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During discussions at a workshop for members of The College, on matters relating to state-regulation, we focused upon issues that currently face psychoanalysis and its practitioners. We also had an eye towards the international conference planned for 31st March and felt it useful to revisit the historical issue of the relationship between psychoanalysis and the state in different parts of the world, including our own. Whilst not directly focussing upon state regulation, as the conference does, we did not doubt that this issue would become the major theme of the debate: a debate that took place on many levels, as reflected by the presentations by Darian Leader and Ian Parker (the text of both of which is set out hereafter) as well as by Sian Ellis, all three members of the Board of Governors. They give a picture of the current interaction between the state and the profession, as we move toward regulation with a proposed date of 2008.

This, then, is an 'interesting time', full of difficulty and complexity, much as the Chinese curse implies. I think the views expressed on that occasion, illustrate well the current picture and open the ground for debate that will lead us into the international public conference on this topic and, hopefully, inform the process of regulation by the state, which now appears to be advancing towards implementation. The pieces cover the difficulties with regulating psychoanalysis, as opposed to other more 'objective' psychotherapies, which may not take the same philosophical views as psychoanalysis. There are also issues about the general philosophical and ethical context within which this pressing question is located and the practicalities of professional regulation post the mapping exercise and pre the Foster review. Darian Leader's article explores the notion of state regulation of psychoanalysis and the conflicts that arise for the project, when examined more than superficially. Ian Parker outlines an argument for ethics from a psychoanalytic perspective which rejects, as a betrayal, a rigid and dogmatic bureaucratic framework for regulation of psychoanalytic practice, as seen from the perspective of Alain Badiou. Sian Ellis presented the political scene as it stood on the 12th of November 2005 which is fully set out elsewhere in Latest News on this website.

From my perspective, there was in the room much of the indignation and weariness that has been my own experience of this process towards regulation for the few years that I have been involved with it. It has been a process full of naked and not so naked power struggles, born out of the profession's formalisation and its associated fears. For me, it is not without note that this particular process is set in the context of the regulation and power struggles right across the healthcare field, from complementary therapy practice to reformation of the GMC. My view is that psychoanalysis holds a particularly interesting and insightful position in this general discourse, especially if one were to take the view that what differentiates psychoanalysis from psychotherapy is an intent to analyse and come to know the nature of human experience and suffering. Therefore, this intent is not to focus upon cure of symptoms but on the underlying causes of symptoms. This is a perspective which both Ian Parker and Darian Leader take and this would lead to a view of psychoanalysis, not as a healthcare product but as a method of enquiry; a means of understanding our experiences such as, for instance, the on-going one of professional regulation and its turf wars. I fear, however, as with all political endeavours, the creativity of this voice might be lost under the dogma of allegiance, splitting and politicking.

Whilst no doubt becoming a player in this political dance, The College has offered the opportunity for this voice to be heard more clearly. On the pages of this website, as in the debate of our recent workshops, we can see the discussions about these issues from many perspectives; not only political but also philosophical.

I hope the following pieces will provoke interest and I urge those so stimulated to explore elsewhere in this website: to become informed in the debate, particularly via Latest News. I would also draw the attention of members of The College to Members' Colloquium which is shortly to offer them the opportunity for the debate to be carried on in a live web-based format. Members will then be able to post their own views for discussion there. Non-members, like members, can nevertheless submit their own views for publication in Professional Forum. It is hoped that these two facilities will prove to be valuable tools in facilitating this debate, as well as many others in the field of psychoanalysis.

Jason Wright
Member of the Board of Governors

Click here to access the presentation by Darian Leader.

Click here to access the presentation by Ian Parker.

In 1989, the Italian government passed Law 56 which sought to establish provision for the registration of psychologists. This law also sought to define exclusive conditions for the practising of all forms of psychotherapy, although it is unclear whether psychoanalysis is considered to be a form of psychotherapy. The principal provisions of Law 56 are that all practitioners of psychotherapy must have a qualification in medicine or psychology acquired from a university and that all training organisations must be licensed by the state and qualify only those who meet the requirement for such qualifications and have completed a further four-year post-graduate psychotherapy training.

The College is pleased to publish a translation of an interesting exchange between two Italian Lacanian psychoanalysts, Ettore Perrella and Antonello Sciacchitano about some of the issues raised by Law 56 and the question of whether Perella's ethical argument applies equally to psychoanalysis and to psychotherapy and, if one takes Santacatterina's point, even to all professions. This exchange was originally published in POL-it and the original introduction there by Paolo Migone is also translated and reproduced, together with an introduction by Mauro Santacatterina to Simona Revelli's translation, all with the permission of the various parties concerned. Simona Revelli, whose note of acknowledgments also appears, practises as a psychoanalyst in the UK.

The translation of the above papers may be accessed by clicking here.

A statement by The College of Psychoanalysts in relation to the issue of state-regulation and psychoanalysis has now been published. This statement may be accessed by clicking here.

OPEN LETTER TO PROFESSIONAL ORGANISATIONS WITHIN PSYCHOTHERAPY AND COUNSELLING

Progress towards statutory regulation of psychotherapists and counsellors.

Introduction
The Government has long accepted the need for psychotherapists, counsellors and other members of the talking therapies to be statutorily regulated in the interests of public protection. This follows complaints over many years of practice by apparently inadequately trained practitioners, and complaints of financial or sexual abuse of clients.

Statutory regulation
Statutory regulation provides a system enforced by law which sets down:

• standards of competence for a profession;
• standards of education and training by which people may meet those standards of competence;
• a register of those competent, with protected titles which may be used only by those registered;
• a means of dealing with registrants who become unfit to practise either by ill health, misconduct or lack of competence, by modifying or removing their registration where necessary so that they do not remain a risk to service users.

Preparation for statutory regulation
Before a law can be passed to provide statutory regulation, there needs to be an infrastructure in place to allow these functions to happen. The Government's intention is that psychotherapists and counsellors should be regulated by the Health Professions Council. This is a regulatory body operating a common regulatory framework which covers 13 healthcare professions and has developed criteria for assessing whether new professions are ready for statutory regulation. These criteria are:

• Discrete, homogeneous activity undertaken by the profession
• Defined body of knowledge
• Evidence based practice
• One professional body covering most practitioners
• Voluntary register of practitioners who are deemed fit to practise
• Defined entry routes to accredited training
• Externally validated qualifications
• Code of conduct
• Disciplinary procedures applied to registrants whose fitness to practise is in question
• Commitment to Continuing Professional Development.

Regulation via the Health Professions Council
The Government is firmly against the proliferation of regulatory bodies as this causes confusion for the public and leads to lack of consistency across healthcare professions. The Government has ruled out the possibility of a separate Psychotherapy Council. For this reason statutory regulation will be via the Health Professions Council.

Next steps: Mapping training and qualifications
The professions of psychotherapy and counselling cover a number of different roles. In order to meet the criteria for statutory regulation, the first step is to map the number of different roles within psychotherapy and counselling. The Department of Health has funded two umbrella organisations, the British Association of Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP), to carry out a mapping exercise of all current training and qualifications in the fields of psychotherapy and counselling. This will compare all existing training and qualifications to determine how many different roles, modalities, and different levels of practice there are within the two professions. Where roles are identified as substantially different from any other within the field it will be possible to set standards of competence and training for each different role, with protected titles to reflect their different identity. However where roles are essentially the same but accessed through different organisations' accredited training, the mapping exercise should enable these roles to be identified as similar so that the same standards can be set and applied to all. It is important that all current training and qualifications are compared to ensure that any future application to the Health Professions Council does cover the whole range of the professions.

Timing
The mapping exercise is scheduled to finish by June 2005. There will then be a need to identify further work needed to meet the ten criteria for regulation by the Health Professions Council. It is expected that this work will take about 3 years. Statutory regulation is unlikely to happen before 2008.

Your involvement
The mapping exercise needs to be as inclusive as possible if it is to ensure that all current roles are satisfactorily covered. The Department of Health has asked BACP and UKCP to ensure they cover all current training and qualifications within the mapping exercise. If your organisation currently provides or accredits training, or if you have practitioner members whose training should be included in the exercise, either BACP or UKCP should contact you to involve you in the exercise. Alternatively you may wish to contact them direct as follows:

Lisa Wake: lisa.wake@psychotherapy.org.uk

Sally Aldridge: sally.aldridge@bacp.co.uk

Please note that the Department of Health endorses this exercise by BACP and UKCP and hopes that all psychotherapy and counselling organisations will take part. The Department of Health is unable to enter into individual correspondence with individuals or with organisations while the mapping exercise is in progress.

Questions Raised by the Report of the Psychoanalytic Consortium on Analytical Training.

Letter to Our American Colleagues.

In 2001, four major American psychoanalytic associations, grouped together under the umbrella designation of The Psychoanalytic Consortium, formally drafted and ratified a document titled "Standards of Psychoanalytic Education." These four organizations are: the American Psychoanalytic Association, the American Academy of Psychoanalysis, the National Membership Committee on Psychoanalysis in Clinical Social Work, and Division 39 of the American Psychological Association. In her official presentation of the "Standards of Psychoanalytic Education," Dr. Laurel Bass Wagner explains that this document is the fruit of compromise among the different opinions of the organizations that ratified it -- a process that took roughly two years and, to some extent, left everyone involved dissatisfied (2). It nevertheless represents, in the words of Dr. Bass Wagner, "an enormous achievement." In support of this document, the Consortium has established an entity called the Accreditation Council for Psychoanalytic Education (ACPE), which is seeking official recognition as the national accrediting body for psychoanalytic training institutes. The express goal of this body is to gain authorization from the US Department of Education as the accreditation center for psychoanalytic institutes in the United States.

Given the nature of the document and its grave implications for how psychoanalysisis is understood and taught, for its very present and future, it appears crucial for us to join in this debate. Let's do it by approaching the issue over a common point of reference: Freud's own teaching. In light of the importance of the matter at hand, it is to be hoped that psychoanalytic associations will acquaint themselves with the Consortium's proposal and voice their opinions regarding its aims and substance.
***
The impetus behind the "Report to the Psychoanalytic Consortium on Analytical Training" can be understood as an attempt to overcome the discrepancies among the training practices of the four major American psychoanalytic organizations, in order to achieve a high level of professionalism in the field and protect the public from malpractice. The document can also be seen as reflecting an effort on the part of psychoanalysts to assure their legitimate authority by establishing basic regulations for their profession, so as to avoid outside interference in their field from governement agencies, such as state or federal courts and legislatures. Finally, the document may be viewed as a strategic step towards the establishment of a coalition calling for recognition as the preeminent or sole authority over questions of accreditation in psychoanalysis, with power of selection and exclusion.

Psychoanalysts are rightfully concerned about the importance of transmitting psychoanalysis in the best possible way, guaranteeing the professional quality of psychoanalytic practice. They have an ethical duty in this regard: first, in relation to the individuals they prepare for the profession; second, in relation to their present and future patients; and third, in relation to the practice and dissemination of the analytic discourse itself. In this respect, psychoanalysts have every reason to claim their authority to establish the regulations of the very profession they practice, since no one outside the profession could fully grasp its complexity and particularity. Indeed, psychoanalysts have a duty to respond to the social reality in which they practice, and must themselves vouch for professional quality and ethical performance.

Over the years, psychoanalytic associations and institutions have fulfilled the task of providing analytic education, functioning from the first as an interface between individual training and social requirements. It is not clear why a single body responsible for the accreditation of training institutes according to the Consortium's specific standards would now promote better training and provide guarantees of performance. Some colleagues may claim that standards of training in different institutes are too unequal and that certain institutes do not even apply what many consider to be basic requirements. If this preoccupation is truly central to the Consortium's proposal, it would behoove us to examine the Consortium document more closely and reflect upon the standards it contains, as well as upon how those standards purport to improve the quality of analytic education.

Many comments could, of course, be made regarding the Consortium proposal. We will confine ourselves to just a few basic questions.

Any psychoanalyst belonging to the Freudian tradition cannot help but notice that the very requirement the creator of psychoanalysis considered to be the fundamental condition -- the conditio sine qua non -- for any possible approach to the formation of the analyst, is put in a secondary place by the Consortium, which gives priority to such issues as the "selection of candidates" and their "eligibility" (3) and "suitability for psychoanalytic education and training" (4). Only after discussing why and how a candidate is selected for training does the Consortium document mention "Psychoanalysis of candidates," recommending a personal analysis "characterized by depth and intensity." This order of things may indicate some of the reasons why psychoanalysts are so often dissatisfied with the outcome of the analytic standards they themselves have advocated.

The priority given to the selection of candidates (with all the requirements attached to it) manifests the spirit of the US tradition in professional analytic training. Considered from its inception as one therapy among many in the field of mental health or "mental hygiene," as a branch of medicine, psychoanalysis continues to be approached as a profession requiring standards of training comparable to those of other professions. The analytic institute has come to represent an establishment devoted to the production and the reproduction of a certain business, just like other professional schools, for instance, those for law, dentistry, accounting and so on. Once a candidate is deemed "fit" for the profession, s/he is already on track, and the experience to come proves predictable for most aspiring psychoanalysts. The candidate will simply have to follow the particular institute's regulations and duly meet its requirements, which may call for variations in the length of training according to individual "character and disposition." Within this framework, high standards encourage conformity. Professional quality coincides with business interests.

It is striking that, in the history of North American Psychoanalytic Institutions, this order of things has never been seriously questioned. In fact, as Freud always insisted, psychoanalysis implies by its very nature a training that is not comparable to that of any other profession, since it implies the experience of the subjective division between unconscious and consciousness and, therefore, the confrontation with the unknown (including the unknown of one's own vocation, which may radically contradict one's career choices). It is not by chance that Freud considered personal analysis to be the condition for becoming an analyst: we cannot know what the outcome of a personal analysis will be. The desire of the analyst can only be the consequence of one's personal analysis, not its condition. Such a desire cannot be confused with the wish "to become" an analyst, which, as an ideational formation or ideal identification, is nothing more than a symptom among others to be analyzed.

To assess "eligibility" prior to analysis on the grounds of involvement and experience in the mental health professions, implies the confirmation of a choice already made , granting to it the status of a requirement, prior to giving a person the chance to analyze it and question it. As supervision attests, this results all too often in the institutional re-enforcement of symptoms, rather than their resolution.

It is of course to be wished that people who have chosen to work in the field of mental health -- social workers, psychologists, psychiatrists, nurses and so on -- will decide to undertake an analysis. This will certainly be helpful in the choice they have already made. Occasionally their analysis will make them into analysts. But to require involvement in a mental health profession as a main condition for a candidate to be eligible implies an error of timing, indicating an error of judgment, a problematic misunderstanding of the specificity and uniqueness of the analytic field. There is no way of shortcutting the process of analytic formation. The outcome of an individual's own personal analysis should be the grounds for his/her decision to become an analyst, for the discovery of that vocation; this will then imply the appropriate theoretical studies and clinical experiences, which the analytic institution should provide and supervise, independently of any previously made career choice.

Strikingly, the Consortium's idea of "suitability for psychoanalytic education and training", is, among other things, paradoxical, insofar as it expresses a mistrust in the process of psychoanalysis: if we believe in the effectiveness of analysis, why should a person not become "suitable" as a result of his/her own analytic experience? Is analysis not the prime instrument for effecting a subjective ethical change, a "subversion," which may lead to a new relation to life, to vocation, to creation? To assuming responsibility, as Freud teaches us, for the very causes of which we are the effect? Isn't this experience itself what grounds the coming-into-being of the analyst's position, of his/her capability to handle the transference, to direct a cure and to transmit the analytic discourse?

The notion of "suitability" proposed by the Consortium necessarily implies an idea of normativity and, with it, a preventive pedagogy: not only can someone deemed "unsuitable" be excluded, but it will also be possible, for instance, to "fix" certain symptoms or character traits and make a candidate fit the standards of the institute. This reflects the belief in a deterministic philosophy that presupposes a pre-established, wholly transparent knowledge -- precisely what the process of psychoanalysis refutes (5). This determinism implies operating according to a fixed model, a norm that excludes differences, chances, revelations, unknown and unexpected transformations.

It is apparent that the Consortium's notion of "psychoanalysis" has little to do with Freud's idea of psychoanalysis. To begin with, Freud is fundamentally opposed to determinism and deterministic pedagogy, since they contradict the very discovery of the unconscious, the discovery of the contingent and over-determined factors at work in the unfolding of psychic causality. These factors, which define the specificity of each individual history, can only be analyzed in the aftermath. The idea of a fixed model for understanding is in stark contrast with Freud's own notion of science, which is built upon theoretical models as temporary working models subject to being refuted.
***
Let us now turn to the Consortium's definition of psychoanalysis:

"Psychoanalysis is a specific form of individual psychotherapy that aims to bring unconscious mental elements and processes into awareness in order to expand an individual's self-understanding, enhance adaptation in multiple spheres of functioning, alleviate symptoms of mental disorders, and facilitate character change and emotional growth". (p. 8)

We immediately see that psychoanalysis is included within a mental health ideology inspired by a medical discourse driven by the idea of adaptation, symptom relief, and assimilation. It refers to a conception of psychic reality defined according to the categories of "good" or "bad" functioning. In a case of "inappropriate functioning" of the mental organism, therapy aims at re-establishing a mental balance analogous to the physical balance regained after illness. Considering a symptom to be the sign of a mental "disorder" implies the belief in a "natural" or "neurophysiological order." This reflects a return to -- or the persistence of -- a 19th-century medical conception that preceded the Freudian discovery of the subjective division. But Freud has shown us that the unconscious is structured and that a symptom, far from being the sign of a disorder, should be understood as the result of a specific order of things, as a compromise formation conveying a subjective truth.

According to its founder, psychoanalysis is to be distinguished from what is generally referred to as therapy. Thanks to the understanding and handling of the transference, psychoanalysis aims not at "suppressing the symptoms," as Freud puts it, but rather to overcome the subject's resistances, which are grounded on a specific libidinal economy (1926: p.225). As every psychoanalyst knows, the disappearance of a symptom or a behavioral "assimilation" does not in itself represent the completion of a cure; occasionally, it may happen that such occurrences actually represent resistance to the cure.

To the concept of "therapy", psychoanalysis opposes the concept of cure, that is, the confrontation with the subject's division and the truth of one's unconscious desire. Such a cure involves the modification of a subject's libidinal economy, which entails the resolution -- not the suppression or alleviation -- of specific symptoms or inhibitions. Analysis is a process of discovery and novelty; the logical time that organizes a subject's structure and history gives to it a particular rhythm; it is a process that can only unfold within the articulation of the transference and its resolution. Every case is a unique case, an "exception," that cannot be reduced to the generality of a diagnostic category. It is not by chance that Freud recommended that analysts approach each and every new patient's analysis as if it were the first they ever handled. To the categories of "general" and "particular" inherent in the notion of norm, psychoanalysis opposes the notions of structure and singularity.

Regarding the notions of "awareness" and "understanding" stressed by the Consortium, let us remember that the process of analysis is specifically characterized by the unfolding of events within the transference generating subjective transformations independently from the subject's awareness; so much so that an analysand is most often incapable of understanding the nature of such transformations. If "understanding" occurs at all, it may only be in the aftermath of the experience. Contrary to intellectual awareness, which is grounded on faith in a rational ego and the belief in a full translatability of unconscious processes into consciousness, psychoanalysis defines itself as the experience of the subjective division. The subjective division cannot be reconciled or undone; it implies awareness and unawareness, revelations and misrecognitions -- the confrontation, as Freud puts it, with the irreducible nature of a subject's castration. This process is underlined much more by emotions, affects and surprises than by intellectual realizations. And the transformation of the subjective position brought about by the end of an analysis leads more to a savoir faire, a "know how" to handle life, desire and limitations, to a new creativity, than to any intellectual understanding.

In opposition to any idea of conformity, psychoanalysis is fundamentally an experience with and towards otherness, a practice of de-identification that enhances the relation to difference. It is the subject's practice of "exile," a leaving behind of mystifying individual and group identifications and of the guarantees provided by the already known. It is a journey towards what is unknown and foreign within the subject, as manifested, for example, in the formations of the unconscious. This practice of exile leads towards the progressive "deconstruction of a person's idolatry (ego narcissism and super-egoic requirements)," towards the "encounter, in the rigour of one's speech, with one's singularity, style and difference" (Fuks, 2002, p.20).

For this to occur, it is necessary that transference, the main tool of and obstacle to the cure, as Freud defines it, must unfold to its end. And this means accepting that the analyst has relinquished the position of the "subject supposed to know". The Consortium's proposed requirements seem, instead, to encourage a candidate's identification with his/her analyst and teachers. This emulation, by fostering devotion to the same ideals, reinforces group identifications and symptoms, while excluding difference, autonomy of style and the possibility of new creations - including research and advances in the field of psychoanalysis. No wonder, then, if the results of such emulation are repetitive and poor psychoanalytic productions, as the landscape of institutional psychoanalytic literature largely shows.

There is no way to shortcut the process of analysis. The making of an analyst --a formation, more than mere education and training-- involves a process much more rigorous, unique and complex than the one outlined by the Consortium's proposal. The required minimum of 3 analytic sessions per week is in no way a guarantee of "depth and intensity," as the Consortium naively puts it (6). More than anything else, such a requirement once again points to a serious misconception about the very nature of psychic time and psychic causality. No required frequency can accelerate a subjective pace or provoke "depth;" much less can it substitute for the appropriate analyst's listening. Only this listening and the unfolding of the cure can establish the appropriate analytic frequency for each individual case, establishing the specific direction of a cure for the formation of an analyst.

Institutions have existed and do exist in the world that have approached analytic education differently than the Consortium's proposal. Such institutions successfully distinguish psychoanalysis from other professions. They respect the need for the best education while recognizing the uniqueness of analytic formation, making out of it a work in progress, a constant challenge. It would be fruitful for the Consortium to realize that, in the vast universe of psychoanalysis, the standards for training it proposes appear, first and foremost, to be not analytical.

It is important, therefore, to reflect upon how the idea of a monopoly on the regulation of analytic standards of training could be beneficial and ask if it would not, in fact, lower the quality of training rather than the contrary. At any rate, doesn't this idea of a monopoly jeopardize the principles of psychoanalysis (and, for that matter, of democracy), grounded as they are on singularity, differences, pluralism? Should we foresee the establishment of an antitrust regulation to protect quality and variety in the field of psychoanalysis?

I will conclude these remarks by recalling Freud's recommendation: analytic education cannot be limited to the medical domain but must include several humanistic disciplines. As Freud writes to Ferenczi (7), the emphasis on medical training can only be viewed as a mask concealing the most dangerous resistance to psychoanalysis. In addition to regular courses, seminars, workshops and working groups in psychoanalysis, an institute should offer -- or request and supervise attendance in -- courses not only in psychopathology, differential diagnosis, neurology, pharmacology, but also in linguistics, anthropology, philosophy, literature, art, epistemology, history of religion, law. And it should make sure that participants take an active role and engage in forms of intellectual production, rather than merely play the passive part of students learning their teachers' words by rote. This broad field of differentiated disciplines will prepare the ground appropriately for the analyst's listening to the subject's discourse in all its cultural diversity and become the base for a psychoanalyst's continuing education. The coming into being of an analyst as the result of an analysis can then be seen as only a first major step into a universe of learning that will accompany him/her throughout life.

In the field of psychoanalysis, theory can only be the outcome of a practice. In turn, theory will inform certain technical approaches that practice may then redefine, producing new theoretical advances, and so on. This loop of experience, of which theory is a consequence, compels the analyst to permanent production, to permanent creation - if s/he really wants to occupy the place s/he claims.

Not an easy choice for a "career".

Dr. Paola Mieli
109 Third Avenue
New York, NY. 10003

January 2003

(1) This letter has been published in: "Les nouveaux enjeux de la psychanalyse: subversion and conflictualité", Analuein, Journal de la F.E.D.E.P.S.Y., Strasbourg, 2004 ; "Come lavorare insieme in psicanalisi", Spazio Aperto, Nodi Freudiani, Rome,2004; Lacan e a formaçäo do psicanalista, Contracapa/Corpo Freudiano do Rio de Janeiro, Rio de Janeiro, 2004 .

(2) Laurel Bass Wagner, "Progress Report on the Psychoanalytic Consortium," Psychologist Psychoanalyst, Newsletter of Division 39, Vol. XXI, Fall 2001, Wahsington, D.C., p. 7 .

(3) According to the Consortium, eligibility for admission to an institute is first determined in terms of a candidate's graduate degrees and his/her involvement in the domain of mental health: "1. Graduate education. To be eligible to undertake psychoanalytic education, a candidate will possess one of these degrees: Ph.D, Psy.D, D.S.W., M.S.W., M.D., Ed.D. D.O., R.N. (plus a master' s degree with Clinical Specialist certification or Ph.D.) or a comparable mental health degree and education/training leading to licensure or certification for independent practice of a core mental health profession at the highest clinical level. [...]
2. The applicant will have the ability to diagnose mental disorders. [...]
3. The applicant will have had psychotherapy practice experience. S/he will have had close supervision of individual cases.[...]" ("Standards of Psychoanalytic Education, Accreditation Council for Psychoanalytic Education, The Psychoanalytic Consortium," Psychologist Psychoanalyst, Newsletter of Division 39 , Vol. XXI, Fall 2001, Washington, D.C., p. 8).

(4) On this point: "Suitability refers to the personal characteristics of the applicant that are deemed necessary for psychoanalytic education. The applicant will show evidence of integrity of character, maturity of personality, reasonable indication of capacity and motivation for self-reflection, psychological mindedness, clinical aptitude, and appropriate intellectual ability. [...] An ethics violation disclaimer will be part of the admission procedure. If an applicant has been found by a recognized professional or governmental body to have comitted an ethical violation the institute shall be responsible for reviewing the finding and documenting its conclusions and actions. If there is an ethics or malpractice case pending against an applicant the institute may defer its decision on the application until the case is resolved (ibid., p.9).

(5) It is interesting to note that, after defining the selection of candidates for analytic training in terms of "eligibilty and suitability," the Consortium feels obligated to specify that: "Applicants will not be excluded on the basis of race, color, ethnicity, religion, age, gender, sexual preference of physical disability. An anti-discrimination clause will be prominently displayed in official publications of the institute (8)."

(6) "Psychoanalytic work is characterized by depth and intensity which are achieved in the context of frequent treatment sessions over a long term. [...] The psychoanalysis of a candidate is expected to be conducted in person at a frequency of three to five sessions per week, for a minimum of forty weeks during a year and for a minimum of three hundred (300) hours. This criterion may be modified to accommodate candidates who are physically handicapped or who live and work at a considerable distance from an appropriate analyst. Such execptions shall be reviewed by the institute and its descision shall be documented (pp. 1; 3)."

(7) Letter, April 27, 1929.

References:
S. Freud, The Question of Lay Analysis, Standard Edition, Vol. XX, pp. 183-258.
B. B. Fuks, "Judéité , errance et nomadisme: sur le devenir juif de Freud", Essaim, Revue de psychanalyse, n.9, Paris 2002, pp.15-25.

Frederick Stanwood

This volume of nearly 400 pages, containing pieces on psychoanalysis from eighteen contributors, hardly touches on the question posed in the title. A few contributors do, and not surprisingly reach similar conclusions: no one owns psychoanalysis. Psychoanalysis is not a brand and therefore it can't be owned. For Thomas Szasz in What is Psychoanalysis, the issue is straightforward:

'Ownership, a legal concept, requires that at least two elements be present: it must be possible to clearly define and objectively identify the "thing" owned and the state must recognize "it" as properly subject to ownership. Psychoanalysis does not qualify on either count.' (p. 25)

I doubt that many ever believed that the future of psychoanalysis would be well served by branding it, though, of course, "Psycho-Analysis" was copyrighted for fifty years. But for most of us, it is a body of ideas, a theory of mind, a science, an intellectual discipline, a practice-whichever we prefer. As Bernard Burgoyne says in the first sentence of the first chapter: 'No one today seriously asks: "Who owns physics" ', a point that no subsequent chapter contests, though Adolf Grunbaum and Frank Cioffi assert at the end of the volume that there is nothing there to be owned

So the question, "who owns psychoanalysis?", apparently provocative, lends itself to a simple solution about which there is no controversy. Yet controversy there is, as members of the College of Psychoanalysts know. Unfortunately, anyone seeking clarification of the current political conflict will search in vain in this volume. There is very little here that addresses itself to questions about definition and use of labels, the ground over which the battle has been fought. The editor, Ann Casement, makes the briefest reference to the question of the label during her time as Chair of the UKCP, though many of us will struggle to recognise her account.

It is also the case that the conflict has been avoided. The contributors are drawn from the ranks of the illustrious and, in most cases, they have chosen to write about what interests them. It is worth noting that Lacanians are well represented among the contributors, perhaps reflecting the view in some circles that the issue will be resolved by allowing Lacanians to style themselves as psychoanalysts, while continuing to forbid it to all others. Assuming that designation of this sort is within the gift of this or that body, of course, takes us right back to the question, Who Owns Psychoanalysis?

The voice of the protagonist, members of the UKCP psychoanalytic section, and of the antagonists, members of the BCP, in the British dispute, apart from the Lacanians, is not heard in this volume. No one makes the argument for the use of the label by the Psychoanalytic Section of the UKCP, or for the creation of something like the College, or even the recognition that what we practise is psychoanalysis. What are offered in its place are chapters on the conflicts elsewhere. These are both valuable and interesting, but surely it would have been more intellectually honest to have examined the views of those involved in the struggle here.

Curiously, the voices of the official BPAS and IPA are not heard either.

But to ask for clarity may be absurd. After all, conflict and splitting were not invented by Freud, or even by psychoanalysis. Indeed, within academic disciplines, conflict is a respected tool for achieving understanding, so much so that it is guarded by the rubric of academic freedom. I would argue that psychoanalysis is enriched by this same freedom. Yet, psychoanalysts, historically, have been intolerant and exclusive in their approach to theoretical innovation and diversity within the discipline. The resulting conflicts are treated in this volume by chapters by Sonu Shamidasani, Paul Roazen, Pearl Appel, Elisabeth Roudinesco and Dany Nobus.

So, the question, Who Owns Psychoanalysis?, doesn't provoke the dissention one might have expected, largely because no one is prepared to argue for ownership, though it is true that Burgoyne proposes that "What is needed…is a psychoanalytical society that is seriously able to claim a relation to science. Only if this were to be the case could such a society claim some propriety rights over psychoanalysis." (p. 19)
The editor, thus, is left with the problem of organising a disparate collection of contributions. Unfortunately, the question in the title, and the range of authors and subjects, gives the volume no focus and therefore a structure has had to be invented. Casement has chosen to group the pieces under four headings: Academic, History, Political and Science. While I think I understand the intention, the groupings are really quite arbitrary. The chapters overlap the groupings and yet have little to tie them together: Placing the contributions in alphabetical order would have made as much sense-or as little.

But it is not my purpose to damn this volume. In itself, it contains interesting and readable material, some new thinking, and many concise statements of familiar positions. Important controversies are addressed here, among them the question of the location of psychoanalysis within the academy, what one might call the fertility of splitting and tolerance, and the problem of the epistemological validity of psychoanalysis, in particular its desire to be a science. There are chapters about the development and plight of psychoanalysis in the New World. What it reveals, perhaps, is how broad a discipline psychoanalysis is, how difficult to define, and how controversial it is, or remains. I would recommend it as a good way to achieve an overview of the current state of several threads of thinking about psychoanalysis. It is bizarre, then, and perhaps significant, that by far the longest piece in the collection is Adolf Grunbaum's Critique of Psychoanalysis, a systematic and potent demolition of Freud's central theoretical assertions.

Yet it is important to all of us to know something about who speaks for psychoanalysis, the basis for their claim to do so, and what it is we can claim if we can't claim ownership. It is self-evident that intellectual disciplines, such as anthropology, physics and history, cannot be owned. Notions of academic freedom, never perfectly realised, but struggled for, as the lives and deaths of Galileo and Giordano Bruno attest, have established the idea that intellectual disciplines can be mastered.

So, while we cannot speak of ownership, we can, perhaps, discuss mastery, not forgetting Jorge Ahumada's warning that "…mastery quickly collapses to possessiveness" and so must renounce "ownership pretences." Mastery of a discipline is something that inheres in the student, and while it can to some extent be measured, by examination or publication, it is to speak of the knowledge of someone, their grasp of the literature, practice, indeed of the conflicts and contradictions, that may reside within the subject matter of the discipline. So perhaps the real question is not so much who owns psychoanalysis as who has mastered it, including, perhaps, its epistemological failures. And, too, perhaps the question is not so much whether or not psychoanalysis is a science as it is whether or not psychoanalysis is an intellectual discipline able to be mastered. The practice of psychoanalysis then becomes a form of research akin to the practice of anthropological or historical research-about which, needless to say, there is conflict. We might do well to recall Harold Blooms' theory of literary history in which "strong poets…creatively misinterpret the dominant poetic forerunner, in order to clear imaginative space" for themselves. (Andrew Delbanco, review of Where Shall Wisdom be Found? Bloom in Love, New York Times, 10/10/2004)

Within the context of the current conflicts of psychoanalysis, the question of mastery is absent. What takes its place are normative and mechanical criteria, devoid of intellectual content, and having to do with who one's analyst is, how frequently the analyst is seen each week, what organisations are involved, and so on. The urge to define psychoanalysis using these crude criteria runs deep. In the United States, for example, having weathered the conflict over medical qualification, the former antagonists, the IPA organisations and the American Psychological Association, have formed The Psychoanalytic Consortium - US branch - to agree new criteria, more or less palatable to both, but which seek to repeat the exclusivist formalism of the earlier period.

One contribution that struck me as new and surprising, Michael Pokorny's Who Decides Who Decides, somewhat unusually touches directly on the contentious formation of the British Confederation of Psychotherapists (BCP). I have always thought of the BPAS's position as analogous to that of chosen people attempting to protect the stetl from the depredations of the impure. Pokorny's understanding of what took place is very different. He sees the BPAS as the naïve victim of the determination of the Tavistock Clinic to defend at all costs its unique position within the NHS. The "plot" to create the BCP was thus not so much a way of defending "purity" and "respectability" as a way of securing the interests of the Tavistock Clinic. The outcome, according to Pokorny, has been damaging to the real interests of the BPAS and has benefited only the Tavistock and Portman Clinic NHS Trust.

Part of Pokorny's thesis is that the BPAS had failed to appreciate that "psychoanalytic psychotherapy" and "psychoanalysis" were becoming difficult to distinguish in practice, especially since so many of the former had been analysed and supervised by the latter. Thus, the distinction between psychoanalysis and psychoanalytic psychotherapy became increasingly formal, having to do with the name of the training organisation. The BAP has now, quite logically, delivered the second blow to the BPAS by applying for membership of the IPA: no doubt other defenders of the BPAS and the IPA are watching carefully, poised to make their own applications.

So Pokorny tells the story of the BPAS differently. It is not a politically calculating and economically grasping organisation at all: rather, it is befuddled. This is a tragedy, with the BPAS as Lear with, unfortunately, only two daughters, Goneril and Regan.

One of the problems with Who Owns Psychoanalysis is its absent centre. For though members of the BPAS are among the contributors, neither the BPAS nor the IPA have made contributions. This is no fault of the editor:

'As the content of some of the chapters is critical of the…IPA and the…BP-AS, I made several efforts to invite prominent officials of these organisations to be their spokespersons. It eventually became clear that…there was "no-one, unfortunately, willing to do it." '. (pp. xvii and xviii)

The editor was informed that a great deal of thinking about the question was in progress, but ' "the timing of the invitation may not be right" ' (p. xviii).

It is curious that the BPAS should assume such a mantle of thoughtful modesty. Its website, and that of the BCP, has, since the creation of the College of Psychoanalysts, been aggressively and publicly asserting absolute ownership of psychoanalysis. The assertion is a familiar one; no one may call themselves a psychoanalyst who is not a member of the BPAS and who is not affiliated to the IPA. 'Psychoanalyst is a term which refers to someone who has undergone a full training analysis by a recognised Training Analyst of the International Psychoanalytical Association, and who has undergone an intensive training by an internationally recognised Psychoanalytical Institute.' : Simple, formal and thoughtless, ignoring as it does controversies and conflicts around the world, some resolved in courts, and, of course, ignoring the existence of international bodies other than the IPA. The conclusions drawn on the website are worth quoting. This is from the "Disclaimer-Re: College of 'Psychoanalysts' " that was published in Spring 2004: Referring to the College's criteria for membership, it says that they make "no mention…of the fact that they fall short of the standards required even for intensive psychoanalytic psychotherapy, let alone psychoanalysis". Since the website repeats the shibboleth that an analysis is five fifty minute sessions per week, it is clear that one, two, three and four times per week is something else. It then becomes necessary to claim that not only are members of the BPAS the only psychoanalysts, but that they are the only competent psychoanalytic psychotherapists. Business must, indeed, be bad.

Frederick Stanwood

Professor Andrew Samuels
148 Mercers Road,
London N19 4PX
Tel: 020 7272 1292
Fax: 020 7272 2122
e-mail: andrew.samuels@virgin.net

18th. June 2004

Dear Convener,

Our profession has certainly suffered from divisiveness in recent years and, in the spirit of Ann Scott's words (BJP Vol20 No 3), I would like to draw the attention of practitioners, in Professional Forum, to the following:

1. The foundation of BCP itself, which had been long prepared in secret and was triggered by the refusal of an AGM at UKCP to accept what was termed (by the BCP-to-be) as the 'Security Council' model for the organisation of the profession of psychotherapy. In this model, all serious power and responsibility were to reside in a small number of long-established training bodies, all of which were psychoanalytic. The intent was to dominate the whole field of psychotherapy; not only psychoanalysis.

2. BCP's adoption of its 'Single Membership Policy' (no organisation could remain in BCP if it was also in UKCP). This policy caused splits in nearly all of its constituent societies, was of dubious legality, and causes friction to this day that could well damage attempts to achieve proper regulation of the profession: whether statutory; or via the Health Professions Council; or by enhanced voluntary models.

3. The announcement made by BPA-S (as it was then) to its members, making it seem very dangerous for them professionally if they continued to participate in the training of organisations that were not aligned with the policies of BCP. The threat was that they might lose their memberships of BPA-S and IPA.

4. The attempts by ACP to halt new developments in child psychotherapy, including making malicious complaints against the newer organisations in the field; instructing its members and trainees not to work for such organisations (and not to continue with their ongoing work). This culminated in ACP's withdrawal from UKCP, rather than accept the decision of the Registration Board to grant the use of the label 'Integrative Child Psychotherapist'.

5. The attempts (written and verbal) made by the Royal College of Psychiatrists (via its Psychotherapy Section in which psychoanalytically-oriented psychiatrists predominate) and the Tavistock Clinic to bring pressure on UKCP not to permit its Registration Board to allow the use of the label 'UKCP Registered Psychoanalyst'. The threat was, and continues to be, that these organisations might leave UKCP, were the contentious label to be granted.

I believe that what the profession as a whole needs to debate, and in respectful and creative terms, is the present distortion of our field by the power and influence of BPAS. The current dispute over The College exemplifies the historical problem.

Yours faithfully,

Andrew Samuels

[email: andrew.samuels@virgin.net]