PSYCHOANALYSIS AND THE QUESTION OF COMPETENCES


A regulatory project that sets itself the task of monitoring training standards and fitness to practise will quite naturally frame its requirements in terms of core competencies. While there is, in principle, nothing problematic about such a project for many professions, it is much more difficult in relation to psychoanalytic clinical practice, for a number of reasons:

a) Competency claims are usually framed in terms of knowledge. The practitioner of a profession trade or craft has acquired the appropriate knowledge to perform one or more tasks. However, psychoanalytic training is not based on the simple acquisition of knowledge but rather a changed relation to knowledge. Psychoanalysis entails the establishment of a critical, questioning attitude to received knowledge and a fundamental shift in any belief that knowledge itself can answer certain basic human problems. In this sense, psychoanalytic training is about knowing how not to know. The problem is that any claim to be competent to know how not to know must be suspect.

b) What can practitioners of psychoanalysis legitimately claim to hold themselves out to do? There is probably no significant leading practitioner in the history of psychoanalysis who has claimed to be able to psychoanalyse others. This is because psychoanalysis is a relational activity: it involves a set of transferences between at least two people. It means that each individual analysis tests, in some way, both analysand and analyst. The analyst, in this sense, has been defined as an 'episodic object', created afresh in each analytic encounter. The complexity of this situation means that there can be no guarantee that psychoanalysis will take place, despite the meetings of two parties. To claim such a guarantee, due to the 'competency' of one of the parties conforming to a particular body of knowledge, is misleading. One would then have to take into account also the 'competency' of the prospective patient to be an analysand. Defining analytic training in terms of the acquisition of competencies thus obscures the relational aspect which defines psychoanalytic work.

c) The search for competencies belongs to a way of thinking about human beings in terms of skills that can be acquired and, more often than not, bought and sold. Freud claimed that the most important elements of psychoanalytic training were the sacrifices made by the candidate for training: what they have given up. This is clearly antithetical to the model of a human being as a set of skills and potentials for use in the market. What mattered for Freud was less what the analyst has than what they do not have: for example, knowledge of what is right. It might be argued that the claim to possess marketable-competence and prior knowledge of what is best for the patient would make any particular analyst unfit to practise. Claims to competency may then be construed as an evasion of ethical responsibility; as if a qualification could guarantee that one would practise well in every case. For Freud, on the contrary, psychoanalysis had to be reinvented with the entry into analysis of each new patient

d) Unlike many other fields of research and practice, psychoanalysis defines its practitioners in terms of their own individual subjective mutations. In the same way that a dream, a slip of the tongue or a symptom may be seen as a formation of the unconscious, it is often argued that a psychoanalyst is also a formation of the unconscious.

e) Psychoanalysis cannot predict an outcome in any concrete or quantifiable way. On the contrary, it can only define itself as a retrospective process: after some time, it might or might not become clear that there has been an analysis. Knowledge cannot be predicted or promised in advance and the key dynamic of analytic work involves surprise. Through the transformative powers of the transferential relationship, a unique encounter is created which is not a result of any incremental increase in insight or knowledge.

Given the above points, there are many problems for any project that aims to define psychoanalytic clinical work in terms of competencies and outcomes. These have tended to fall back on bureaucratic criteria, such as the number of hours of study, the texts to be read and the knowledge sources to be accessed. Such criteria miss what is crucial and unique to psychoanalysis: the experience of analysis itself. This, after all, is the central part of psychoanalytic training and the subjective changes an analysis involves will result, in many cases, in the formation of a psychoanalytic practitioner. No amount of courses or hours of meetings with a tutor, clinician or supervisor mean anything compared to the dynamic effects of analytic work itself. Indeed, it is the subjective change introduced by analytic work that will allow trainees to critically assess what they learn in seminars, rather than the parrot-like acquisition of knowledge, in order to please some imagined or imposed authority.

The regulatory framework, at least as it is currently conceived, dispenses with this core aspect of analytic formation. This is not to say, however, that psychoanalytic practitioners cannot be assessed and evaluated. There remains within the profession a very strong and, entirely justifiably, widely held conviction that this is a necessity, not only for the protection of the public but also for the protection of the profession and of the clinical discipline of psychoanalysis itself. Through a discourse about the clinical work of an individual, a practice can be assessed and put in question. But this is not the same thing as defining a set of core competencies. Rather, it can show whether practitioners maintain an ethical position and are willing to put themselves in the position of risk which is necessary, in order to allow any analytic process to take place. Many trainings in psychoanalysis already have robust evaluative frameworks in place, which put each trainee to the test in relation to criteria that have, in most cases, been thought through with great care and integrity.

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