimulate the individual’s psychoanalytic creativity and their capacity to contribute to theoretical development. A further aim of training might be to maintain the numbers of those who communicate and spread psychoanalytic ideas in society, through influencing various kinds of mental health training and practice, university teaching, and so on. There are many related, individual, less conscious training aims which one could add, such as establishing a personal or group following. Another aim would be to see if the training aims of the many European Societies differ. What philosophical and cultural distinctions may underlie these differences, and how do these relate to explicit and implicit models of psychoanalytic work?How do Societies judge whether their aims have been achieved? If in certain individuals the training aims of a Society have not been met, are these candidates allowed to fail, or are they kept on like problematic members of the family, or treated like patients who will improve if only they have more analysis, or post-qualification training?

In the ongoing work of the WPE we would like to establish contact with the other three Working Parties (concerning theory, clinical work and the interface with the external world), as many of the themes cross boundaries. For instance, how do the different theoretical frameworks and models of clinical work relate to systems of training, and do Societies have clear models of training itself, which form an integrated experience – do the distinct elements cohere into the process that was intended? In terms of theoretical frameworks, are the differences between models within a Society explicit, and how do candidates choose or become assigned to a clinical school? Do training analysts with different theoretical/clinical models openly or covertly compete for candidates, and what impact does that have on the training experience and its results? How do supervisors communicate their explicit and implicit theories? How do training analysts do that, and how well does the didactic aim sit alongside necessary therapeutic work? How do analysts’ unconscious attitudes to the external world – to neighbouring disciplines, to the universities, to psychotherapists, to all things non-analytic – colour the selection of candidates and their ‘socialization’ as psychoanalysts?

  1. The beginning

As a first step, Mary Target began her work with a review of the literature on psychoanalytic education, which she presented at the IPA’s Research Conference on Psychoanalytic Training in March 2000. Click here for more information She was surprised not to find within the literature on psychoanalytic education any contributions describing in detail how we assess clinical competence or what it might mean in detail. Instead the majority of the contributions to psychoanalytic education up to this point have focused on the limitations of training analyses.

In addition she found a general absence of a coherent and explicit approach to learning and teaching in psychoanalysis, including any attempt to discuss and share the use of what we might already know, from either psychoanalysis or education, about these processes. (Target, 2001). In consequence, this led to the formulation of 3 levels of investigation, from facts to more implicit aspects involved, led by the idea of going deeper and deeper.

I will begin to report on levels 1 and 2, that have since been renamed as projects 1 and 2, as the dimension of going deeper was not met by other following projects.

Project 1 (former level 1):

Factual Mapping of organisational procedures across European training institutions. Project 1a.

Working together as European Training Analysts we need to know more about the facts that outline and define our different training activities.

As consequence this approach was designed to enable us to describe explicit facts and procedures that should result in a “map” of training practices across Europe, including figures about the candidates applying for, beginning and completing the trainings. One representative of each training organisation was asked to complete a factual questionnaire about the training procedures used in their Society. As questionnaires have been returned only by 18 of the 28 training organisations in Europe, it was decided by the group that this pilot study requires further elaboration (see project 1b); Let me report briefly about these preliminary results:

These were unsurprising to those familiar with the European training institutes, the major difference in procedures being between the French / Belgian systems and others, especially in the separation of personal analysis from the training system, and the means of evaluation. Other examples of findings to note were that only one institute requires psychotherapy practice as part of training, only one has a formal training in supervision, in three the clinical training is linked with an academic qualification (in psychotherapy), and four organisations reduce requirements for candidates far from the Institute. The majority of candidates across Europe are over 40 years old when accepted, and about one third are medically trained. Candidates in Germany and Scandinavia get more financial support than those elsewhere. On average across the institutes that answered, 89% of candidates who begin the training proceed to qualify as analysts, which suggests (given that some will drop out because of life crises etc) very little ‘weeding out’ of weak candidates Click here for more information

Project 2 (former level 2 ): A Survey of Personal Opinion and Experience

The aim of this research was to approach a more subjective view: to find out about how training analysts, members and candidates see the aims and practices of their training, and whether the aims were met by the current practices. This approach was originally designed as an interview of several people at different levels in each training organisation, by WP members or other interested colleagues within each Society. As interviewing turned out not to be practicable in most societies, this survey has been answered in a written form. Responses from several colleagues across eight training organisations, altogether 66 self-completed ‘interviews’ could be collected. Mary Target has reported on these preliminary findings in Sorrento (2003) and New Orleans (2004)

Responses came from 19 training analysts, 27 members, and 17 candidates. Questions covered the same areas as Level 1, but with the emphasis on full descriptions of personal points of view, experiences, impressionistic thinking (‘beliefs’) about psychoanalytic education and the respondent’s understanding of these. Examples of questions asked are ‘What do you believe to be the criteria used to select candidates?’… ‘Do you think the system works well?’ ‘Once in training, what are the main things a candidate is supposed to learn, or ways in which he/she is supposed to change?’ … ‘Do you think the components of the training program map onto these main things?’ … ‘What are the criteria for qualification? … Do they assess the learning that was aimed for?’ Click here for more information

One striking observation on reading the 63 interviews was the very high agreement on desirable qualities in applicants and candidates. Qualities seen as positive: Ability to make contact, empathize, mentalise; ability to express emotions appropriately; awareness of unconscious processes from own analysis; capacity to listen and change; flexible defences; ability to complete things; tolerance of ambiguity; containment of own and others’ demands and anxieties; intellectual capacity and creativity; curiosity about the mind and the unconscious; realistic motivation. Qualities seen as negative: personality narcissistic, paranoid, ‘over-projecting’, sadomasochistic, perverse, psychopathic, schizoid, obsessive, borderline, addictive; generally pathology which ‘has little chance of being analysed’; in unstable relationships; intellectualization, false self; denial of own weakness; lack of sense of humour.

Some typical comments, just cited here but not discussed any further, were “To be humble and at the same time to be daring” for positive qualities. “To be insecure and with a need to look perfect” for negative ones. “ I don’t know if the selectors choose the right people. I think only the analysands of those becoming analysts can “bear witness” and “judge” that question in the end.” A large minority expressed concern that selection might be too ‘safe’, that it might lead to the choice of ‘uncreative people’ who promise to dedicate themselves ‘uncritically’ to psychoanalysis. Problems in recruitment were attributed alternatively to the negative image of psychoanalysis, or to idealization which leads to seeing oneself as too unworthy and hence to fears of not being accepted (or of being accepted!).

In terms of how competence should be assessed, the prevailing view was that the supervisor would know when it felt right, but one training analyst mentioned that it is vital to assess ethical behaviour (but how should this be done?), and another proposed that the training patients must have been shown to have benefited from their analyses. Qualification was seen to follow from fulfilling the formal requirements: very few fail if they have done the required ‘time’, regardless of actual skill.

Respondents made criticisms of the training system which were very similar to those found in literature (e.g. in the papers of Kernberg): infantilisation, crushing of creativity, the Institute’s avoidance of actually assessing competence, a paranoid, insecure atmosphere among candidates (presumably at least partly a result of the unclarity around assessment), etc. Candidates who responded, while wanting clearer criteria for evaluation of their progress (and clearer indications as to how they were seen as getting on), were mostly positive about the quality of teaching they were receiving. Some qualified members, however, were less impressed, suggesting that teachers needed to be ‘taught how to teach’, that it should not be assumed that clinical skill ensured good teaching capacities, or even supervisory skill.

What to learn from this first approach and how to go on?

A recap of the work done until now with Mary Target (2004, when G.J. took over as acting chair) showed that there is still work to be done to clarify and properly complete these first 2 projects. This was done in 2004; in 2005 we will have a full investigation done on the former “level 1”.

Project 1b: Factual Aspects on Training Systems in Europe in 2005 chaired by Mira Erlich – Ginor, Jerusalem; Leena Klockars, Helsinki.

This project follows and expands the lines of project 1 and its declared aim is to include all European Societies in this study, thus raising the number of participating Societies and enlarging the questionnaire to cover issues that would refer to changes in the training system during the last 7 years.Mira Erlich Ginor, presently head of the training committee of the Israel Society, is working with the WPE findings in her Society together with Leena Klockars from Finland, who has already done a similar overview for her Society. They are currently sending out the revised questionnaire (winter/spring 2005). Their aim is to create an updated “map” of training practices across Europe which will be available on the web to all Societies, training analysts, colleagues and candidates who are interested. The results should be available for the late summer 2005.

Project 2b: Comprehending Analytic Education in Europe – a follow up study (chaired by Anna Danielsson-Berglund and Majlis Winberg Salomonsson)

The discussion of the existing projects showed that rich material has been collected that requires further investigation. The numerous completed questionnaires have not only given a quantitative result, as described by Mary Target, but also include highly interesting qualitative material that has to be studied in depth as well as needing to be linked to the findings of project 1b, project 3 (L3) and to project 5. This work is scheduled to be done in Summer 2005.

Project 3 (former L3): Implicit Perspectives underlying Psychoanalytic Education (Jointly chaired by Mary Target, Ursula von Goldacker and Joan Schachter )

The aim of this most in-depth level of study isto investigate the underlying principles guiding the work and judgments of experienced training analysts, together with the personal meanings of this work to the central figures in the training systems. The conviction behind? initiating this kind of project was that the nearest thing to a psychoanalytic way to understand these phenomena would be to try to discover what psychoanalysis training meant, intellectually but also emotionally, to those who shape and maintain it.

The approach to this study was built on the findings in the review of the literature on training that has strongly indicated that psychoanalysis training is distorted as an educational process by what seems to be intense irrational (probably unconscious) and group factors in institutes, which seem to produce remarkably similar unintended consequences the world over.

Following this idea, formal research interviews have been carried out by a psychoanalyst researcher. The methodology[3] was designed to elicit the underlying principles guiding the work and judgements of experienced training analysts, through asking them to talk about detailed examples of practice, more than by asking them to describe the principles directly. The group of interviews of the pilot study included three senior training analysts from each of two societies, and two from a third training organisation.

So far this project has gone through a pilot phase. The results of this have been studied and reviewed before a further set of interviews is carried out across a wider range of institutes.