Psychoanalytic Standards: Highest or Good Enough
There is disagreement amongst psychoanalysts about the aspirations that we should strive for in recruiting candidates, graduating analysts, and appointing training analysts. Some believe we should strive for excellence and the HIGHEST STANDARDS, while others believe we should strive for GOOD ENOUGH STANDARDS. I regretfully think, for several reasons, that striving for the HIGHEST standards is a fatally flawed goal –and know that I make these comments as a Training Analyst and Fellow of the American Psychoanalytic Association’s Board of Professional Standards–thus, someone who has supposedly met the HIGHEST standards:
1. Psychoanalysis is an extremely complex, 2-person procedure that is inherently idiographic, not nomothetic. Even Freud commented, in his comparison to chess, that one could only prescribe the opening moves. I do not think any of us can be as effective with all patients. Our “evidence base” is on a case-by-case basis.
2. In my experience, and I say this with some pause and humility, there is
great variance in the competence of both analysts and training analysts,
not only person-by-person, but also over time. For example, I have seen
candidates who appeared marginal, flower into very talented analysts, and I
have experienced the opposite as well.
3. In my work with colleagues locally, nationally and internationally, I have not experienced (with any reliability) that training analysts are superior clinicians. In fact, I have regretted that some of our most talented analysts decline to become training analysts because of the requirements of meeting the HIGHEST standards.
4. Since our procedures for appointing training analysts are not based on the analysis of candidates (you cannot analyze candidates until you become a TA), these procedures cannot take into account what I consider to be one of the most critical considerations in the analysis of candidates: The ability to work with all the indirect counter-transference of analyzing someone who is immersed in your own analytic community. Thus, this standard is not even included in the evaluation to become a TA. So to my thinking this is a catch-22, making it impossible to meet the HIGHEST standard. To do so, we would need to evaluate a training analyst’s success
at analyzing candidates.
I could go on but will not. My point is that there are many reasons that
the best we can strive for is GOOD ENOUGH standards, not the HIGHEST
standards.
Lee Jaffe