To Three or Not to Three: That is Not the Question
Written by: David Jachim
A controversial psychoanalytic training relic regarding the adequate (or required) frequency of analytic sessions has recently been exhumed, culminating in the International Psychoanalytical Association (IPA) making a policy change in its recommendation to component societies. This change gives each society the individual prerogative of establishing a three session minimum and a five session maximum per week for psychoanalytic training. This change (not the first of its kind in psychoanalytic history) has fueled tensions between various sections of the international psychoanalytic community and the steam that this movement has created is not yet run out.
To understand the tenacity of this continued steaming one needs to consider several factors. First we start with Freud who never endorsed a mandate of four or five sessions but realized that three sessions were perfectly fine for many people. It was only for more disturbed patients that he felt a higher frequency was necessary. For various historical reasons (e.g. American models vs. European models) that go beyond the scope of this essay Freud’s flexible thinking in this regard was lost and a higher frequency became concretized, creating an analytic moat that, for some, could not be crossed.
Second, the defense of high frequency philosophy has been supported by some legitimate clinical concerns regarding the potential re-hardening of defenses (e.g. “Monday Crust”, “thread loss”) that can occur between widely spaced, infrequent sessions. Others, like Kernberg (2001), even warned of a “slippery slope” of decreasing traditional frequency (“If three then why not two or one?”). In addition, there is perhaps the less often mentioned and less conscious fear for some analysts regarding the economic loss in a reduced frequency scenario. READ FULL ARTICLE.