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<\/div>\nD. 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. <\/i><\/p>\n
LONDON, May 28 – Who owns psychoanalysis? That question is<\/p>\n
at the center of the most recent battle here in the Freud<\/p>\n
Wars, the epic (or as the man himself might say,<\/p>\n
interminable) struggle over the legacy of Sigmund Freud,<\/p>\n
pioneer psychotherapist, cartographer of the unconscious<\/p>\n
and former resident of Hampstead, the leafy corner of<\/p>\n
Northwest London where the concentration of therapeutic<\/p>\n
couches per square mile may be even higher than on the<\/p>\n
Upper West Side of Manhattan. <\/p>\n
Late last year a new group calling itself the College of<\/p>\n
Psychoanalysts sent out a letter inviting British<\/p>\n
therapists who met certain qualifications to list<\/p>\n
themselves on the organization’s “register of<\/p>\n
practitioners.” The British Psychoanalytical Society,<\/p>\n
headquarters of classical Freudian analysis, responded with<\/p>\n
a statement accusing college members of “misleading the<\/p>\n
public about their training and qualifications.” And then<\/p>\n
the fireworks really started. One founder of the college –<\/p>\n
which is a professional organization rather than a training<\/p>\n
institution – countered with a letter describing the<\/p>\n
society’s action as “a phobic response to growth as<\/p>\n
symbolized in the Oedipal myth.” An opponent of the<\/p>\n
college, on the other hand, described the new group as “an<\/p>\n
association of wannabes and poseurs.” <\/p>\n
More recently, the society’s Web site included a disclaimer<\/p>\n
describing the college as a device for allowing therapists<\/p>\n
“to pass themselves off to the public as though they were<\/p>\n
trained psychoanalysts.” In British law, “passing off” is a<\/p>\n
form of fraud; this was a declaration of war. <\/p>\n
Susie Orbach, a therapist, an active member of the college<\/p>\n
and the author of the best-selling “Fat Is a Feminist<\/p>\n
Issue” and other books, says the dispute has already had “a<\/p>\n
chilling effect” on British intellectual life. To her, the<\/p>\n
society’s argument that the title psychoanalyst “refers not<\/p>\n
to what the practitioner does, but what they have been<\/p>\n
trained to do” is nonsensical, a spurious restraint on<\/p>\n
trade. <\/p>\n
“I do the work,” she said. “My contributions are<\/p>\n
contributions to psychoanalysis, its theory and clinical<\/p>\n
practice, not to some other field.” <\/p>\n
On the surface, this is a parochial argument about labels<\/p>\n
and credentials, a tempest in a Viennese teacup – or at<\/p>\n
most, a professional turf war. But you don’t have to probe<\/p>\n
the protagonists too deeply to discover that this is also a<\/p>\n
battle over the nature of therapy itself – what it is, what<\/p>\n
it does, how it works. And it quickly becomes apparent that<\/p>\n
alongside the intellectual controversy is a bare knuckles<\/p>\n
fight over money, power and prestige. These people, after<\/p>\n
all, are professionals of the ego. <\/p>\n
The roots of this battle are in some ways peculiar to<\/p>\n
Britain. Unlike American psychotherapy, which is regulated<\/p>\n
by states (with some states, including New York starting<\/p>\n
next year, licensing psychoanalysts as a separate<\/p>\n
category), British psychotherapy is completely unregulated<\/p>\n
by the government. Also, until recently, most<\/p>\n
psychoanalysts in the United States were required to have<\/p>\n
medical degrees. The British analysts, however, like others<\/p>\n
in Europe, follow Freud’s view in his essay “On Lay<\/p>\n
Analysis” and have never required medical training or<\/p>\n
graduate study in psychology. And because almost all<\/p>\n
psychotherapy in Britain takes place outside the National<\/p>\n
Health Service, the government has remained neutral.<\/p>\n
Legally, anyone with sufficient chutzpah can call himself a<\/p>\n
psychoanalyst here. <\/p>\n
Still, the arguments and effects of the dispute are likely<\/p>\n
to reverberate on both sides of the Atlantic. <\/p>\n
“The same conflict exists in the United States,” says Jaine<\/p>\n
Darwin, president of the American Psychological<\/p>\n
Association’s division of psychoanalysis. “There are the<\/p>\n
same arguments about standards within the profession,” she<\/p>\n
added, having to do with licensing, training requirements<\/p>\n
and government registration. <\/p>\n
Some of these battles have been raging for years. In 1989<\/p>\n
the American Psychoanalytic Association – which had<\/p>\n
required members to have a medical degree – agreed to<\/p>\n
settle an antitrust lawsuit and allow psychologists, social<\/p>\n
workers, nurses and other mental health professionals to<\/p>\n
enter analytic training. That opening to the outside,<\/p>\n
however grudgingly done, probably saved American<\/p>\n
psychoanalysis from extinction. (In Britain the members of<\/p>\n
the British Psychoanalytical Society have an average age of<\/p>\n
65.) <\/p>\n
The flow of new analysts, though, raised a new set of<\/p>\n
problems. New candidates had to agree to the traditional<\/p>\n
training regime: a personal analysis four or five times a<\/p>\n
week lasting several years, and a number of supervised<\/p>\n
training analyses where the candidate saw patients, again<\/p>\n
four or five times a week, under supervision. What is so<\/p>\n
magical, some wanted to know, about four-times-a-week<\/p>\n
analysis? Why not three times a week, or two? Is there a<\/p>\n
real difference between analytic psychotherapy and<\/p>\n
psychoanalysis? <\/p>\n
These questions are now being asked in Britain, along with<\/p>\n
some others. What began, said Joseph Schwartz, as “a simple<\/p>\n
jurisdictional dispute – like a fight between rival unions”<\/p>\n
– has the potential to become something far more<\/p>\n
interesting. An American transplant to Britain and the<\/p>\n
author of “Cassandra’s Daughter: A History of<\/p>\n
Psychoanalysis” (Penguin, 2001), Mr. Schwartz is a<\/p>\n
Berkeley-trained physicist as well as a therapist on the<\/p>\n
register of the College of Psychoanalysis. <\/p>\n
Ever since the day in 1911 when Alfred Adler and his<\/p>\n
followers left the Vienna Psychoanalytic Society, the<\/p>\n
history of psychoanalysis has been notoriously divided.<\/p>\n
Even so, all psychoanalysts share certain beliefs: the<\/p>\n
importance of the unconscious, for example. And Freud’s own<\/p>\n
legacy is still central. His sense of mistreatment by<\/p>\n
Viennese academics is one reason psychoanalytic training<\/p>\n
still goes on mostly in private institutes rather than in<\/p>\n
university departments. <\/p>\n
Shaped partly by their divergent histories and partly by<\/p>\n
differing national cultures, British and American<\/p>\n
psychoanalysis became quite different enterprises. In<\/p>\n
Britain, the encouragement of lay analysis and the<\/p>\n
influence of Bloomsbury figures like Virginia Woolf, who<\/p>\n
published Freud’s writings in English, and whose brother<\/p>\n
Adrian Stephen actually trained as an analyst, gave<\/p>\n
psychoanalysis a distinctly literary flavor. The Hungarian<\/p>\n
refugee Melanie Klein, with her emphasis on internal<\/p>\n
experiences, envy and aggression, became the dominant<\/p>\n
figure in postwar British psychoanalysis. <\/p>\n
During the same period in the United States the vast<\/p>\n
majority of psychoanalysts were also medical doctors. One<\/p>\n
consequence of this was that much more psychoanalysis in<\/p>\n
the United States took place in institutional settings like<\/p>\n
hospitals or asylums. Another was a gradual loss of<\/p>\n
prestige as psychiatry, with its growing armory of<\/p>\n
antidepressant and antipsychotic drugs, turned toward the<\/p>\n
pharmacy and away from the talking cure. <\/p>\n
Both sides of the current dispute in Britain put clinical<\/p>\n
practice at the heart of psychoanalysis. Here the<\/p>\n
differences are as much political as theoretical. Analysts<\/p>\n
today are already free to discount Freud’s focus on<\/p>\n
instinct. And though the requirement of analysis four or<\/p>\n
five times a week for candidates does guarantee steady work<\/p>\n
for the training analysts, their trainees are going to have<\/p>\n
to compete for patients in a world enthralled by quick<\/p>\n
fixes, whether out of a bottle or in a behavioral<\/p>\n
therapist’s office, and where the superiority of<\/p>\n
psychoanalysis – once commonly described as the “gold<\/p>\n
standard” of therapy – is no longer taken for granted. <\/p>\n
Julia Fabricius, incoming president of the British<\/p>\n
Psychoanalytical Society, says, “Psychoanalysis as an<\/p>\n
academic discipline is open to anybody,” but she defends<\/p>\n
the society’s qualifications for membership. She adds that<\/p>\n
she does not regard psychotherapists who aren’t analysts as<\/p>\n
“second-class citizens.” <\/p>\n
Robert Maxwell Young, a Yale-educated British-trained<\/p>\n
psychoanalytic psychotherapist and former Cambridge<\/p>\n
historian of science, is outside both camps. Though he<\/p>\n
points out that he held the first chair of psychoanalytic<\/p>\n
studies in Europe, at the University of Sheffield in<\/p>\n
England, he is not a member of the society. And he has no<\/p>\n
desire to join the college. “I don’t go to parties where<\/p>\n
I’m not invited,” he said of the college’s claim on the<\/p>\n
label psychoanalyst. “Even so, I have nightmares,” he<\/p>\n
confesses, about not being allowed into psychoanalytic<\/p>\n
meetings. <\/p>\n
What gives the dispute over the College of Psychoanalysts<\/p>\n
even more urgency is the sense that, in the next few years,<\/p>\n
psychoanalysis in Britain will soon be regulated. Lists and<\/p>\n
standards are going to be drawn up. Battle lines are<\/p>\n
forming over who who sets the standards and who keeps the<\/p>\n
lists. <\/p>\n
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