Comments on: Why Do I Want to Include Our Colleagues in Licensing as Psychoanalysts?

By: Jane S. Hall

Jane S. Hall — Sun, 14 Oct 2007 18:51:37 +0000

The issue of frequency of psychoanalytic sessions is an albatross. It is symbolic of the fears of individuation and asserting one’s freedom. Frequency of sessions, as everyone knows deep down, does not make an analysis. Like the use of the couch, it is an artifact. But worse, it has become a rallying point that, like all rallying points, serves to blind us to the nuances of a situation. Without using the excuse that there is no scientific evidence for issues of frequency, I would hope that we all can stand back and regain our perspective. Rigidity in psychoanalysis is an anathema. Despite its origin of strict adherence to Freud’s way, and even perhaps because of it, psychoanalysis has flourished and continues to mature. There is room for all kinds of thinking – from Lacan to Bion to Klein and so on. Never before have there been so many roads to Rome. And for all we know, Rome may not be the only place to go.

My deep respect goes to those who look beyond what we call “received wisdom” (not that some of it isn’t valuable), but such wisdom can diminish our creativity. Think of all the myths we have shattered, like the analyst as blank screen.

Respect for another’s point of view is what seems to be missing in this field. I thank Arlene Richards and others for reminding us that not one of us has THE answer. And thank heavens for that – for there really are no answers. It is the questions that just might save us.

By: KTArnold

KTArnold — Sun, 14 Oct 2007 02:51:11 +0000

My own analysis may offer a telling example of some of these issues. I began in 1x weekly dynamic therapy, and didn’t find that it was enough to get as deep as I needed to get. I then moved into 3x weekly analysis, which was fruitful for a few years, but as the treatment progressed I found that it began to feel overwhelming and began to stall. After beating our heads up against a wall for a year, my analyst and I then shifted again to 1x weekly “therapy,” and found that the analytic process dramatically improved and speeded up, and continued 1x weekly through termination.

The argument of some members of the NAAP, as I understand it, is likewise that different frequencies may be better for different patients and even for the same patient (like myself) at different junctures in the treatment, depending on a multitude of variables. The risk in enshrining any particular frequency as ideal would be a loss of clinical flexibility.

By: mark sehl

mark sehl — Sun, 14 Oct 2007 01:47:03 +0000

Arlene,
I want to thank you for welcoming other analysts with different views rather than the constant fight which has been going on for years with certain groups trying to own psychoanalysis. Possession and one-mindedness does not lead to creative thought and psychoanalytic freedom. I trained at IPTAR as you know. I also have found that modern analysts have much to offer in terms of working with narcissistic problems. The theory, and in particular the technique, is different that the standard mainstream approach. And there is a reason why many patients are not seen more than once a week.

It has been said that all the major analytic (exception CIPS) institutes are in the Psychoanalytic Consortium, and since they all recommend at least 3x week then that is the last word on the subject. In other words, since there is a majority opinion then that is the only correct view. Well, how many injustices have done under the guise of majority opinions. I have been in analysis 4x a week and once a week and the most important aspect was the skill of the analyst. I fared as well at once a week as 4x.

I just came from a NAAP conference. Wow! Many different views and interesting perspectives. There were at least 13 different analytic institutes represented there and none, as far as I know, were from the consortium. It is just awful that the attitude above (all major institutes exist within the consortium) exists – it is such a condesending attitude toward all these people.

I trust that these groups can find some common ground and, instead of the repetitive antagonism, can band together, accept differences, and work toward a common good of bringing psychoianalysis to the community. That would entail letting those who perceive that analysis can be conducted once a week have their place in the world. I am proud to be an IPA analyst that supports this point of view. I am not threatened by losing anything by an attitude of inclusion. I think I have everthing to gain.
Mark Sehl

By: mleffert

mleffert — Sat, 13 Oct 2007 23:50:08 +0000

I see people for analysis 3,4 and 5 times a week. On rare occasions, a twice weekly patient does something I would call analysis. The reasons for the different frequency are multiple. If someone wants to tell me something is or isn’t analysis based on frequency this is usually about power and standing, not clinical psychoanalysis. I’ve never heard it talked about but it would probably be best for someone training to be an analyst to experience at least some of their analysis at ALL of the above frequencies to see first hand what it all feels like. For what its worth, I do analyze candidates of the American 4-5x. If someone came to me seeking a training analysis from another non-American institute wanting a 3x training analysis I would not turn them away but would reserve the right to tell them it was not working at that frequency if it proved to be the case. I have also never heard someone who argues that 3x is analysis say that they would not be happy to see someone more frequently if possible and necessary.Given the current position or lack thereof of the American on duration of a training analysis, operationally speaking as opposed to policy, the American is actually quite flexible on the subject so the whole business is rather pointless.

By: Judith Logue

Judith Logue — Sat, 13 Oct 2007 22:48:51 +0000

Thank you, KT Arnold, for the clarifying and reassuring reply! Decades ago we used to say, “Why take out a stomach when Maalox will do the trick”?

Obviously, we agree regarding the Big Picture.

Judith Logue, Ph.D.

By: KTArnold

KTArnold — Sat, 13 Oct 2007 18:06:05 +0000

Wow. I’m really taken aback. Although I don’t think this is the forum to discuss mine or Dr. Logue’s respective views in detail, it looks like some clarification is in order. I never would think of denigrating 5 times weekly analysis, I am only emphasizing that for many patients other treatments are clinically optimal. For *these* patients, 5 times weekly psychoanalysis is not better but worse than other treatments. For *these* patients (not for everyone!), psychoanalysis is not a Mercedes but a jalopy.

By: Judith Logue

Judith Logue — Sat, 13 Oct 2007 15:17:27 +0000

It is interesting and surprising — though naive of me to be surprised — that of all of the healing and forward-moving themes in the article by Dr. Arlene Richards that K. Arnold chooses to find one with the most potential for division and combat.

I’ve owned new Jaguars and old VWs, each for its time and place. Unlike some less fortunate people, I have had choice. Why does Arnold have to denigrate five times a week analysis, which may be indicated and fine for some people, in order for Arnold to choose, prefer, and see more benefit in weekly psychoanalytic therapy?

An antique jalopy with a running board, which my daddy drove, was a beautiful thing. If one loves this and it’s good for him or her, why isn’t this acceptable, approved, and okay? It may be overpriced to some people, and preferred to a Mercedes by others. Who the hell cares, if each person is choosing what s/he needs and wants.

As Dr. Richards’ kindergarten teacher taught her, manners and consideration of others preferences are important and to be respected. It continues to dismay me that there are so many, like KT Arnold, who continue to find and use paradoxes, contradictions, and potential for combat and division. This hurts all of us.

Hurray for Dr. Arlene Kramer Richards and her post. I don’t give a flying saucer about whether you call something an overpriced jalopy, Mercedes, or Ford, so long as you are driving what you want to be drive, and let others drive what they want to drive.

The disdain, condescension, arrogance, and defensive stances, as suggested in the reply by KT Arnold, are a good example of perpetuating collateral damage to all of us –whatever “standards” or frequency we prefer.

Judith Felton Logue, Ph.D.

By: KTArnold

KTArnold — Sat, 13 Oct 2007 13:41:37 +0000

Richards’ post is paradoxical. One the one hand, she encourages analysts to “welcome colleagues” who practice at a different frequency. On the other, she portrays high-frequency analysis as the “Mercedes” in comparison with the “Ford” of lower-frequency analysis. If Richards’ goal is to make friends and avoid hurt feelings, I suspect that her comparison may not help. For patients unable to tolerate or to benefit from high frequency treatment, it isn’t a Mercedes at all but an overpriced antique jalopy. For clinicians who treat these patients using appropriately low-frequency therapy, to imply that what they do is somehow inferior to high-frequency treatment would likely be viewed as insulting in light of their earnest attempt to provide the optimal technique for their patients.