Commentary

Inclusion of psychoanalytic thought in doctoral programs of psychology: Results of a survey of APA- and CPA-accredited programs

Data and discussion of a survey of doctoral programs in psychology and their inclusion of psychoanalytic thought

By David L. Downing, Aimee Dershowitz, and Bryn Higgins

Paper Based on a Presentation for the 31 Annual Spring Meeting of the American Psychological Association, Division of Psychoanalysis (39), New York, New York April 13–17, 2011

In attempting to transmit an ethos of treatment as embedded within and across the many paradigms contained within the movement known as “psychoanalysis,” the primary author has encountered considerable difficulty in his roles as a practicing psychoanalyst who is also an administrator and professor in a doctoral program in clinical psychology accredited by the American Psychological Association. Being inclusive of the paradigmatic diversity that marks the psychoanalytic movement; as well as how to effectively communicate often dense, turgid material, generally embedded in complex jargon, to professionals-in-training, presents daunting enough challenges. Graduate students in contemporary professional school programs—usually “generalist” and diverse with respect to theory to begin with—are individuals for whom psychoanalysis may represent an alien, and often unwanted, excursion into a little-known theoretical and clinical practice base. Additionally, it is well-known that many graduate psychology programs are not merely disinclined toward psychoanalysis, but have, especially in the United States, been positively hostile toward it; jettisoning it from the curriculum and the discourse of the program and, hence, the profession completely. Adding the problems attendant with a contemporary cultural milieu of the country that privileges a distinctly reductive biobehavioral model that negates the complexities of an experiencing subject— let alone an intrapsychic focus that includes the possibility of the dynamic unconscious, and the challenges facing psychoanalysis in simply remaining relevant, are obvious. The valorization of “the symptom,” which brackets the patient, and is the product of a disease process that is to be treated via a medicalized technology, as prescribed by “science,” promises a “quick fix,” if inferior to the even quicker fix of medication, becomes enshrined in the collective consciousness of the culture, aided and abetted by a professional promise of a quick and easy “treatment-by-manual.”

In an attempt to go beyond an impressionistic “sense” of the state of psychoanalysis in the academy, it was decided to gather actual data on the existence of psychoanalytically friendly programs in psychology in the United States and Canada. This paper will discuss how the complex situation noted above is itself premised upon the status—the presence—of psychoanalytic ways of thinking, conceptualizing, and treating diverse clinical populations and associated treatment issues in graduate psychology programs.

The results of a survey sent to all graduate doctoral programs in clinical and counseling psychology developed by the authors will be offered for review and discussion. Results of the survey will be accompanied by various analyses of the findings for consideration and action.

Methods

We utilized a modifi ed version of a prior survey used by Division 39 of the American Psychological Association that was created for the purpose of ascertaining the number of psychoanalytically friendly APPIC-affiliated or APA-accredited internships (Downing, Greenlee, & Louria, 2006). Two graduate assistants (the coauthors of this study) were recruited to help collect and analyze the data. After modifying the survey and creating a brief cover letter, a comprehensive list of PhD, PsyD, and terminal MA programs in clinical or counseling psychology was compiled from the book Graduate Study in Psychology (APA, 2010) and entered into a spreadsheet. This spreadsheet included the names of the schools, the programs they offered, the name of the primary contact person, and the email address provided. These email addresses were then entered into an email application, and the primary contact person was sent both the cover letter and the survey instrument.

Duplicating the survey conducted by Downing, Greenlee, & Louria (2006), we examined nine different content areas, including:

  1. Whether the program is accredited by the American Psychological Association;

  2. Whether the program considers itself to be open to and inclusive of psychoanalytic/ psychodynamic theory and practice;

  3. Whether the program has any faculty that are certifi ed psychoanalysts, or are in psychoanalytic training;

  4. Whether the program employs psychoanalytically oriented faculty and includes psychoanalytic thought in its courses;

  5. Whether the program requires introductory courses on psychoanalytic theories and psychotherapy;

  6. The types of psychoanalytic perspectives offered by the program, including:

    a. None
    b. Freudian/classical
    c. Ego psychology
    d. Object relations
    e. Self-psychology
    f. Lacanian
    g. Other perspectives

  7. Whether the program covers special topics from psychoanalytic perspectives such as treatment of severe psychopathology, race, class, gender/sexuality, dreams, supervision, transference/countertransference;

  8. Whether the program requires courses on short-term psychotherapy and crisis intervention that include psychoanalytic perspectives;

  9. Whether the program would like to be listed on a psychoanalytically friendly universities website.

Items one-five and seven-nine were modified for the analysis in the present study.

Emails that were returned to us as undeliverable were removed from the spreadsheet and the list of email addresses. We followed up the emailed surveys one month later with requests to the programs we had not heard from asking that they complete the survey in order to increase the response rate. The survey and cover letter were attached to the follow-up email. This process was completed yet again one month following the fi rst reminder email in an attempt to obtain further responses. Questions obtained from the respondents were handled on a case-by-case basis.

Following the return of each survey, the data was printed out and placed into a binder to maintain a hard copy of all responses, including responses declining to participate in the survey. The answers to the survey were then input into SPSS, coding the answers with a “1” for “yes” and a “0” for “no.” Analyses were conducted to determine the percentage of programs who answered each question “yes” from the responses received.

Results

Of the 487 PhD, PsyD, and MA programs surveyed, we received 83 surveys that were able to be rated (17.04 percent). Of the programs surveyed, 18 (15.8 percent) of the PsyD programs surveyed responded, 56 (57.9 percent) of the PhD programs surveyed responded, 22 (19.3 percent) of the MA programs surveyed responded, and 7 (6.1 percent) programs responded that reported having more than one degree program.

Of the 83 programs that completed the survey, all 83 responded to the question “Is your doctoral program accredited by the American Psychological Association?” Of those 83 responses, 66 (80 percent) of the programs responded “yes,” and 17 (21 percent) of the programs responded “no.” Of the 83 programs that completed the survey, 81 programs responded to the question “Is your program considered open to and inclusive of psychoanalytic/psychodynamic theory and practice?” Of the 81 responses, 56 (69 percent) of the programs responded “yes” and 25 (31 percent) of the programs responded “no.” Of the 83 programs that completed the survey, 82 programs responded to the question “Does your program have any faculty that are certifi ed psychoanalysts, or are in psychoanalytic training?” Of the 82 responses, 29 (35 percent) of the programs said “yes,” and 53 (65 percent) of the programs said “no.”

Of the 83 programs that completed the survey, 80 programs responded to the question “Does your program have psychoanalytically oriented faculty, and include psychoanalytic thought in their courses?” Of the 80 responses, 51 (64 percent) said “yes,” and 29 (36 percent) said “no.” Of the 83 programs that completed the survey, 81 programs responded to the question “Does your program require introductory courses on psychoanalytic theories and psychotherapy?” Of the 81 respondents, 34 programs (42 percent) responded “yes,” and 47 programs (58 percent) responded “no.”

81 respondents completed the question “Which psychoanalytic theoretical perspectives does your program offer?” However, only 80 respondents completed the subquestion regarding the “Freudian/classical” theoretical perspectives. Of the 81 programs that responded to the “None” prompt, 24 (30 percent) responded “yes” and 57 (70 percent) responded “no.” Of the 80 programs that reported about a “Freudian/classical” theoretical perspective, 43 (54 percent) indicated that the perspective was included and 37 (46 percent) noted that the perspective was not included. Thirty-nine programs (48 percent) stated that “Ego psychology” was incorporated in their programs and 42 programs (52 percent) stated that it was not. Of the 81 respondents who responed to the subquestion regarding “Object relations,” 50 (62 percent) stated it was incorporated in their program and 31 (38 percent) stated it was not. Thirty-four (42 percent) of the programs reported that “Self-psychology” was utilized in their program and 47 (58 percent) stated that it was not. Eight programs (10 percent) noted they used a “Lacanian” perspective in some of their coursework and 73 (90 percent) stated that it was not used. When questioned about their use of “Other perspectives,” 27 programs (33 percent) stated they incorporated other perspectives and 54 programs (67 percent) stated they did not use other perspectives. The top three psychoanalytic perspectives utilized in the programs surveyed were, in order: object relations, Freudian/classical, and ego psychology.

Of the 83 programs that completed the survey, 80 programs responded to the question “Does your program cover special topics from psychoanalytic perspectives such as treatment of severe psychopathology, race, class, gender/ sexuality, dreams, supervision, transference/ countertransference?” Of the 80 responses, 49 programs (61 percent) said “yes” and 31 programs (39 percent) said “no.” Of the 83 programs that completed the survey, 80 programs responded to the question “Does your program require courses on short-term psychotherapy and crisis intervention that include psychoanalytic perspectives?” Of the 80 programs who responded, 19 (24 percent) said that they did and 61 (76 percent) said that they did not. When the 83 programs were asked if they wanted to be listed on a website of psychoanalytically friendly universities, 76 programs responded, with 38 (50 percent) saying “yes” and 38 (50 percent) saying “no.” Of all 83 respondents, including master’s- and doctoral-level programs, 34.78 percent wanted to be included on the website. Of the doctoral-level programs who responded, 43.48 percent wanted to be included on the website.

Summary

This study was conducted in order to assess the openness to psychoanalytic theory and psychotherapeutic paradigms within mainstream psychology graduate programs—historically anathema to such programs—across the United States and Canada. Programs surveyed included PsyD programs, PhD programs, master’s programs, and programs that contained more than one degree program. The majority of programs that responded were APAaccredited and reported being open and inclusive to psychoanalytic and psychodynamic theory and practice, and to have faculty who were psychoanalytically oriented and utilized that orientation in their curriculum. Despite this, few programs had any faculty that were certifi ed psychoanalysts or had psychoanalytic training or required courses in the core curriculum on psychoanalysis.

Over half of the programs noted that they included psychoanalytic programs in their special topics courses. However, these courses were rarely on short-term psychotherapy or crisis intervention—an oddity, given that it was psychoanalysis that founded these types of treatments. This is a further indication of how psychoanalysis has failed to communicate and represent itself accurately in the “marketplace of ideas” that, optimally, constitutes the academy. Of interest is the fi nding that psychology programs’ utilization of psychoanalytic perspectives indicated a wide variety of different schools of thought being utilized throughout the country. Object relations was the perspective that was taught most frequently, followed by Freudian/classical, ego psychology, self-psychology, other perspectives, no perspective, and Lacanian, in that order. Half of the schools that responded wanted to be included on a website for psychoanalytically friendly universities. The greatest concentrations of programs that considered themselves to be psychoanalytic, at least in terms of those that responded, were in California, followed by Texas, Indiana, and Pennsylvania.

There are several limitations to this study that should be considered. Because the schools were drawn from the book Graduate Study in Psychology, it is possible that some programs were overlooked because they had not been included in the book. It is also possible that the contact information was out of date and thus that not all of the programs received a copy of the survey. Due to the email nature of the survey, it is possible that some of the emails were delivered to the “junk mail” folder of the recipients, which might have reduced our total potential responses. The sheer number of surveys and requests to respond to one communication or another that are received by academic administrators may also be reaching a level that is beyond the capacity to undertake because of the other demands that administrators face. In addition, because of the low response rate, the data collected here might not be based on a representative sample of the United States and Canada. Due to the survey nature of the study, the sample might be biased due to the inclinations of the programs and directors who chose to return the survey.

Anecdotally, member programs of the National Schools and Programs of Professional Psychology (NCSPP), the organization for professional schools of psychology, most often PsyD programs, largely preserve generalist theoretical and psychotherapeutic offerings, including psychoanalytic. It is curious, indeed, that such a small number of PsyD programs responded (18, out of an NCSPP membership of 65 programs; 18 associate member programs; and 4 observer programs). That such a robust number of PhD programs answered—and were positive toward psychoanalytic thought, which goes against the received wisdom of behaviorism and cognitive behaviorism holding uncontested monopolies of clinical theory and practice as transmitted—provides some modicum of hope for psychoanalysis in psychology.

Further research would be benefi cial to gain more information regarding the psychoanalytic openness of psychology programs in the United States and Canada. It would be benefi cial to modify the survey in order to assess the extent to which each university is, indeed, “psychoanalytically friendly,” rather than to dichotomously assess aspects of each program. Future research could also be productively directed toward discerning the types of courses taught exclusively from, or incorporating, a psychoanalytic perspective.

Evaluating the presence and use of psychoanalysis in contemporary graduate psychology programs is essential to understanding the changes occurring in the field of psychology, and its practice in the near and distant futures. Results indicate that a majority of psychology graduate programs are open to psychoanalytic theory and practice, but do not require psychoanalytic coursework or include psychoanalysts on their faculty. Future research would be beneficial to continue assessing the function psychoanalysis plays in modern psychology.

Discussion

The mark of a good theory is noted by many factors: its empirical elements, its rational appeal, its pragmatism—and, interestingly enough, its aesthetic qualities. The elegance and beauty of psychoanalytic theories and their valiant effort to conjecture about and word the nuances of the intrapsychic life of the subject—especially the murmurings of the unconscious—are nothing short of aweinspiring. The seeming impossibility of the task seems only to have, across time, inspired psychoanalysis to undergo nothing short of periodic revolutions, resulting in a profusion of psychoanalytic perspectives, including but not limited to: the neuropsychoanalytical position that takes up the Freudian “Project for a Scientifi c Psychology,” armed with the recent advances in the cognitive/neurosciences, neuroimaging, and the so-called psychopharmacological revolution; psychoanalysis as a hermeneutic endeavour; applied psychoanalysis; gender studies; developmental psychoanalysis, with its long and important legacy; along with the entire panoply of theoretical and associated clinical perspectives— the familiar “camps” that populate the psychoanalytical landscape—Freudian, neo- Freudian, Kleinian, neo-Kleinian, Bionian, and so on and so forth. However, does the clamor of our elegant pantheon of theories with their accumulated wisdom make an impact if there is nobody listening?

In the spirit of Wundt, Tichener, and Helmholtz, American psychology has disparaged that which cannot be measured. The sound of psychoanalysis in the academy is that of one hand clapping, because psychoanalysis is generally absent. So colonized by an experimentalist ethos, the academy in America has managed to take some of the best movements born abroad and eviscerate them of their more subversive, revolutionary, illuminating, and compelling elements. In the case of psychoanalysis, its embrace by departments of psychiatry proved disastrous as it became aligned with a medicalized discourse and an elite for whom adjustment and adaptation was the sine qua non. The seeds of its marginalization were sown at the very stroke that it reached its zenith of popularity in the United States, and much of its more readily accessible (and often pejorative) terminology was co-opted into the fabric of the everyday. The academy was left to the quantitative experimentalists who continued to devotedly measure micro- and epiphenomena and confabulate from the part to the whole that something of signifi cance lay in their SPSS, ANOVA, MANOVA, and canonical correlation spreadsheets; brain scans and genetic and twin studies; and randomized controlled trial (RCT) responses to various chemical compounds. Small wonder that such mutual antipathy has arisen amongst psychoanalytically oriented clinicians and scholars, and the rest of the academic and clinical fi elds—or why so many psychoanalysts hold the idea of “research” in such low regard. Yet, we discard and disregard “empirical” and quantitative research at our cherished profession’s peril.

Indeed, we would do well to recall that the term “empirical” actually has a meaning rather different from the generally accepted modern connotation. Historically, the term references an epistemic system as derived from experience, learning, and direct observation. Historically, this has depicted the mind as a tabularasa. It has traditionally been counterposed with a rationalist view, emphasizing a priori knowledge, the existence of innate organizing principles, and the concept of an active mind (Viney & King, 2003). In this sense, the assaults on psychoanalysis are specious and posed through fallacious reasoning. Psychoanalysis is most certainly anchored within an empirical tradition, yet it also embodies rationalistic elements as well. The knowledge produced by psychoanalysis is as difficult to pin down as it is to claim any one school as the psychoanalysis.

Yet, as Division 12 of the American Psychological Association has claimed a particular, political rendering and appropriation of the term “empirical” as a method of scientifi c enquiry and the way of knowing, psychoanalytic communities (and humanisticexistential communities as well) have been put on the defensive. We have routinely indicated to students—as well as in responses to surveys on the matter—that an immersion in psychoanalytic theory and practice is, in fact, an immersion in an empirically supported treatment approach. Psychoanalysis sponsors a way of knowing that is different from that promulgated by the bedfellows of logical-positivism—and the so-called evidence that is privileged in a cognitive-behavioral discourse. That this has not captured the favor of third-party payor systems within the medicalized, corporatized industrial health care matrix is not at all surprising. The corollary of the fate of an experiencing subject within a psychiatry captured by a biological franchise is a logical extension of the same epistemological, ontological struggle for conceptual, economic, political, and pedagogical dominance. So long as psychoanalysis cedes the field and abjures its own storied legacy within the domain of scientifi c enquiry, it shall be (dis)placed and lodged in the defensive position of naysayer, unable to determine and define the terms of the battle. The empirical findings of psychoanalysis over the past 120-some years will be adjudged as inferior, and the stuff of a pseudoscience.

About the authors

David L. Downing, PsyD, ABPP, is Director of Graduate Programs in Psychology and Professor at the University of Indianapolis. He is an APA Council Representative of Division 39 (Psychoanalysis) and President of the Division’s Section V (Psychologist-Psychoanalyst Clinicians). Treasurer of the American Board & Academy of Psychoanalysis, the psychoanalytical subspecialty within ABPP, he is in private practice in psychoanalysis and psychotherapy in Chicago and Indianapolis.

Aimee Dershowitz, MA, is a doctoral candidate at the School of Psychological Sciences, University of Indianapolis, with a concentration in Child-Adolescent Psychology. She will begin her predoctoral clinical psychology internship the summer of 2012 at the Family Psychological Center, through the Heart of America Psychology Training Consortium, in Harrison, Arkansas.

Bryn Higgins, PsyD, is a graduate of the School of Psychological Sciences, University of Indianapolis, completing her postdoctoral fellowship year at Indiana University-Perdue University-Indianapolis. Dr Higgins completed a concentration in Health and Neuropsychology and continues to practice chiefl y in this area of interest.

References

American Psychological Association. (2010). Gradaute study in psychology. Washington, DC: American Psychological Association.

Ainslie, R., Scarborough, J., Zeddies, T., & Adams, M. (1997). Psychoanalytic training opportunities: Alive (and well?) in pre-doctoral internship settings. Psychologist-Psychoanalyst, 16(4), 13–14.

Downing, D. L., Greenlee, T. M., & Louria, S. (2006). Psychoanalytical training opportunities in pre-doctoral internships: Opportunities and challenges. Psychologist-Psychoanalyst, 26(4), 81–84.