D. D GUTTENPLAN filed this interesting report from Britain in today’s NYT. I have one recommendation for British vacationers in Spain and Portugal, age 18 and above, who are thinking about seeing a psychotherapist. Look up the local catholic priest. He does not charge any money for a talk therapy.

LONDON, May 28 – Who owns psychoanalysis? That question is

at the center of the most recent battle here in the Freud

Wars, the epic (or as the man himself might say,

interminable) struggle over the legacy of Sigmund Freud,

pioneer psychotherapist, cartographer of the unconscious

and former resident of Hampstead, the leafy corner of

Northwest London where the concentration of therapeutic

couches per square mile may be even higher than on the

Upper West Side of Manhattan.

Late last year a new group calling itself the College of

Psychoanalysts sent out a letter inviting British

therapists who met certain qualifications to list

themselves on the organization’s “register of

practitioners.” The British Psychoanalytical Society,

headquarters of classical Freudian analysis, responded with

a statement accusing college members of “misleading the

public about their training and qualifications.” And then

the fireworks really started. One founder of the college –

which is a professional organization rather than a training

institution – countered with a letter describing the

society’s action as “a phobic response to growth as

symbolized in the Oedipal myth.” An opponent of the

college, on the other hand, described the new group as “an

association of wannabes and poseurs.”

More recently, the society’s Web site included a disclaimer

describing the college as a device for allowing therapists

“to pass themselves off to the public as though they were

trained psychoanalysts.” In British law, “passing off” is a

form of fraud; this was a declaration of war.

Susie Orbach, a therapist, an active member of the college

and the author of the best-selling “Fat Is a Feminist

Issue” and other books, says the dispute has already had “a

chilling effect” on British intellectual life. To her, the

society’s argument that the title psychoanalyst “refers not

to what the practitioner does, but what they have been

trained to do” is nonsensical, a spurious restraint on

trade.

“I do the work,” she said. “My contributions are

contributions to psychoanalysis, its theory and clinical

practice, not to some other field.”

On the surface, this is a parochial argument about labels

and credentials, a tempest in a Viennese teacup – or at

most, a professional turf war. But you don’t have to probe

the protagonists too deeply to discover that this is also a

battle over the nature of therapy itself – what it is, what

it does, how it works. And it quickly becomes apparent that

alongside the intellectual controversy is a bare knuckles

fight over money, power and prestige. These people, after

all, are professionals of the ego.

The roots of this battle are in some ways peculiar to

Britain. Unlike American psychotherapy, which is regulated

by states (with some states, including New York starting

next year, licensing psychoanalysts as a separate

category), British psychotherapy is completely unregulated

by the government. Also, until recently, most

psychoanalysts in the United States were required to have

medical degrees. The British analysts, however, like others

in Europe, follow Freud’s view in his essay “On Lay

Analysis” and have never required medical training or

graduate study in psychology. And because almost all

psychotherapy in Britain takes place outside the National

Health Service, the government has remained neutral.

Legally, anyone with sufficient chutzpah can call himself a

psychoanalyst here.

Still, the arguments and effects of the dispute are likely

to reverberate on both sides of the Atlantic.

“The same conflict exists in the United States,” says Jaine

Darwin, president of the American Psychological

Association’s division of psychoanalysis. “There are the

same arguments about standards within the profession,” she

added, having to do with licensing, training requirements

and government registration.

Some of these battles have been raging for years. In 1989

the American Psychoanalytic Association – which had

required members to have a medical degree – agreed to

settle an antitrust lawsuit and allow psychologists, social

workers, nurses and other mental health professionals to

enter analytic training. That opening to the outside,

however grudgingly done, probably saved American

psychoanalysis from extinction. (In Britain the members of

the British Psychoanalytical Society have an average age of

65.)

The flow of new analysts, though, raised a new set of

problems. New candidates had to agree to the traditional

training regime: a personal analysis four or five times a

week lasting several years, and a number of supervised

training analyses where the candidate saw patients, again

four or five times a week, under supervision. What is so

magical, some wanted to know, about four-times-a-week

analysis? Why not three times a week, or two? Is there a

real difference between analytic psychotherapy and

psychoanalysis?

These questions are now being asked in Britain, along with

some others. What began, said Joseph Schwartz, as “a simple

jurisdictional dispute – like a fight between rival unions”

– has the potential to become something far more

interesting. An American transplant to Britain and the

author of “Cassandra’s Daughter: A History of

Psychoanalysis” (Penguin, 2001), Mr. Schwartz is a

Berkeley-trained physicist as well as a therapist on the

register of the College of Psychoanalysis.

Ever since the day in 1911 when Alfred Adler and his

followers left the Vienna Psychoanalytic Society, the

history of psychoanalysis has been notoriously divided.

Even so, all psychoanalysts share certain beliefs: the

importance of the unconscious, for example. And Freud’s own

legacy is still central. His sense of mistreatment by

Viennese academics is one reason psychoanalytic training

still goes on mostly in private institutes rather than in

university departments.

Shaped partly by their divergent histories and partly by

differing national cultures, British and American

psychoanalysis became quite different enterprises. In

Britain, the encouragement of lay analysis and the

influence of Bloomsbury figures like Virginia Woolf, who

published Freud’s writings in English, and whose brother

Adrian Stephen actually trained as an analyst, gave

psychoanalysis a distinctly literary flavor. The Hungarian

refugee Melanie Klein, with her emphasis on internal

experiences, envy and aggression, became the dominant

figure in postwar British psychoanalysis.

During the same period in the United States the vast

majority of psychoanalysts were also medical doctors. One

consequence of this was that much more psychoanalysis in

the United States took place in institutional settings like

hospitals or asylums. Another was a gradual loss of

prestige as psychiatry, with its growing armory of

antidepressant and antipsychotic drugs, turned toward the

pharmacy and away from the talking cure.

Both sides of the current dispute in Britain put clinical

practice at the heart of psychoanalysis. Here the

differences are as much political as theoretical. Analysts

today are already free to discount Freud’s focus on

instinct. And though the requirement of analysis four or

five times a week for candidates does guarantee steady work

for the training analysts, their trainees are going to have

to compete for patients in a world enthralled by quick

fixes, whether out of a bottle or in a behavioral

therapist’s office, and where the superiority of

psychoanalysis – once commonly described as the “gold

standard” of therapy – is no longer taken for granted.

Julia Fabricius, incoming president of the British

Psychoanalytical Society, says, “Psychoanalysis as an

academic discipline is open to anybody,” but she defends

the society’s qualifications for membership. She adds that

she does not regard psychotherapists who aren’t analysts as

“second-class citizens.”

Robert Maxwell Young, a Yale-educated British-trained

psychoanalytic psychotherapist and former Cambridge

historian of science, is outside both camps. Though he

points out that he held the first chair of psychoanalytic

studies in Europe, at the University of Sheffield in

England, he is not a member of the society. And he has no

desire to join the college. “I don’t go to parties where

I’m not invited,” he said of the college’s claim on the

label psychoanalyst. “Even so, I have nightmares,” he

confesses, about not being allowed into psychoanalytic

meetings.

What gives the dispute over the College of Psychoanalysts

even more urgency is the sense that, in the next few years,

psychoanalysis in Britain will soon be regulated. Lists and

standards are going to be drawn up. Battle lines are

forming over who who sets the standards and who keeps the

lists.

http://www.nytimes.com/2004/05/29/arts/29PSYC.html?ex=1086846149&ei=1&en=76bb7f71a6f5c6b8