Variations in the Eitingon Training Model


Questions and comments such as the following promise an interesting discussion:

  • “Does the  Eitingon model lead to an enlightening and liberating education, or, by totalizing one's experience, to indoctrination and a closed mind?”
  • “In North America (probably in Europe and Latin America too) some institutes that formally adhere to the Eitingon Model don’t use a Training Analyst system and others allow three times a week training cases”
  • “The debate concerns once more the status of Training Analysis (including the Training Supervision Cases) and the proposal to extend the possibility for each Full Member to conduct analysis for potential future candidates”


To participate in the debate, please log-in first to the website. Then, to add your comment, click the link 'reply'.

          
                 

       
Posted March 31, 2015 by Ms. Rhoda Bawdekar


This Round Table on “Variations on the Eitingon Training  Model” offers us all an opportunity to learn more about the most common training model in the IPA and about how it is implemented throughout the IPA world.  For many of us it has not been clear that there are in fact variations on the Eitingon model. We know that as of 2006 there is a French model and a Uruguayan model – though the details of these other models are for many members shrouded in imaginings. This gathering of discussants from all three regions of the IPA will familiarize us with the variations on Eitingon and allow us to consider how we can improve upon our own versions of Eitingon.

Max Eitingon (1881-1943) was known as a quiet behind the scenes diplomat of the early psychoanalytic world. He was fiercely devoted to Freud, a founder and benefactor of the Berlin Polyclinic in 1920, and an early affirmer of the requirement that all analysts must be analyzed. According to Abraham he was the “driving force” behind the establishment of the Berlin Training Commission which established the tripartite essentials of psychoanalytic training that are in place today – training analysis, theoretical instruction and treatment of analysands under supervision.

There are many particulars that need to be fleshed out regarding the variations on Eitingon.

Some of these include-

What frequency is required both for one’s training/personal analysis and in one’s work with control cases as an analytic candidate.

If a candidate has two cases at 4-5 times weekly, can a third and fourth cases be seen with supervision three times weekly?

What is the nature of the Eitingon variations that institutes apply throughout the IPA world?  

What are the differing requirements to become a training analyst and how are they instituted variously around the world.

What can we learn from the fact that outside of APsaA there is seemingly no requirement to have a supervised training experience analyzing both male and female analysands.

Our discussants are -

Europe:

Madeleine Bachner, Swedish Psychoanalytical Association (SPAF)

Marta Badoni, Italian Psychoanalytic Society (SPI)

Angelika Staehle, German Psychoanalytic Society (DPV)

 

Latin America:
Roosevelt Cassorla, Brazilian Psychoanalytic Society (SBPSP)

Maria Cristina Fulco, Uruguayan Psychoanalytic Association (APU)

Jorge Lievano, Colombian Psychoanalytic Society (APC)

 

North America:
William Glover, San Francisco Centre for Psychoanalysis (APsaA)

Robert Paul, Emory University Psychoanalytic Institute (APsaA),

Rose Vasta, Canadian Psychoanalytic Society (CPS)

 

Our discussants provide us with a rich variety of meditations on the Eitingon model as they represent all three regions of the IPA world. A sampling of their considerations include -

Some consider that  institutional structures such as Eitingon serve a paternal function, a 'third space', separating the supervisee from their supervisor/institute. It is stressed that this function must be libidinally endowed in order for it to inspire respect rather than mere compliance.

Regulations that are commonly attributed to the IPA turn out in fact to be the prerogative of the local institute. What factors lead to this "projection of the superego" and how do we balance the need for local autonomy with the need for professional consensus?

How should training analyses that are much longer today than they were in the 1920s accommodate to the greater mobility in lifestyles of patients and candidates? How do we make training more portable without requiring stricter IPA regulations?

Are there operational differences among institutes who see their function as "teaching" psychoanalysis versus "transmitting" psychoanalysis.

What are the variety of methods by which institutes fulfill the IPA requirement that TA appointment requires "a presentation of detailed, in-depth clinical material as evidence of the quality of work."

Are there unique aspects to training analyses that require additional vetting of graduate analysts? Are we unable to be sufficiently confident that our graduates are competent to analyze all patients including candidates?

Reading through all these contributions, I am struck by the common challenges that we all face throughout the psychoanalytic world. While acknowledging our cultural differences it is clear that in sharing many of the same difficulties and opportunities in 2015 psychoanalytic education that we also share the possibility of deep collaboration.

I look forward to our online conversations.

Harvey Schwartz



We are excited to announce the new debate on Variations in the Eitingon Model. In anticipation of the upcoming Boston Pre-Congress and Congress, the Website Editorial Board and the Education and Oversight Committee have joined together to begin a discussion on topics in psychoanalytic education that is of interest to the analytic community. This is now the second joint venture. We invited this time 9 participants representing the three regions, Europe, North America and South America to an online roundtable discussion. The debate will be chaired by Harvey Schwarz (APsaA). 


Each participant outlines his view on Variation of the Eitingon Model via a position paper.

Following their initial statements, the panel will continue to discuss this important topic. We invite IPA members, and candidates to join the conversation by replying to the statements anytime they wish during the debate.

The debate will be running from April-June 2015.


Hanna Ratjen
Robin Deutsch



17 Replies
A History of the Eitingon Model
Posted April 7, 2015 by Daniel Traub-Werner, M.D.
In Prague (2013) the E&O Committee planned a series of presentations to the Directors of Training Meeting. The following Introduction to the Eitingon Model was one of the E&O Committee presentations and is hereby reprinted as a "comment" to add to the current debate. E&O Committee: DIRECTORS OF TRAINING MEETING, Prague 2013. EITINGON INTRODUCTION by Daniel Traub-Werner (Toronto, Canada) In today’s presentation, I will briefly review the History of the Eitingon Model, outline its salient objectives, share some difficulties the Model faces and summarize its principles as outlined in the Procedural Code. In 1914 Europe came to a standstill. The Great War touched the lives of all people. Loss and devastation, death and disability, trauma and post-traumatic stress disorder made it urgent for the survivors, and their families, to obtain treatment. This became an opportunity for psychoanalysis. Freud (1915) understood the war and its effects when he wrote “Thoughts for the Times of War and Death” (SE 14:273-288) and “Introduction to Psychoanalysis and the War Neurosis” (1919) (SE 17:205-215) In the opening address to the September 1918 Budapest Congress, Freud delivered ” Lines of Advance in Psych-Analytic Therapy” ( SE 17:158-168) where he outlined the need for treatment accessible to the population at large, with little or no payment. Freud’s address inspired Eitingon and Simmel to found in 1920 The Berlin Psycho-Analytical Policlinic, also known as the Berlin Free Clinics. Melanie Klein, Karen Horney, Franz Alexander, amongst others, became active participants in the delivery of treatment at the Clinic (M. Eitingon 1923: Bul. Int. Pschoanal. Assn. 4: 254-269). What about Training? Psychoanalytic Training in EU and in NA started around 1918-1919 with Sandor Ferenczi in Budapest and, the Menninger Clinic and the Austin Riggs Centre in NA (Young-Bruehl and Dunbar 2009: One hundred Years of Psychoanalysis A Timeline 1900-2000). Freud (1923), never one to mince his words, wrote: “Institutes such as the Berlin Policlinic are also alone in a position to overcome the difficulties which otherwise stand in the way of thorough instruction in psycho-analysis. They make possible the education of a considerable number of trained analysts, whose activity must be regarded as the sole possible protection against injury to patients by ignorant and unqualified persons, whether they are laymen or qualified doctors.” (“Preface to Max Eitingon’s Report on the Berlin Psychoanalytical Policlinic” SE 19:285) Hans Sachs was the first Training Analyst at the Berlin Clinic. The instruction of psychoanalysis consisted of a three pronged approach composed of the personal analysis conducted by a Training Analyst followed by theoretical instruction and the treatment of cases under close supervision. Psychoanalysis and psychoanalytic training expanded and flourished throughout the 20th century. In 1999 several LA Societies requested from the IPA increased autonomy and flexibility in Training Standards including lesser frequency. Following this request, the IPA created the Education Committee chaired by Sara Zac de Filc (2001). In a 2002 memorandum On Education the Committee wrote that the question of frequency, as requested by the LA Societies, could not be considered separately from a re-examination and re-evaluation of Training as a whole and called for the creation of Pluralism in Training. In 2006 the Education Committee under the leadership of its Chair: Shmuel Erlich, recommended the adoption of Three Models of Training. The underlying principles to be established were as follows: a. A rationale for each Model of Training. b. A philosophy of the Model. c. To outline the Psychoanalytic Process underlying the educational rationale behind each of the models. d. To establish the Breadth and Depth of the Model. e. And, last but not least, the issues of Authority and Power had to be addressed for each. The Eitingon Model of Training, like the French and the Uruguayan, is based on the three mainstays of Training: The personal analysis, the supervisions and, the seminars. From a comparative perspective, I am privileged to live and work in Canada. The Canadian Society is the only IPA Society that, by virtue of its multi-cultural nature, was granted the authority to provide training in Two separate Models (Eitingon and French); all other Societies conform to One Model without hybridization. In Canada, the Training Committee of the Canadian Psychoanalytic Society meets twice a year; its composition is made of representatives from the French and Eitingon Models. The French Model is practiced in the French speaking branches and the Eitingon Model is practiced in the English speaking branches. The meetings of the Training Committee are a learning experience for all of us because, as much as we think we are familiar with both models, in our meetings and in our discussions, we inevitably encounter facts about the differences in the Models we either didn’t know or, we didn’t remember. I will give a brief example. Recently, one of the branches inadvertently brought forward for graduation a candidate who had all its control cases with patients of the same gender, this caused confusion amongst those of us present at the meeting. A quick reference to the Procedural Code alerted us to the forgotten fact that Eitingon calls for pluralism of gender while the French model does not. The question for us today is whether, the Eitingon Model, continues to be useful for the training of candidates. To this effect, I will briefly review its salient components: 1. The Eitingon Model calls for specific criteria for Admission and Admission Procedures. 2. The frequency of the Personal Analysis must be 4 to 5 times per week. 3. The outcome of the personal analysis of the candidate should include, amongst other desired qualities, the capacity for an Observing-Ego capable of ongoing Self-Analysis. 4. The Training Analyst responsible for the personal analysis must be non-reporting and the analysis continues throughout the majority of the training period. 5. Readiness for Control is the responsibility of the Education Committee. 6. The Eitingon Model calls for two Control Cases of different gender, seen at a frequency of four or five times per week throughout the analysis. 7. The Supervision of the control cases must be conducted by a Supervisory Analyst at a frequency of once a week, for a period of no less than 150 hours. 8. The didactic component of the training requires no less than 450 hours of lectures or seminars conducted over a period of four to five years. The seminars should include Theory, Technique, Psychopathology, Development, Continuous Case Seminars and Electives. The Qualifying Criteria in the Eitingon Model are as follows: a. To have successfully completed no less than 450 hours of course work. b. At least 150 hours of supervision, of at least 2 cases in analysis at a frequency of no less than four times per week. c. The reports from the supervisors must attest to the competence of the candidate to conduct psychoanalysis. d. All required writing assignments must be completed and found satisfactory. e. All financial obligations to the Institute discharged. f. And, last but not least, Membership in the local Society is open to all colleagues who have graduated and have no legal or ethical complaints against them. The questions that my colleagues in the Training Committee, the Progression Committee and the Curriculum Committee continue to ask are as follows: 1. Under Eitingon, are we providing the necessary training for candidates to become psychoanalysts who, at a future date, will themselves be responsible for the transmission of knowledge? 2. Does Eitingon prepare the candidates to switch the thinking they arrive with into psychoanalytic process thought? In our opinion and, in our experience, the switch in thought process is neither an easy nor a smooth transition; this view is shared by most analysts responsible for Training. Generally speaking, two distinct groups of candidates apply for Training. On the one hand we have medical doctors, psychiatrists, psychologists and social workers. They arrive with clinical experience and years of professional practice. Their model of thought is mostly causal, in the scientific tradition of Claude Bernard and in the philosophical traditions of Aristotle and Descartes. On the other hand, applicants for training come from the Humanities and Social Sciences at the doctoral level; they teach Literature, Philosophy, History, Sociology, Epistemology, Environmental Studies and/or Education. The above applicants are bright and enthusiastic and, their demographic cohort is younger than the ones coming from the helping professions. Most of them are familiar with Freudian Thought and/or Object Relations Theory, with Bion and/or Lacan; their perspective is an academic one and, most lack clinical experience. Their hermeneutic interpreting is, for the most part, Post-Structural in the traditions of Foucault, Derrida and Kristeva, amongst others. Some of the applicants had years of personal analysis before making the decision to become Psychoanalysts. As Directors of Training our challenge is to provide a Training Model that will help candidates transform their thinking from, either a cause-and-effect Cartesian Scientific Model or, from a Post-Structural Model, into a Psychoanalytic Multi-Layered Process Thinking that accounts for Transference, Counter-Transference, Primary and Secondary Process, the Unconscious and the Psychoanalytic Process as a process in its own right. One of my colleagues remarked that we teach psychoanalysis but, we do NOT graduate psychoanalysts; some will become psychoanalysts, others will not. I share the opinion of those who believe that becoming a psychoanalyst is a lifelong learning endeavour, a continuous and never ending development, where the end is the process in itself, the process of living and thinking psychoanalytically. With this I conclude my presentation. I briefly reviewed the history of the Eitingon Model, its objectives and, its challenges. I summarized its principles and its practices as outlined in the IPA Procedural Code. Respectfully submitted, Daniel Traub-Werner (Past) Member, E&O Committee Canadian Psychoanalytic Society Prague 2013
Eitingon Variations
Posted April 12, 2015 by Dr. Harvey J. Schwartz
Dr. Traub-Werner has helpfully outlined the principles of the Eitingon model. Yet, we know that there are indeed variations to the model that are practiced throughout the IPA world. There is controversy about whether or not cases of both genders are required for graduation. There are many different ways that vetting of prospective TA's clinical work is carried out. There are experiments in Skype/phone analysis and supervision that are taking place. It would be a shame if colleagues felt they were doing something 'wrong' in adopting these variations and as a result felt inhibited in sharing their experiences more widely. We do need to learn from each other and that includes learning from our creative solutions to our common challenges. Harvey Schwartz
Adalberto Perrotta
Posted April 14, 2015 by Ms. Rhoda Bawdekar
1) Me formé en el modelo Eitingon hace más de 60 años y, visto desde aqui, me parece que tiene muchas falencias. 2) Mi formación supuso cinco sesiones semanales 11 meses al año, con diferentes analistas lo largo de muchos,muchos años.Fueron cuatro hombres y una mujer.El mejor fue el último, kleiniano pero creo que mejor por sus condiciones personales. 3) No estoy de acuerdo con ciertos modelos laxos actuales, sobre todo con los lacanianos. Tampoco con análisis de conveniencias, para poder hacer la formación, análisis que duran sólo el tiempo exigido por los Institutos. 4) Creo que la formación debe iluminar la mente, no condicionarla - como decía Franck Lloyd Wright - pero los Institutos tienen demasiada política interna, de manera que los profesores elegidos son aquellos que permiten que los alumnos "pasen" por los seminarios. 5) La formación, en general,peca de teórica,los alumnos egresan eruditos en teoría psicoanalítica -generalmente de una sola opinión, sobre todo los lacanianos - y además de desconocer otros pensamientos psicoanalíticos desconocen el contexto científico en el que comenzó el psicoanálisis y en el que se desarrolló durante un siglo.Por ejemplo, los psicoanalistas ignoran -casi como un rasgo de valor - los desarrollos de la física cuántica, los cambios metodológicos y, sobre todo, ignoran lo elemental de la clínica médica. 6) En mi época era necesario ser médico y, en mi caso, los muchos años de práctica clínica me han salvado de psicoanalizar un tumor cerebral confundiéndolo con una psicosis. Todas estas críticas ya fueron hechas públicas por mi desde hace muchos años y parte de ellas están en mi libro Contratransferencia y Regresión, Un modelo científico no tradicional aplicado a la clínica psicoanalítica. Gracias por hacer la encuesta, el psicoanálisis en LatinoAmérica es un caos y tiene un bajísimo nivel cientifico. Adalberto Perrotta,
Posted for Valeria Clark
Posted April 25, 2015 by Dr. Robin A. Deutsch
This debate has shown great differences in the way our colleagues relate to the Eitingon model. As we have nine contributors, three from each IPA region, we can notice that even in the same region there seem not to exist a common ground. Some members see as “deviations” the variations of the model, which take into consideration local, cultural and historical diversities. A model is, by definition, a prototype, and as such does not imply that it may not evolve and improve in the process. Indeed, there is always a risk of an “anything goes” situation and the recognition of the coherence of the three models of training by IPA was a measure that considered that fact by rejecting hybrid models. Jorge Lieviano disagrees that different models of training should be accepted and believes it leads to chaos. Tough I respect his opinion, I think that the acceptance of the three models was just an acknowledging of a situation that was already present, but had not been yet discussed openly. In that sense, it was not that IPA decided to accept the three different models; it was actually the regulation of a reality in order to guard a certain standard of requirements. Several colleagues in the debate mentioned the crucial aspect of confidentiality and of leaving the personal analysis as an endeavor solely between analyst-patient, without the interference of the institution. I strongly support the non-reporting policy. At the same time, I believe in the need of a therapeutic analysis for those who are in training. That leads to an issue that has been seldom mentioned in the discussions about training: The emphasis on the need of analysis for those who wish to become psychoanalysts. Here I am not concerned about the possible psychological stress imposed by the seminars and by the conduction of the control cases. I am talking about what draws all of us to follow a career in the treatment of psychic conditions: first of all, the wish to deal with our own personal issues and psychic distress. It is evident that as the training goes along there will be an extra burden of psychological stress on the candidate. In the first place, however, the wish to become a psychoanalyst comes along with the wish to “heal “ourselves! Angelika Staehle said that she believes…,”each individual in the IPA thinks in some ways that the model in which he was trained…is the best one…” This is probably true for her, but at this point, having read the other contributions, she might think otherwise. There seems to be an opposite phenomenon taking place: some members have deep criticisms about their training and the way their personal analysis was conducted. Some blame the model of training for the decrease in the number of candidates searching for training. It is not in the scope of this debate, but that is truly the main concern of many institutes in the world, i.e the future of their institutions and the future of psychoanalysis. Here goes my suggestion for the next debate. Last, but not least, and on a happy note: Madeleine Bachner mentioned that in Sweden, after ten years of discussions, the two societies decided to merge. Some of us can discuss and find a way to celebrate an agreement, even if is after ten years! Voilà! Valéria Clark Nunes Brazilian Psychoanalytic Society of Rio de Janeiro
The paternal function
Posted April 26, 2015 by Mrs. Jane S. Hall
I agree with Bill Glover as to the idea of presenting work to others. It was Hans Loewald in his paper Ego and Reality where he spoke of the father as helping the child separate from the mother. This is important but I think Bill's use of the phrase paternal function is problematic and casts an oedipal tone. Presenting one's work to others is an adult process. At CFS we invite the graduate analyst who has met the IPA criteria for TA, to present work to a committee of her/his choice. This is not an evaluation exercise but an opportunity to exchange thinking. It is not a rite of passage but an invitation to speak in one's own voice, a sure sign of maturity. Our TA selection process has been successful. See http://internationalpsychoanalysis.net/2011/11/08/on-becoming-a-training-analyst/ Sincerely, Jane Hall Janehallpsychotherapy.com
What's New On The Web: How were you trained?What's New On The Web: How were you trained?
Posted May 14, 2015 by Dr. med. Hanna Ratjen
Thank you for your request. I am happy to let you know that I was trained first with a training in Florence of 4 years which requested a personal training with 2 sessions a week and one group analysis plus theory lessons. Then I attended a six year training course for qualifying as a psychoanalyst for children, adolescents and parents . I trained with Tavistock model courses in Italy . This training is composed of 2 years “Observation course in psychoanalytic Observational studies” and 4 years of clinical course . The request for being admitted to the Clinical course is to have completed the “ 2 Years observation Course” with the presentation of 5 papers :2 theory papers, one on the "Infant observation" ( completed after 2 years of weekly sessions of an infant and mother or somebody taking care of the baby ) ,one of "Young child observation” (after one year of weekly observations of a child from 2 to 5 years of age ) and a paper on “work discussion” ( about the work presented in supervision in seminars ) . - For attending the four clinical courses the student needs to have started a personal analysis with an IPA analyst 4 sessions a week at least 6 months before , - Then there are seminars for clinical group discussions about psychotherapies with children and parents (15 weekends every year) - 3 psychoanalysis, three or four sessions every week (one of a young child - 0-5-, one of a latency child and one of an adolescent ) with weekly supervisions. - theory discussions seminars. At the end the student should present a detailed dissertation on one of the three psychoanalysis and two shorter dissertations on the other two cases . I find my training very complete: theory is discussed with the help of clinical experiences . Always at your disposal for any question you might like to ask, all the best dott.ssa Maria Paola Martelli Viale Trenta Aprile , 10 Rome , 00153 Rome Italian psychoanalytic society
Eitingon model
Posted May 18, 2015 by Dr. Robert A. Paul
I would be interested in further discussion of how people feel about three-day-a week cases. Many of the faculty members at our institute do not qualify for the immersion requirements to become TA's under the US version of the Eitingon model, but would be eligible if it were possible for one or more cases at 3x were allowed. This is not due to a lack of effort on their part: it reflects the market and current realities about patients' availability, financial resources, etc.. How do people feel about this matter? Robert Paul Atlanta, GA
Three times weekly
Posted May 19, 2015 by Dr. Harvey J. Schwartz
I think it's time to take up Robert Paul's query and consider allowing APSaA candidates third case to be a three times weekly case under supervision. Much to discuss about it. Harvey Schwartz
Variations in the Eitingon Model Training Model
Posted May 19, 2015 by Dr. med. Hanna Ratjen
Dear Rose Let me try to address some of your ideas in the Introduction, that you made initially, to beguin the Debate about the Eitingon Model of Training. First of all, your report about the current psychoanalytical Canadian Organization and the multiple challenges that you face, given the enormity of Canada and the extensive territories where psychoanalysis has limited opportunity to have access to the isolated population there, makes one become vividly aware of how that reality affects your country and so many others, similar to yours, be that Argentina, Brazil, Russia, etc. Indeed, it also portrays the obvious difficulty to train candidates from such remote areas, more so considering the limited number of training analysts available to provide the Training and personal analysis for potential candidates, who live at a distance from the large cities, be that Montreal, Toronto, Vancouver , or Ottawa, where most of those analysts concentrate. Additionally, you point to the rigid regulations governing the training of new psychoanalysts, thus, making it difficult to promote the growth of psychoanalysis. Perhaps, one must ask, which is the ideal set of regulations, to that effect , that could promote quality of psychoanalytic care and training, without being so flexible and laxed that it defeats the propose and the standards that psychoanalysis, be that training , teaching, or treatment, requieres as a minimum best ?. In my mind and experience, the Eitingon Model of training offers many positive points, particularly it´s tripartite method of training. Yet, by no means, it is perfect and as such, it can be improved, which is the main goal of our debate and for the recommendations that may come out of this democratic Forum .However, the IPA, has succeeded to have most institutes in the world follow their guidelines, while offering enough autonomy for each Institute to organize itself. Unfortunately, as you almost accidentally found out, the myths that go along with any large organization,as IPA, creates fictions, obviously not based in reality, but in popular believes, which to your surprise, you found out were not the criteria of IPA,but obeyed to other reazons, or entities, such as the CIP. Indeed, as you so courageously acknowledged, you found the hard way, in fact surprised and sad, yet liberated, that as you so recognized realized : "that we had been guilty of splitting off our institutional ´superego´and projecting it into IPA." " In that way ,we were not really taking full responsibility for our own sometimes harsh and arbitrary behaviors toward candidates,attributing them instead to the immutable ´rules´set up by our governing body." You followed such acknowledgement with several meaningful examples , whereby for many years, you followed, in good faith, a so called rule , that in effect it turn out to be merely a myth, (i.e., when the believe was that the candidate must conduct three analyses with at least one patient being a male and one being a female.As you were again surprised, you found directly"from The Education and Oversight Committee of the IPA, that they had no such regulation and that such rules are strictly a matter of local policy!!!" To me, such a poignant example indicates, perhaps, a traditional isolation of the IPA and it´s committees, with the membership at large , as well as with the institutes themselves , so that a manual of regulations has not been made available -and/or, is not regularly updated and debated, to be of common knowledge to each one concern, so as to avoid such avoidable mistakes, based in fictions , or as I call them myths,not founded in reality. You also pointed out another example of a "problematic rule", namely, " the one that requieres the potential candidate to be in analysis withan IPA approved TA at the time of beginning the program ,(of training.) You added, that it posses a conflict for excellent potential candidates who have a succesful ongoing analysis with a well known analyst, who is not a T.A.,thus, causing the candidate to renounce to the idea of entering in an analytic institute for training . As you so stated: "The institute in that case , finds itself taking part in a particular cruel disruption of psychoanalytic attachment, in the name of education." An important issue to discuss in our debate is the increasing voices from the membership and from different institutes, questioning the regulations regarding TA´s and the requirement for candidates to only be analysed by a TA, if she, or he, wants to be trained as a candidate in an IPA sponsored Institute . Likewise, the debate regarding the number of analytic sessions that the candidate must have as a minimun with his ,or her, analyst, how many sessions the candidate must have per week with each of his/her patients and for how long, are all matters that requiere further debate, as well.! Obviously, the world have changed a great deal since S. Freud and Eitingon - and the contemporary challenges and realities that no doubt, we must face, for our own survival, demand our immediate attention and as Hartman, so well indicated ,requieres our adaptation to it, as well. The great shortage of analysts and of TA´s world wide are realities we must not deny , belittle, or rationalize.One certain reality, is that most of us TA´s are not too far from an advanced age ,or senility. Therefore, Rose, as you so well put it by the end of your introduction remarks, IPA and CIP (as well as the CPS, that is, the Canadian Psychoanalytic Society) "have rather unique challenges, due to its very large geographical boundaries and specific societal values." Thank you very much for sharing with all of us the current state of affairs of psychoanalysis in Canada.As I felt free to comment about your initial contribution, I hope that you feel free to do the same, regarding my contributions to the Debate. Best regards, Jorge Enrique Liévano. R., M.D. [email protected] Bogotá, D.C. May 18, 2.015
Variation in the Eitingon Training Model
Posted May 19, 2015 by Dr. med. Hanna Ratjen
Dear Robert : First of all, let me indicate to you that I enjoyed your introductory comments, in particular about your Socratic-Freudian method of questioning, one thing , or another.Thus, provoking in us, your readers, more possible answers and plenty more of questions, some of which perhaps have no specific replies, but requiere idiosyncratic thinking to figure out whichever adaptative solutions apply, or not, to our individual selves and institutes-training programs-universities, associations, etc .You certainly, as a good anthropologist, just like S.Freud , dig and dig,"layer by layer, as if peeling an onion." I too, received the benefits of Emory, early on, when I did my intership at Crawford Long Memorial Hospital of Emory University. You shared with us an anecdote of a female colleague attending a meeting of anthropologists and challenging your enthusiasm, when she wondered if the " multi-faceted and rich training in Psychoanalysis, that you shared with the audience then, it was in fact a form of brain washing." Although, at that time you mumbled some "insufficient answer," you proceded to state that "the question still stands":"does the Eitingon Model lead to an enlightening and liberating education, or by totalizing ones experience, to indoctrination and a closed mind.? The reply to such question is partially replied by your next reference to the article by Michael Schroeter (2.002) , regarding the origins of "International Standards for Psychoanalytic Training," "a process chaired by Max Eitingon, a central concern then,(the mid 1.920´s)as it is now, is the question of the degree to which local institutes may set their own standards and chart their own course depending on local conditions, and to what extent they should be required, or at least expected, to conform to a centrally established model, such as the ones endorsed by the IPA (and/ or by APsaA in the case of the United States" You then go to argue about the advantages of centralization,- and of the disadvantages "of not having some form of uniformed control,for it may lead over time to such wide variation and perhaps also a decline in adherence to fundamental psychoanalytic precepts that the result will be anarchy, or anything goes, as long as one calls it analysis." You then counter-argued about the different nature of countries, continents and cities -cultures, universities, candidates and institutes-universities, that vary considerably regarding sizes, needs, etc, and therefore, you so indicate, that "there can not be ´one size fits all.´ " Indeed, the obvious is thereby represented.It may bring possible dilemas ,potential conflicts,or solutions.Exactly, the same issues apply to an organization, with a centralized directionship, or an autonomous one, as the decentralized way in which states are run in USA. Yet, for a team to work well, that is, to be more effective, requieres an equilibrium of check and balances, of compromises and the spirit of a ´diversified unity,"ligated not by dictatorial or slavery power or control,but by common interests, under the umbrella of one organizer, regardless of wether we call it IPA, APsaP, or in the personal, an EGO structure, a benevolent mediator so to speak, that applies not just to the individual ,but extrapolating the principle, to a given institute-training program, etc. Yet, much like it happens with a democratic governamental organization,the idea is to balance out the tripartite forces, wether coming from the executive, the legislative, or the judicial entities, or from the judicial one, which by paralellism in what pretends to the individual, as it relates to the pulsions from the ID, the compromiser and stabilizer-defensive effects, as examples, of the EGO ,or the inhibitory and guilt promoting demands, amongst others, from the SUPEREGO-EGO-IDEAL. The obvious conflict arises whenever the directive body goes to, or operates at extremes,such as literally turning into a rigid set of religious-like principles,infantilizing the candidates,or on the other hand operating in such a permissive fashion,that in either of those two polarities,become chaos.Therefore, requiring at least the organizing assistance of an structured entity, be that IPA or any equivalent one. Then , in a round trip, we go back to our Debate. What is that we may recommend for IPA to consider in terms of desirables modifications, or adaptations, that will be in the best interest of most concern ? By the end of your report, you mentioned the issues related to "portability"of training and "mobility " of the candidates and also about the unnecessary delays to initiate training,expecting that candidates for training will postpon their plans, in other words, that they will flex their lives to meet our sttuborn,if not rigid regulations, hardly making waivers for those who so requiere. Finally , you made some questions regarding which is "the purpose of the "training analysis.?" Also, about wether or not, as EUPI, the idea regarding "reporting" being only to report the beginning and termination dates by the analyst to the institute. Even then, some question doing so. Again, the question is, what is best about it, for most? You did not enter into questioning the regulations regarding TA´s; those too, must be addressed by our debate. Thank you again for your valuable contribution. Feel free to comment on mine. Best wishes, Jorge Enrique Liévano R., M.D. [email protected] Bogotá, D.C. May 19,2.015
Reply to Dr. Lievano
Posted May 20, 2015 by Dr. Rose A. Vasta
Dear Dr. Lievano, Thank you so much for responding to my contribution to the debate on changes to the Eitingon model. It is notable that there has been so little response overall to the debate and I wonder if this has to do with a general reluctance to be seen as questioning the authority of the IPA and the model in which so many of us were trained. I, for one, am very proud of my membership in the IPA and I view that membership as something that brings with it a number of responsibilities. One of those responsibilities has to do with keeping the profession of psychoanalysis healthy and relevant for the next generation of practitioners. Whatever changes we agree to make to the training model must ensure that the model will continue to honour the psychoanalytic process and the circumstances in which that process can flourish. If our governing body, the IPA and its training models, are idealized by its membership to the point that they are experienced as estranged from practical concerns, then the members themselves must question why that has been allowed to happen. Why do we have a need in our respective countries to feel we are held to a set of regulations that in their perceived rigidity may be stifling the very future of our profession? This does not sound like a healthy approach to take. Part of the difficulty in discussing changes to the Eitingon model stems from a need to more clearly define the various problems. There are issues that have to do with the candidates, their analyses and the cases they treat, as well as problems that have to do with the duties of training and supervising psychoanalysts (TA’s). Both these areas, those that affect the candidates and those that affect the TA’s, require attention, but they are not the same and cannot be confused. One of the great difficulties we have in Canada is the aging of our TA population. Graduate analysts are not stepping forward to apply as the criteria is often said to be too difficult to meet. Many graduate analysts state they do not have enough four times a week analyses in their practices to qualify. In addition, the preparation of a Membership Paper, the approach that most of our component institutes in Canada use to appraise the psychoanalytic thinking of the potential TA, is intimidating for many otherwise qualified graduate psychoanalysts. Is the solution to reduce the qualifications necessary to apply to be a TA or is the solution to reduce the need for TA’s by allowing analyses of candidates to be done by graduate analysts who are not yet TA’s? It appears that the IPA gives great latitude to the individual institutes to determine the selection of TA’s. Yet so many of our institutes suffer from the lack of TA manpower. I, personally, think that the scarcity of TA’s is the most pressing problem for the Canadian Institute of Psychoanalysis (CIP) at this time. I am not alone in this opinion as this is a problem that we in the CIP are currently studying and hope to resolve. Once again, thank you for your response to my earlier paper. I hope I have helped clarify my point of view and perhaps opened up some additional areas for discussion. Warm regards, Rose Vasta, PhD Director - Vancouver Institute of Psychoanalysis
Eitington variations - further thoughts
Posted May 24, 2015 by Dr. William C. Glover
Eitington Variations – Further thoughts: • Eitington’s biography – In his initial contribution Jorge Liévano reports that Max Eitington was quite possibly a Soviet agent implicated in dark intrigues. What should we make of this? For me it doesn’t detract from the usefulness of the model but does remind me not to idealize the man or the model that bears his name. • Adherence to one model? - Maria Fulco asks ‘what is not negotiable… when we consider transmission in psychoanalysis’. For me what is essential are the three pillars of psychoanalytic training - personal analysis, theoretical instruction, and supervised cases - not adherence to a specific model. It was a positive step for the IPA to officially recognize that training can be valid even if these pillars are arranged differently than in the traditional Eitington model. The provision that an institute must adhere to one model, however, may have been designed to gain political support for the compromise by isolating the more controversial variations of the new models; particularly 3x/week analysis, requiring analysis during training, and loosening of requirements for Training Analyst eligibility. No established institute is likely to entirely switch models. They do, however, evolve in adaptation to their circumstances and, as we see, variations abound, including the more controversial ones. Instead of adherence to one of the three approved ‘models’ perhaps each institute could be expected to maintain its own internal consistency and adherence to the three universally accepted pillars of training. This would be a more realistic basis on which the IPA Education & Oversight Committee could exercise its function by “Promoting a process of self-reflection about one’s educational practices in the presence of a third.” • Transmission – Training. Maria also asks if transmission and training are a ‘dialectical couple or contrasting concepts’. I think dialectical couple. Our challenge is to maintain a dynamic balance between them and between maintaining standards and embracing creativity. • Paternal function – I wrote earlier that an element of evaluation is needed as a ‘paternal function’ to help the candidate separate from his analyst and supervisors. A number of colleagues have objected to using ‘paternal’ to describe functions that can be fulfilled by either gender and may also be thought of as ‘maternal’. Evaluation as a ‘third’ in training is another way to put it, but I find the term ‘paternal’ useful in that it conveys the libidinal, bodily aspect of psychoanalytic education. Jane Hall feels that using the term ‘paternal function’ in connection with presenting one’s work for TA appointment casts an ‘oedipal tone’ on what is an adult process. I quite like the procedure she describes at her Society where the applicant chooses whom to present his or her work to. But does this provide a sufficient ‘third’? I’m enjoying this debate, appreciate all the contributions, and look forward to further exchange. Bill Glover San Francisco
posted for Marta Badoni
Posted May 26, 2015 by Dr. med. Hanna Ratjen
I would like intervene again starting from Bill Glover’s writing I quote: “ Recognizing three models of training was a creative and positive solution but the fiction of adherence to one unified model of training was replaced with the fiction of adherence to one of the three models”. Three special questions have found evidence in our debate: 1.The importance to guarantee freedom to promote adjustment in training due to local necessity and to specific needs and changes in our world without losing the possibility to compare our work and reflections. Following Glover thinking the IPA should function as a Third and not as an Instance giving rules and judgements. 2. The possibility to permit to younger people to begin their training is a question in evidence in our debate and has found different solutions among the IPA Societies. 3. Appointment and Functions for Training Analyst is a delicate question everywhere. Therefore I’m particularly interested in the passage where Glover talks about this passage as “ moving from a bias-prone vetting procedure for Training Analyst appointment to a developmental process that greatly reduces the role of explicit evaluation”. It would be of great interest to discuss how this developmental process goes on. warm regards Marta Badoni
Analysis in training... or not?
Posted June 18, 2015 by Mrs. Lida Bitrou
Hello all, As someone who has done an analysis before training (with a training analyst) and is doing a second one in training, I must admit that an analysis outside of training doesn’t have many similarities with the one that is done in training. Personally, I think that using the term “training analysis” isn’t such a good idea, not because one doesn’t learn through it (of course one does, like the child learns how to be a parent primarily through his/her own parents) but because it misleads as to the purpose and function of an analysis. For me, psychoanalysis is first and foremost a therapeutic method, so if candidates think that they are doing a “training analysis” then it is very probable that they will feel that they don’t need therapy. And of course they do because there are very few people who don’t and these would probably not be interested in becoming analysts. I often come across candidates (and analysts occasionally) who pathologize their patients while at the same time they seem quite disconnected from the pathological aspects of their own personality. I don’t claim that analysis “cures everything” but doing one before you begin training is good for your narcissism (in the sense that it moderates it). On top of that, I think that becoming an analyst after having an analysis yourself, makes your decision more sound and well-informed. So although I am being trained according to the Eitingon model, I think that the mingling of personal analysis with training is a weak point of this model for the reasons I mentioned and also because I believe that an analysis should be conducted in an atmosphere of freedom of expression and a good deal of independency from external factors, preconditions that I’m afraid are hindered by the context of an institute or a psychoanalytic society. Best regards, Lida Bitrou Candidate at the Hellenic Psychoanalytical Society
variations in TA appointment
Posted June 23, 2015 by Dr. William C. Glover
Marta Badoni asks about the ‘developmental’ model for Training & Supervising Analyst appointment in San Francisco that I mentioned in my last post. In 2008, as part of a reorganization into a psychoanalytic Center, San Francisco changed its appointment process so that becoming a TA would be an achievable career achievement instead of a status of special distinction. Previously TA appointment was a highly selective procedure requiring the standard objective requirements, Certification by APsaA, and two votes by our Education Committee, the first on general suitability, and the second following a rigorous clinical vetting by a sub-committee of TAs. This hierarchical procedure was listed as a major source of discontent in our Strategic Plan of that time. Following a lengthy, comprehensive discussion the EC voted to make our TA appointment process a more welcoming, collegial experience. The idea is that analyzing candidates and supervising their cases are functions that an analyst can develop in the course of their careers. Those of our analyst members who meet the objective criteria and are willing to do the work are welcome to apply. Certification by APsaA is still required, although this may become optional. We added a requirement that applicants participate in two study groups, one on the TA function and the other on supervision. The most distinctive feature of our new process is the clinical presentation. Once the applicant has fulfilled the objective requirements, our Training Analyst Development & Appointment committee appoints an individual sub-committee of 3 TA’s (the applicant is consulted on the selection) who meet with the applicant several times for discussion of their clinical work and what it means to be a TA. These meetings provide the presentation of clinical work specified for TA appointment by the IPA but are collegial discussions not examinations. The individual’s sub-committee informs the Appointment committee when it has completed its work, unless for any reason it feels it cannot do so, in which case the applicant can request a more traditional vetting committee or wait and re-apply after further preparation. Once the sub-committee completes its work the Appointment committee recommends the applicant to the larger Education committee who approve the final appointment. We are pleased with the procedure and it has contributed to improvement in organizational morale. We will continue to refine it as we go forward. The entire procedure can be found as Appendix B of the SFCP PED Policies & Procedures Manual at http://sf-cp.org/sites/default/files/psychoanalytic_training/ The Contemporary Freudian Society’s has a similar process that Jane Hall has mentioned in this debate and is fully described in ‘On Becoming A Training Analyst: Working Through From Group Examination to Self-Evaluation at the New York Freudian Society.’ by Hall, Kramer Richards, Sloate, & Turo. At http://internationalpsychoanalysis.net/wp-content/uploads/2011/11/AttachmentNYFSberlinpaper.pdf These variations in the Eitington model are examples if how psychoanalytic training evolves in dynamic ways balancing standards and authority with innovation and growth. I’ve appreciated the contributions of my colleagues and look forward to continuing discussion in Boston. Best wishes Bill Glover San Francisco
Angelo Battistini Training Analyst of the Italian Psychoanalytical Society
Posted July 2, 2015 by Dr. med. Hanna Ratjen
Angelo Battistini Training Analyst of the Italian Psychoanalytical Society As Full-member of the Italian Psychoanalytical Society, and Training Analyst for 17 years, I have always been interested in issues on training and psychoanalysis transmission, often with an impression of dejà vu: discussions that have regarded the thousand hues of the same topics, with the same captiousness of the most refined “scholasticism” for 70 years. It is an evident sign of the difficulties of facing the change of times. Due to space reasons I shall limit my speech to one single point: the fundamental need to update the Eitington model allowing Psychoanalytic Societies which follow this model to accept personal /training analysis for of at least three sessions a week. The sessions frequency of the analysis, carried out with analysts that the different Societies consider suitable for the task, should be agreed on by the analytic couple, according to the needs of the analytic process. In the same way, candidates would be allowed to carry out supervised analyses at the frequency of at least three sessions a week. In order to endorse the reasons of this request I have to make a few preliminary remarks. -In the first decades of the 19th century, Freud carried out analyses in 6, and eventually 5, sessions a week not because of an ineludible technical problem, but because this method was the best to analyze patients/followers, mostly coming from cities far from Vienna, willing to stay in Vienna for an average of 8/12 months with the only purpose of being analyzed by Freud. In other words, the high session intensity was justified by the short length of the analyses. -When Eitingon, who had carried out a five-week analysis with Freud (more or less the same length of Ferenczi’s analysis), set up the Berlin System of Psychoanalytical Training, he was evidently inspired by Freud’s method and custom. -Yet, in 1913, in “New advice on psychoanalytic technique”, Freud himself maintains that in not serious cases 3 weekly sessions are sufficient. In conclusion: the Eitingon model, as all training models, is historically determined, and it cannot be scientifically claimed that it is possible to offer a valuable training model only by fully adopting all its original criteria. Moreover, regarding the value of a personal/training three-session analyses we should remark that: -Both the French and the Uruguayan models allow three weekly session analyses. -For many years several Psychoanalytic Societies have trained analysts at this frequency, before IPA, after the Second World War, firmly decided to impose standard uniformity. -Currently nearly all analysts (excluding candidates training analyses) carry out three-session analyses successfully, without finding any real difference compared to those at 4 or 5 sessions a week. -The Italian Psychoanalytic Society allowed for ten years, in experimental way, that candidates brought in supervision a 3 session analysis. At the qualification examination no examiner ever remarked meaningful differences compared to the 4 sessions analyses. -At present, in a deeply changed society compared to last century’s, in which there is great mobility in lifestyle, in which many candidates do not have the financial resources, having 4/5 weekly sessions for 6/10 years, in addition to supervision sessions, is no longer affordable to many. With the following consequences: -Many brilliant potential candidates for psychoanalytic training renounce to it. -Among those who undertake it, not a little part includes people with a conformist/dependent attitude, to the detriment of creativity and autonomy. -This training is often undertaken by professionals who can afford it only after several years of working. The result is the gradual ageing of new analysts: the average age of qualification in Italian Psychoanalytical Society is about 47/48 years, the one of Training Analyst is around and beyond 60. -The difficulty in respecting today’s standard leads to remarkable risks of corrupting the setting and the analytic relationship: -analyses that turn into 4 sessions a week after years of gradual approach, starting from psychotherapies in 1 or 2 weekly sessions. -“Budget price” sessions (even 10/20 euro) in order to let the patients meet the costs of the sessions, with counter-transferential consequences and risk that these analyses end abruptly after the two years needed for the training. -Candidates that, exasperated, declare years later that they are having 4 session analyses, deceiving their supervisor and the Society. -Training analysts who certify a higher session frequency than what they actually carried out, etc. Concerning the question that the three models recognized by IPA are to be accepted as a whole as they present (alleged) internal coherence: -it is sufficient to read thoroughly the description of their features to see how these descriptions are actually suited only to an abstract theoretical model, where the differences often arbitrarily emphasize some aspects of analysis which would be valid for any analysis, in any model. Moreover, if we consider important variables which usually are not taken into account (the analyst’s personality and personal style, the specificity of the patient’s pathology, the influences of the analyst’s theoretical background in the age of “many psychoanalysis” etc. etc.) the alleged internal coherence dissolves and what is left is a series of theoretical justifications which look more like rationalizations deriving from wishful thinking rather than from a realistic description of things. In conclusion, if we consider that : -training models are historically/geographically determined. -We cannot establish the superiority of one over the others. -The question of the model’s internal coherence is a myth rather than reality. The French and Uruguayan models are definitely favoured as they allow three weekly session analyses. And if we consider that: -Our society has profoundly changed in the course of a century -The current Eitington model, if not “mitigated”, contributes to the crisis of psychoanalysis, to the gradual ageing of the Societies which adopt it, to the risk of corrupting some aspects of the training -IPA established the three models more out of political/institutional convenience than for scientific reasons I claim that it would be wise and necessary to modify the standards concerning the frequency of sessions, allowing the candidates, as patients and as analysts, to do three weekly session analyses. Lastly, we have to acknowledge that already today, despite the three recognized models, there is a growing variety in their application (for example, regarding the Eitingon model, in the Italian Psychoanalytical Society a candidate is allowed two supervisions with patients of the same gender; training analyses can be carried out also by full-members, without Training Functions ), so that the only possible, realistic common ground about the training model is the one represented by the tripartite model, consisting in a deep personal analysis with qualified IPA analysts, theoretical courses and supervisions with the current standards, respecting the socio-theoretical specificities of the different component societies. I am talking about that common ground that allows analysts of different countries, on the occasion of international confrontation, of discussing fruitfully about clinical psychoanalysis.
On the issue of Eitingon model some considerations are circulating:
Posted July 2, 2015 by Dra. Celmy De A. A. Quilelli Correa
The SBPRJ, through its INSTITUTE of Training, has promoted a JOURNEY on the issues that are circulating in the IPA, through DEBATES section and Educational Directors Commitee coordinated by Fernando Weissman. a - considering the frequency of 4-5 sessions per week, although it is desired to all of us as to allow closer proximity and vision of the analytic process, at the time it is almost unfeasible to maintain it. Our economic and financial issues, the transit inside the city and consequent displacement problems that often make patients expend two hours to reach the offices of their analysts, and many more to return. Those are the most often heard arguments. Moreover we are thinking about keeping the frequency three times per week. b- also the official supervision cases are subject to the same restrictions. It should be considered that even the price of the Social Clinic (R $ 20 to 25 per session, R$ 80-100 to R$100-125 per week and R$ 320-400 to 500-625 monthly by the Brazilian currency would mean an amount nearly the Brazilian minimum wage, which is not a small expense for a middle-class family. c- we are also considering the possibility of training analyses being carried out by IPA’s full members. The average age of current training analysts is quite high. One must consider that many of them are over the age of 75. d- we are concerned in determining the invariance within the Eitingon model number of sessions. Being analyzed throughout the training by the training analysts is it a common ground? e - considering the continental dimensions of Brazil, we are discussing to import the model designed for IPA for the societies of Eastern Europe, to create new nuclei: analysis by Skype, with number of personal sessions from time to time, etc. . All these issues listed above have emerged from meetings that have advisory characteristic, only to know different experiences and difficulties, without the prescriptive concern. We also send through our representative, educational Vice-Director Ruth Lerner Froimtchuk, more expository arguments that will make substantial front position to the questions put by the IPA Education and Training Committee. Celmy Quilelli Corrêa- Chair of Educational Institute, SBPRJ, By the Training Committee