The American Psychoanalyst

Gunther Perdigao, IPA Executive Committee 2019-present, associate secretary IPA, 1993-97; House of Delegates 2002-04; secretary general IPA 2009-13, chair North American ING 2005-07 and 2013-17; chair Recife, Brazil Sponsoring Committee 1990-95; chair Campo Grande Brazil Sponsoring Committee 1997-2005.
guntherperdigao@gmail.com

Gunther Perdigao

Going as far back as the 1920s, APsaA and the IPA have a long history of disagreements beginning with the controversy over so-called lay analysis. In this article I will review the APsaA-IPA relationship. But I will also highlight that APsaA has not been the only group that has had divisive issues with the IPA. In all three IPA regions most of the conflicts have centered on training standards. Nor is APsaA the only group functioning to some degree as a “regional association.”

Currently, APsaA is being attacked by some of the Northern European Board representatives regarding what they call “the American Exceptionalism” in part because we were granted the regional status by the IPA. I will show that other countries, in fact, also operate with a de facto regional status.

It is also my contention that not only does APsaA’s presumed special status serve as a scapegoat and a diversion within the IPA group process, but also that the entire over-concern with such guild issues is an easy but unfortunate fallback position when more complex and less definable challenges might be more worth our attention. Such as, to say the least, what is the future of our field and how do we best shepherd it to the extent that is in our power?

To put the present disagreement in context, I will briefly review the history of the APsaA-IPA relationship. In 1925 the IPA created an International Training Committee (ITC) under the directorship of Max Eitingon. He wanted to establish centrally regulated training guidelines under the authority of the IPA.

APsaA opposed the idea because it did not want to be subordinate to the ITC, particularly on the issue of lay analysis and the status of emigre analysts in the States. (I will continue to use the rather offensive term for including non-medical analysts in training, “lay analysis,” in recounting its history since it was the terminology at the time of the disputes being reported here.) Abraham Brill, in particular, felt allying psychoanalysis to psychiatry was a way to get greater acceptance of the new field in the medical community.

Several societies rebelled against the IPA’s assumption of authority over local standards and a new committee to discuss the issue, chaired by Ernest Jones, was set up in 1929. Unfortunately, Jones’s efforts failed and dissatisfaction with the IPA’s Training Committee continued (Werner Bohleber 2019).

As early as 1934 the New York Society wrote a letter to the IPA declaring complete autonomy in administrative matters and training of candidates Michael Schröter 2008). This decision was a reaction to Eitingon’s rigidly insisting that training should be the same all over the world. Eitingon did not want to allow autonomy in training matters for local or national associations.

In 1936 at the Marienbad Congress, the American contingent won its first independence from the International Training Committee through passage of a remarkable resolution that stated: “Any resolution passed by the Congress relating especially to America is subject to veto at the next meeting of the American Psychoanalytic Association.”

In 1937 APsaA formed a committee charged with exploring its relationship with the IPA. The committee reported its findings at the 1938 IPA Congress in Paris. Its declaration of independence from the ITC was received as if a bomb had exploded at the Congress (Schröter 2008). The response was a mixture of astonishment and condescension (Robert Knight 1953).

In addition, APsaA recommended the dissolution of the ITC and notified the IPA that at-large membership in the IPA was not an acceptable accreditation for any analyst practicing in the U.S.

Four core issues were responsible for the shift in APsaA’s relationship with the IPA from relative submission to IPA authority in 1932 to its bold declaration of independence in 1938:

Whatever one feels about the stand APsaA was taking on these issues, the underlying dynamic appears to be then—as it is now—what is the role of central authority in psychoanalytic organizations?

…the underlying dynamic appears to be then—as it is now—what is the role of central authority in psychoanalytic organizations?

In 1948 an APsaA delegation met in London with Jones, Anna Freud, and other members of the British Society. The result was a “gentleman’s agreement” (Pearl King cited by Robert Wallerstein 1988). According to this agreement, APsaA was given full authority for training and was no longer accountable to the IPA. The formal codification of APsaA’s new status as “regional association” was finally ratified at the Stockholm IPA Congress in 1963.

Meanwhile, France had had its own problems with lay analysis. The argument of lay analysts and medically/university trained analysts split its analytic community into two societies. Sacha Nacht from the SPP (Paris Society) wanted the medical training model whereas Daniel Lagache proposed a model open to lay analysis. Lagache and others founded the French Psychoanalytic Society, which soon fell apart because of conflicts with Lacan. A number of analysts left in 1963 and founded the French Psychoanalytic Association (APF), which was recognized by the IPA.

In the 1950s many in the French psychoanalytic community began to object to the Eitingon model believing it was akin to vocational training.

In addition to that conceptual framework, they also took issue with the IPA regarding frequency of sessions. The French view was that frequency was a matter to be settled between analyst and analysand and not by external authority. In 1971 the APF abolished the training analyst status and the frequency was reduced to three times a week. French analysts in both societies see their analysands at a 3x a week frequency. There is no “training analysis,” only “personal analysis.” This personal analysis takes place before the start of the seminars. This was a radical departure from the Eitingon model.

In the 1970s Serge Lebovici became the first French IPA president. The two French psychoanalytic societies were finally admitted to the IPA even though they did not follow the Eitingon model.

Latin America has had its own disagreements with the IPA standards. From its beginning, the Uruguayan society followed a modified Eitingon model with a 3x a week frequency. The stated reason was both conceptual and practical. In 1999 the presidents of the Latin American societies wrote a letter to the IPA requesting some flexibility in training standards because of the difficult economic conditions in many countries. The IPA denied the request.

It was not until 2005 at the Rio de Janeiro Congress that the IPA officially recognized the three distinct training models: Eitingon, French, and Uruguayan. Note that both France and Uruguay operated for a long time as autonomous associations making their own decisions about training requirements.

In Germany, the DPV society has 13 training branches scattered around the country. These 13 training branches were created with a system similar to the CNTF system that used to be practiced by APsaA before the introduction of the six-point plan.

At present there is considerable apprehension in Germany that groups that practice analysis at 3x a week are planning to apply for IPA membership. In this case they are bypassing the national federation and applying directly to the IPA for approval. The DPV fears its political clout will be greatly diminished if a large number of societies that practice 3x a week analysis are accepted as constituent societies of the IPA. The exact nature of the threat is unclear. Reacting to this perceived threat the German psychoanalytic establishment seems to have resorted to a more authoritarian position, favoring forcefully imposing rigid standards of training. Although the DPV oversees 13 training centers, it seems to be disturbed that it does not have a monopoly over training in Germany, if groups can go directly to the IPA for membership under standards the DPV doesn’t support. Even within its ranks the DPV has training centers that favor three to five frequency. It should be noted here that despite its regional association status, it’s been many years since APsaA claimed a monopoly over training in the U.S. There are numerous American societies that are direct members of the IPA.

The Italian Psychoanalytic Society (SPI) is a large national group with four component training centers. The Italian Society has unified training at the national level, providing local societies with a degree of representation and some autonomy in curriculum.

The Canadian Psychoanalytic Society (CPS) is a national federation with seven societies in Canada under its umbrella. Montreal has two. One French and one English.

Italy, France, Germany, Uruguay and Canada have all functioned in one way or another as “regional associations.” A few, Uruguay and France, have gone farther than APsaA in rejecting the IPA’s training standards and substituting their own.

Thus, Italy, France, Germany, Uruguay, and Canada have all functioned in one way or another as “regional associations.” A few, Uruguay and France, have gone farther than APsaA in rejecting the IPA’s training standards and substituting their own.

There have been many challenges (both direct and under covers) and modifications to the Eitingon model. The changes in France have already been discussed. In general, the Europeans have been critical of the changes in the other two regions but they themselves have introduced variations of the Eitingon model when expedient, notably with the introduction of the concentrated analysis in their training of Eastern European candidates in 1993. Few dispute that this was a necessary, if radical, adaptation of the Eitingon model. (In this model of concentrated analysis, a candidate has more than one session a day for a short period of time followed by a long period of time until the next tranche of concentrated sessions.)

However, when the Brazilians introduced concentrated analysis in the early eighties, to accommodate trainees who had to travel extremely long distances for training, their innovation was met with strong disapproval by the IPA.

APsaA has been criticized because some of its affiliated Institutes have introduced another variation in training, namely distance analysis and training. This has been used primarily to provide training for candidates in foreign countries, mainly China where local training is not available.

In the U.S., after the recent round of changes under the six-point plan, APsaA allows institutes significant autonomy. It expects them to follow the Eitingon training model as defined by the IPA in its rules and procedures but allows the component institutes to define various terms and procedures as they think best. Each affiliate society is free to add more requirements if they wish.

More flexibility about standards issues would add more members to the IPA. It is striking that I have never heard this positive value of flexibility mentioned in these contentious discussions. In Germany alone, if the membership of the three-times-a-week societies were supported, the IPA would have hundreds of new members.

Unfortunately for the IPA, there has been this recurrent repressive process of demanding obedience to a higher authority whether this fits local conditions or not, or indeed whether there is evidence behind the assertions that this way or that way is superior.

I have watched this drama proceed for more decades than I sometimes care to admit. Passionate arguments about “standards” and perennial efforts to control or exclude the unwashed or less classical have never been to our benefit.

APsaA is being criticized for having special prerogatives as a regional association, but a closer look at the situation worldwide has revealed that many other countries engage in very similar practices—setting training standards, modifying issues of frequency, and others.

Imagine yourself as a young enthusiastic professional having fallen in love with psychoanalysis through your reading, your personal analysis, your exposure to our ideas and as you get closer to our organizations you start to hear impassioned arguments about these guild issues dominating the leadership’s discussions. Is this not disheartening to the prospective future analyst? Do we not have anything better to think about?

In Max Eitingon’s day, psychoanalysis was brand new and the need to define and fight for uniform standards for training was essential. I would argue this is no longer the case. Rather, let’s encourage thoughtful innovation and share our findings with colleagues around the world.

…let’s encourage thoughtful innovation and share our findings with colleagues around the world.

I wish to acknowledge and thank Werner Bohleber for the historical background on the Eitingon model.