In an ongoing conversation about analytic training, Debora M. Worth, LCSW, responds to our recent colloquium, “More Simply Clinical Than Otherwise: A Roundtable Discussion on Psychoanalytic Training” (January 11, 2019). There, Sandra Buechler, PhD, and Steve Kirschner, LCSW, presented papers, outlining some of their core principles of, not only training, but psychoanalytic work itself. Jamieson Webster, PhD, provocatively challenged the current state of training, particularly the hierarchical nature of most institutes.

At the recent colloquium, Jamieson Webster’s comments about analytic training stirred up some strong reactions that I’d like to share. Among other things, Jamieson questioned the value of analytic institutes, saying bluntly that her training experience “sucked.” She argued that the inbred hierarchy of institutes makes them inherently “sucky” and thus unsustainable, and suggested that analysts could be trained more effectively outside the institute structure.  

Unlike Jamieson, I didn’t feel that my training sucked. In fact, my years at Manhattan Institute were rich, fulfilling and exciting. Early in my work, an adolescent patient told me she didn’t understand why therapists were called “shrinks” when they should be called “expanders.” I think “expansive,” far better than “sucky,” describes my experience as both candidate and analysand. 

In preparation for beginning training at MIP I interviewed several potential training analysts. I had completed a prior analytic treatment, so I had a rough sense of what I was looking for. I was ambivalent about the first analyst I met, but shortly into the hour with the second one I knew the fit was good. We arranged another meeting, and between those two sessions I had the following dream:

I was in a huge, grassy field. It was a bright, warm, sunny day. The sky was blue. Growing in the field were thousands of ice cream cones in all flavors and colors. I love ice cream, and I was excited to see all those goodies there for me to taste. At first I was anxious because I felt I had to hurry and try them all before they melted. Then I realized that, despite the warmth of the day and the shining sun, the ice cream was not melting. It was just there, endlessly cool and refreshing, for me to eat as fast or as slowly as I wanted. I wandered aimlessly through the field, stopping to taste one here and one there, enjoying the different flavors with a great sense of ease and relaxation.

That sense of limitless opportunity, of time and space to taste and experience new and wonderful things, was what I felt analysis with this person would be, and what I hoped my training experience would be. I was not wrong.

Of course there were difficult, wrenching moments in both my analysis and my training. Not all of my experiences with teachers, supervisors, cohort, or analyst were positive. I sometimes felt inadequate, exhausted, and angry. But throughout and despite it all, I felt enveloped in a family — sometimes a dysfunctional family, but one in which I was nurtured and supported enough to enable me to grow in my own way and at my own speed.

Jamieson’s experience seemed starkly different, and I wonder how much of that difference reflects the specific characteristics of the institutes in which she trained. I do not mean this as a proclamation of the superiority of one institute to another but rather as a consideration of fit. A quiet, sensitive baby born into a family of loud extroverts may have great difficulty. So may a vocal, active baby in a family of quiet, careful people. We think a lot about the fit between analyst and analysand, but we don’t often talk about the fit between institute and candidate. This is a mistake. I do not think there is a one-size-fits-all institute. 

My decision about where to apply for analytic training was somewhat haphazard. At the time, I had a supervisor who was affiliated with the Freudian Society. I knew she expected me to apply there, so I did. At her suggestion I also applied to IPTAR. White did not accept social workers then, and New York Psychoanalytic felt too intimidating. I eliminated the others for reasons I no longer remember. I had attended several of MIP’s colloquia and had been impressed, so I applied there also. But I assumed I’d choose one of the more classical, established institutes.

However, in interviewing I learned something about those places and about myself. Both the Freudian Society and IPTAR felt very hierarchical, doctrinaire, and rigid. In open houses and interviews, I felt myself slipping into a familiar yet uncomfortable posture of trying to be what I thought they wanted, asking questions I thought they would approve of, and stifling questions I thought they would not welcome. At one institute the interviewer asked nothing about my professional life and instead conducted the interview as if it were an analytic consultation, or worse, a psychiatric evaluation. I went along, but afterwards I felt queasy.

Then I had my first interview at MIP, with Irwin Hirsch, and I stepped into an entirely new world in which my interviewer was actually curious about me, my work, my life, and my ideas. I realized that if I went to one of the other institutes I’d continue being a good girl who would struggle to conform to their explicit and implicit expectations. Some spark of clarity in my otherwise muddled mind knew I’d succeed but be miserable.

I had friends whose experiences were the opposite; they found the structure of those other places comforting and holding, and found MIP loosey-goosey and unfocused. Unlike me, they had no trouble asserting their individuality within a more rigid system. Unfortunately, one doesn’t necessarily know these things before one embarks on analytic training. And once you’re in, you make the best of it—and may feel trapped in a training experience that sucks.

I do not disagree with all of Jamieson’s points. There are many times nowwhen I think MIP sucks and when aspects of its culture frustrate me. As I’ve grown up in this family and become, shockingly, one of its elders, I often see things differently. I find myself doing that horrible parental thing of thinking (and often saying), “When I was in training…”, and assuming that what was then can and should be now. It is challenging, though ultimately rewarding, to find ways to train candidates with no clinical experience, but with much more impressive backgrounds than mine in other fields. It is frustrating to recognize that although to me participating in the running of this institute has felt like a reward and honor, not everyone feels that way. There have been times, especially recently, when I have felt like one of the few people who is willing to do anything around here. And now I sound like my mother!

Institutes are strange families. But I think in any family one wants to give back what one feels one has been given. I do share Jamieson’s concern about hierarchy. So to me our greatest current challenge is this: we must find ways to include our candidates in the day-to-day running of their institute from the very beginning so as to nurture in them the desire to participate in its future. To accomplish this we need to hear their concerns, and find ways to meet their needs without compromising our core values. We need to respect the individuality of person and circumstance each candidate brings to us, we need to listen when they tell us what sucks about their training, and we need to be creative in our responses. We can do this and still maintain our high standards.

I believe that if we can improve our ability to do these things for our candidates, institutes will sustain themselves. If we cannot, then perhaps they will, and should, become extinct.

Debora M. Worth, LCSW, is a graduate of the Manhattan Institute for Psychoanalysis. She is faculty, supervisor, and training analyst at MIP, and served as co-director of the institute from 2007 to 2012. In addition, she is teaching and supervising faculty in the Child and Adolescent Training Program at the William Alanson White Institute. She is in private practice in New York City, working with adults, couples, children and adolescents.

If you enjoyed this post, we recommend:
Why Did You Become a Psychoanalyst? PART I and PART II
On Psychoanalytic Training: Remarks by Steve Kirschner, LCSW