Doc.

12c

BACKGROUND OF THE THREE MODELS IMPLICATIONS AND UNFINISHED ISSUES The aim of this paper is to trace the developments that led the IPA to the recognition and acceptance of three models of training as constituting its minimum requirements for qualification for admission. The significance of this background, beyond refreshing our collective memory, are its repercussions and implications for the current issues facing the IPA. Some relevant documents are attached as appendices. An important caveat: The focus of the following remarks is on standards of training and not on the practice of psychoanalysis. Although these are clearly related issues, they need not and should not be equated and confused. A. Background: Frequency vs. Internal Consistency To recapitulate what is probably well known: the IPA was created in order to define and establish standards for psychoanalysis. To quote Freud: "There should be some headquarters whose business it would be to declare: All this nonsense is nothing to do with analysis; this is not psycho-analysis." (Freud, 1914, On the History of the PsychoAnalytic Movement, SE 14:43, emphasis added). The establishment of the International Training Committee (ITC) in 1925, with Eitingon as its chair, was designed to promote the general institutionalized training in accordance with the pioneering model of the Berlin Psychoanalytic Institute. The model of training evolved by the ITC was subsequently established as the one and only set of requirements for training and admission to IPA membership. Until 2007, the Provisional Code regarding qualifications for admission consisted solely of the requirements of the Eitingon Model. The years after World war II saw the evolution of French psychoanalysis, which due to a number of factors reduced the frequency of analysis (both for the analysis of candidates and for regular patients) from the 4-5 times a week of the Eitingon Model to 3 x week. Heated psychoanalytic debates subsequently centered on this issue: Can 3 x week psychoanalysis be acceptable as an analysis? Is it acceptable for the training of candidates? It is clearly beyond the scope of this paper to review the arguments advanced on both sides formally and informally. Developments in Uruguay created yet another "model" which espoused 3-5 x week for the training/personal analysis of candidates. Both the French and the Uruguayan models were recognized de facto under a "grandfather clause" in 1973, i.e., their

1 - IPA Board Meeting - 27-29 July 2012 - Background of the three models

Doc. 12c

graduates were accepted by the IPA. The Procedural Code, however, continued to recognize and represent only the Eitingon model. Further work on training practices was undertaken by the COMPSED and TRAMPE committees, revealing considerable variations. In 2002, the newly established IPA Board was asked to approve a resolution which among other items stated: "In accordance with the model used by the Society, analysis of candidates should be held at a regular frequency of 3 to 5 sessions a week, lasting a minimum of 45 to 50 minutes each." (Memorandum on Education, July 2002) The heated debate that broke out in the Board led to a split vote (12:10) on whether the document should be accepted in principle, i.e., not constituting ratification (it was never voted on again). The debate and split vote led to the realization that frequencies should not be discussed as such but only within the overall context of the model of training they represent. A Board Working Group, chaired by Bob Pyles, was charged, according to one interpretation of the mandate, with clarifying the language of the document, and according to another interpretation, to further investigate the existing educational models. The next step was the establishment of the new Education Committee in 2005 with the mandate of studying the educational practices and models within the IPA. The EC, chaired by Shmuel Erlich and consisting of two members from each region, identified three existing training models (Eitingon, French and Uruguayan) and six dimensions on which they could be compared in order to establish their similarities, differences, and most importantly their internal consistency. Frequency was seen to be an important integral aspect of each model, based on and reflecting the dimensions psychoanalytic, educational and organizational which characterize it. The six dimensions on which the models were compared and described are: intellectual rationale; philosophy of psychoanalytic education; conceptualization of the psychoanalytic process underlying educational process; breadth vs. depth of exposure; the way issues of power, authority & authorization are handled; and concerns about the model (the last dimension was not included in the PC). B. Adopting the Three Models Concerns and Corrective Measures Following review and discussion, the Board decided to recognize and adopt the three models. The Table outlining the Three Models became part of the Procedural Code (in Appendix A to the section on Requirements for Qualification and Admission) together with a second

2 - IPA Board Meeting - 27-29 July 2012 - Background of the three models

Doc. 12c

Table (Appendix B) that lists the actual requirements based upon the conceptual outline. It is important to note some of the concerns expressed by the Board during this process and what corrective measures, if any, were taken: i. The immediate and most prevalent fear was that the recognition of more than one model of training might result in adopting partial components of models, thus creating patchwork or hybrid models. This concern led to the formulation that any model must be adopted in toto, and that no hybrid models would be recognized. The Board thus expressed the view that each model possessed internal consistency, and that this consistency needs to be maintained. ii. It was noted that considerable variation existed within each model (especially Eitingon, to some extent the French model, and the Uruguayan is still undergoing changes). However, this variability does not contradict the inherent essence of the model. iii. It was clearly stated, both in the Board discussion and in the document describing the models, that the philosophy (psychoanalytic, educational and professional) underpinning the Eitingon model uniquely requires an intensive immersion in the training, as expressed in its several components: a required "training" analysis i.e., a personal analysis that nevertheless is part and parcel of the training, concomitant with it, and conducted at a frequency of 4-5 x week; a minimum of two cases under supervision, conducted with the same frequency; and a structured curriculum that aspires to give a sound theoretical basis for the evolving psychoanalytic practitioner. iv. Recognizing more than a single model implied that the IPA must undertake an oversight function to ensure the integrity of the models. Historically, however, the IPA had not exercised an oversight function once societies became component organizations, except in very rare cases that required intervention. There was thus potential conflict between introducing an oversight function for established societies and the resistance and persecutory feelings this might arouse. v. The oversight function was mandated to the Education Committee, which henceforth became the Education & Oversight Committee (E & O).

3 - IPA Board Meeting - 27-29 July 2012 - Background of the three models

Doc. 12c

vi.

The recognition of the Three Models produced new issues, such as: societies opting to change from their existing model to another one; the possible coexistence of different models in the same country or city; whether different institutes belonging to the same society may adopt different models (e.g., in the case of large societies with numerous institutes, such as Brazil, Germany, or APsA); the need to choose a particular model relatively early as part of the work of Sponsoring Committees with New Groups; etc.

C. Education & Oversight Activity i. The Education & Oversight Committee (E & O) discussed the issue of oversight as part of its mandate. In view of the concerns raised by some and the support by others (at the Berlin pre-Congress meeting with Presidents and Directors of Training), E & O determined to take up its mandate of oversight as follows: "Promoting a process of self-reflection about one's educational practices in the presence of a 'third'" . To this end, E & O promoted and conducted a variety of activities which engaged Training Analysts and DOT on various aspects of their training model (e.g., admission, supervision, determining readiness for qualification, the "problematic candidate", etc.) in which they could openly discuss and compare their practices with others. It was possible through these discussions to deepen our understanding of the integrity, the differences, and certain strengths and weaknesses of the models. ii. E & O brought to the attention of ING the need to introduce Sponsoring Committees to the newly posed requirement to assist new groups in the process of deliberating and eventually adopting a single coherent model of training. Since not all members of Sponsoring Committees are sufficiently aware and well versed in the Three Models, this may require a special training experience for members of SCs. D. Unfinished Business i. While the Board ratified the Three Models and they became part of the PC, some issues mentioned as sources of concern or in need of revision and updating were not fully discussed and finalized. There is a backlog of work that clearly requires the attention of the Board in order to introduce coherence and closure to training requirements and to bring the PC entries up to date. I will list a few of these outstanding issues:

4 - IPA Board Meeting - 27-29 July 2012 - Background of the three models

Doc. 12c

a. The work with New Groups needs to be brought in line with the Three Models; b. The procedure for societies and institutes wishing to change their model is vaguely defined and implemented; c. Issues of remote or irregular training (e.g., telephone, Skype, shuttle, etc.) need to be defined and decided a Working Group paper was discussed and revised by the Board but not yet ratified; d. The issue of unacceptability of hybrid models was mentioned in an early document but needs to be clearly defined and stated; e. The section on the requirements for Training Analyst needs to be updated and revised (a proposal was submitted and needs to be discussed and voted on); f. Integrated Training (of child and adult analysis, currently worked on by the Committee on Integrated Training) should be brought in line with the models; g. The assessment of new educational schemes (e.g. the one introduced by the British Society) needs to determine if they are in line with the model of the Society; etc. E. Principle Issues Yet to Be Resolved The picture sketched above appears to steer the IPA towards having to face certain questions and eventual choices. Has the recognition of more than a single binding model of training opened the gate to the addition of one, two and possibly many more models? Does it serve the strategic aims of the IPA or does it hinder them? Is it possible to distinguish between what is essential in a model, between aspects that are its core and others that are variations on a theme? Will it be possible to determine whether the product of the different models produces different analysts and/or different psychoanalyses? The conflict, which is nearing the surface, seems to be between two major aims of the IPA, which are the basis on which and for which it was created: On one hand, the IPA aims to safeguard the quality and integrity of Sigmund Freud's psychoanalysis, as its only global standard setting entity. On the other hand, it needs to assure its continued vitality and survival, which is at times threatened by economic and demographic forces, such as the problem of an aging membership or

5 - IPA Board Meeting - 27-29 July 2012 - Background of the three models

Doc. 12c

declining attractiveness of psychoanalytic training and treatment. For some, these aims may seem to be contradictory under certain circumstances; for others, they are not necessarily conflictual. It is an issue that touches on deep-seated values and attitudes about psychoanalysis. The resolution of this conflict will depend to a large extent on the quality of psychoanalysis the IPA will opt to protect, and this will inevitably depend on what will be done in the area of training and educating the next generation of analysts. Respectfully submitted, Shmuel Erlich Consultant to the Education & Oversight Committee

6 - IPA Board Meeting - 27-29 July 2012 - Background of the three models