Impossible Training: A Relational View of Psychoanalytic Education (Book Review)

Author:  Berman, Emanuel
Publisher: Hillsdale, NJ, The Analytic Press, 2004
Reviewed By: Juan Tubert-Oklander, Fall 2005, pp. 51-53

Emanuel Berman is a highly gifted relational psychoanalyst and psychotherapist. In this fascinating book, he approaches the question of psychoanalytic training from the relational perspective, this being a subject in which the author has an ample experience.

The Introduction, called “On Training and History” presents Berman’s approach to the understanding of these problems. His perspective is essentially historical, since he strongly believes that, just as the life and thought of individuals are determined by their infancy and childhood, groups and institutions are similarly ordained by their early origins, even though their individual members are usually unaware of this influence. And this unconscious sway of history is to be found, more often than not, in the biographies of the institution’s founding fathers—or mothers.

A thorough analytic inquiry of the life and writings of psychoanalytic authors shows them to be highly complex individuals, whose work is “characterized by inherent tensions and even inner contradictions rather than by the simple expression of a single-minded view” (p. 8). But one of the most interesting contributions of Berman’s approach to this question is his contention that the development of psychoanalytic ideas stems, more often than not, from a relationship, a dialogue, even an opposition between persons involved in the psychoanalytic experience: “theoretical innovations do not spring from the mind of an isolated person (‘immaculate conception’) but usually evolve in the transitional space created within an intense, lively, interactive dyad (an ‘impregnating intercourse’)” (p. 12).

Chapter 1 is called “Freud and Ferenczi: Their Generative Dyad as a Springboard for a Relational View of Treatment and Training,” and it focuses on the highly complex emotional and intellectual relationship between these two forefathers of psychoanalysis. They were alternatively father and son, teacher and student, analyst and patient, friends, colleagues, and rivals, joined by their passion for psychoanalysis. However, there were differences between them from the very beginning. Freud strongly believed in the need for a firm hierarchical structure for the regulations of the relations between the sexes, between generations, and between therapists and their patients, while Ferenczi had an equally intense penchant for equality, openness, and mutuality, and a firm conviction that all knowledge should be shared. Other differences derived from their respective attitudes towards therapy, since Freud was manifestly uninterested in curing, while Ferenczi had a passion for aiding the sick and alleviating their suffering, as well as from their disagreements about Ferenczi’s brief analysis with Freud, which the latter mentioned in “Analysis terminable and interminable” (Freud, 1937).

Even though Ferenczi strove until the end to preserve his relationship with Freud, their rupture became inevitable, as the former continued his passionate research into the analysis of severely traumatized patients, which led him to a revamped version of Freud’s original traumatic theory of neuroses. This development was unacceptable to the master, who was also increasingly uncomfortable with the younger man’s non-hierarchical approach to psychoanalytic technique, which finally lead to his explorations in mutual analysis (Ferenczi, 1985). But it was Ferenczi’s last paper “Confusion of tongues between the adults and the child” (Ferenczi, 1933) which finally made Freud forsake all contact with his former pupil, who died soon after that.

For many decades, the psychoanalytic community repressed the memory of this conflict, and even seemed to deny the very existence of Ferenczi and his transcendence for the history of psychoanalysis. As Berman points out, “for a long time we have become accustomed to viewing psychoanalysis, and with it psychoanalytically oriented psychotherapy, as a single-parent family” (p. 62). Reacknowledging Ferenczi as the other half of the original generative dyad—not necessarily a mother, unless we are willing to uphold the traditional gender roles—opens a path for the revival of the broken dialectic between two ways of conceiving our discipline.

Chapter 2 is about “The Klein-Winnicott Relationship and the Debate on Inner and Outer Reality.” The Klein-Winnicott dyad, just as the previous Freud-Ferenczi relationship, started auspiciously, but was later marred by conflict, when the younger partner became too independent and the senior one rejected his original contributions as a manifestation of disloyalty. Their main disagreement was about the importance of external reality and the real object on both infantile development and the analytic treatment. Winnicott felt that trying to speak to Klein about these issues was like “talking about color to the color-blind,” and indeed she seemed to show an utter denial of the effect of both the mother’s and the analyst’s personalities on children and patients alike, which may be understood in terms of her own personal biography.

Chapter 3 deals with “Psychoanalytic Training and the Utopian Fantasy of the New Person,” in which the author tries to understand the common observation that psychoanalytic training institutes tend to operate in a persecutory climate that induces in candidates an extremely cautious and frequently submissive response. In trying to account for this phenomenon, Berman focuses on the relationship between rescue fantasies and utopian visions in the development and transmission of psychoanalysis.

Rescue fantasies certainly play a part in the psychoanalytic vocation. Utopian views, which are the social and institutional equivalent of individual rescue fantasies, may promote valid social reform, but they may also breed an omnipotent and narcissistic form of ruthless dogmatism and authoritarianism. In psychoanalytic institutions, this takes the form of an idealization of psychoanalysis and of the “fully analyzed person”—usually identified with training analysts—as a New Person. Some of the consequences of such view are an exacting screening of applicants and a thorough evaluation of candidates, which are partly responsible for the paranoid climate of the whole teaching-learning process, and may foster the development of an “analytic false self.” The corresponding idealization of senior analysts may stagnate any fruitful interchange of ideas, and certainly strengthens a rigid hierarchical structure, quite unlike that of universities. In many utopian movements—national, religious, social, or psychoanalytic—“a gap tends to develop between ideals and the structures created to implement them” (p. 122); this requires some sort of correction, if it be possible.

Chapter 4, called “Detoxifying the Toxic Effects of Psychoanalytic Training: A Case Study,” is Berman’s attempt to answer the inevitable question about whether it is at all possible to correct such distortions of psychoanalytic education within a traditional psychoanalytic institute. His answer is that it is, and describes the evolution and outcome of the controversial discussions that took place in the Israel Psychoanalytic Society, from 1992 to 1996, in which he played an important part. This heated debate between “traditionalists” and “reformists” focused specifically on the structure and atmosphere of training, but the fiercest battles were fought about the proposal of allowing non-training analysts to conduct the personal treatment of candidates. Finally a compromise solution was found, which made no one happy but all could live with: candidates were still expected to have their analyses with a training analyst, but were allowed two years to finish their present treatment, and could still request a special waiver to continue it afterwards. There was also a slackening of the requirements for admission to the Institute, for graduating, and for becoming a training analyst.

The author’s point is that reform is possible in a traditional psychoanalytic institute, as long as the opposing parties are willing to compromise, and there is “a process of patiently searching for pragmatic compromises acceptable to most members” (p. 136). If these changes are made at a moderate pace and introduced without provocations, the process need not have a catastrophic impact on the institution’s structure and functioning, nor on its commitments to the international psychoanalytic community.

The subject of Chapter 5 is “The Trainee’s Personal Analysis and its Dilemmas.” In this there are again differences between analysts. If the fact that the analyzand is in an institutional training course is seen as “merely external and conscious,” then the analyst should ignore it and focus on “making conscious the unconscious.” On the other hand, if he considers that personal relations and group, institutional, and social processes are an essential part of unconscious mental life, he should also strive to interpret and discuss with his patient this part of their shared reality. The truth is that training analyses are carried out in a highly incestuous milieu, since analyst and analyzand are both part of a same community, and a rather small one. The author advocates, from his relational conception of psychoanalysis, actively inquiring about the information received by the patient about the analyst, both personal and institutional, as well as his or her own perceptions and opinions about him, which may not be offered spontaneously otherwise, in order to advance a fuller analysis of the transference. The impact of the institute’s dynamics on the analytic process may be reduced by eliminating concrete forms of interference, such as reporting about the analysis, but the continuous presence of this third party should anyway be thoroughly analyzed.

Chapter 6 focuses on another essential aspect of psychoanalytic training: “Psychoanalytic Supervision: The Intersubjective Turn.” If psychoanalysis is not only a “one-person psychology” that studies intrapsychic processes, but also a “two-person psychology” that studies interactions, as posed by intersubjective and relational thinking, then supervision should not be seen as merely teaching “the right technique.”

Since transference and countertransference are constantly mutually activating and shaping each other, countertransference analysis cannot be excluded from the psychoanalytic supervision, even in its more personal sources. In this, the strict separation imposed by the Eitington model between training analysis and supervision may militate against a deeper understanding of the articulation of the unconscious dynamics of the two dyads—the supervisand with his patient and with his supervisor. Therefore, the work of supervision should also include an inquiry into the dynamics of and the difficulties found in the supervision. The author’s proposal is not “turning the supervision into a mini-analysis,” but rather to use it as an opportunity for an inquiry in depth of the articulation of the unconscious dynamics of these two dyads.

The seventh and last chapter, called “Training for the Future,” is perhaps the most fascinating part of this book. Here Berman develops his own view of psychoanalytic treatment as a synonym for a “talking cure,” rather than of a particular theoretical or technical model. Consequently, the core of psychoanalytic training is not the transmission of any such model, but rather “the development of a unique state of mind and of particular sensitivities that facilitate better empathic and introspective perceptiveness” (p. 228) vis-à-vis the patients and other human situations. This requires a thorough recognition and understanding of “the unavoidable defensive processes that inhibit and sidetrack such perceptiveness of the analyst” (íbid).

This development requires a flexible and reflective approach, including a critical understanding of the history of psychoanalysis, which may allow the candidate to benefit from the many models proposed in the past, while understanding their social and psychodynamic contexts, thus avoiding the perils of dogmatism and ancestor worship. The dangers of a teaching that includes diverse and conflicting models—ambiguity, conceptual confusion, ecclecticism—may be avoided if candidates and teachers develop a comparative-evaluative metatheoretical dialogue that places each model in its social and biographical context.

One final requirement is the need to consider the impact of social reality on the training process, and on the analytic process itself. This does not only mean including the institutional aspects of analytic training, but also the implications of the broader social economic, political, ideological, and cultural reality:

Paraphrasing Ferenczi, I would suggest that keeping “political” issues out of the consulting room, in a society which experiences them with great intensity (especially at times of crisis, war, and massive controversy), may also be experienced by some patients as professional hypocrisy and become destructive for the analytic process [p. 250].

This last statement, which practically closes the book, was especially welcome for this reviewer. While I was reading the book, I felt an admixture of a full agreement with and admiration for the author’s exposition, and an unsettling feeling that something was missing. For instance, in the extensive analysis of the crisis in the Israel Psychoanalytic Society, even though there was a careful consideration of the institutional and social processes affecting the professional communities of psychoanalysts and psychotherapists, no mention was made of the particularities of Israeli culture, or of the unavoidable impact of teaching, learning, and practicing in a country that has been at war ever since its creation. However, Berman’s comments, in this last chapter, about the one-sidedness of the membership of the IPS—no Arabs, few of a Mideastern background, few Orthodox, barely any gays or lesbians, most of them Azhkenazim from middle- and upper-class; in other words, “an exclusive membership club”—show that he is keenly aware of these problems. He is also firm in his conviction that social and political issues should be a part of the psychoanalytic dialogue, in order to deepen our psychoanalytic understanding of human experience.

So, why the overt omission of this wider social dimension in the first six chapters? While reading the book, I had a feeling that it is not an organic whole, but that it represents an evolution in the author’s thinking and writing, depicted by the transit towards Chapter 7. Besides, perhaps keeping a low key about social issues is part of the negotiation process that allows a psychoanalytic community to reach compromise solutions within a traditional psychoanalytic institution.

I have also observed that the author does not quote group-analytic literature, which would help him to theorize the kind of hyper-complex phenomena that he is trying account for. Since his first training was in group and family therapy, this omission cannot be attributed to a lack of knowledge. Of course, Enrique Pichon-Rivière’s (1971) ideas on group analysis had been unavailable in English, until quite recently, on account of the language barrier (Tubert-Oklander and Hernández de Tubert, 2003; Hernández de Tubert and Tubert-Oklander, 2005), but Wilfred R. Bion’s (1961) and S. H. Foulkes’s (1948, 1964, 1975) writings have been readily available for many years. Perchance leaving behind other theoretical frames of reference is a necessary stage in the process of becoming and growing as a psychoanalyst; hopefully a temporary stage.
Nevertheless, it seems that there is a heavy toll to be paid in order to play an active part in the international psychoanalytic institution, as a part of the necessary effort to share the language of the community, in order to be understood and feel a part of it. Such accommodations are not usually conscious decisions, but an aspect of the unconscious dynamics of the relation between the individual and the larger group. In this instance, just as in every other case, the attempt to reach an analytic understanding of the unconscious underpinnings of the writer’s craft does not, in any way, disqualify his statements, but it certainly adds depth to our comprehension of the text.

In any case, this book is a much-needed contribution to the contemporary debate about psychoanalytic training, and an extremely valuable reflection on the unavoidable impact that the relational perspective has on the latter.

References

Bion, W. R. (1961). Experiences in Groups and Other Papers. London: Tavistock, 1968.
Ferenczi, S. (1933). Confusion of tongues between adults and the child: The language of tenderness and of passion. In Ferenczi (1955), Final Contributions to the Problems and Methods of Psycho-Analysis. New York: Brunner/Mazel, 1980, pp. 156-167.
Ferenczi, S. (1985). The Clinical Diary of Sándor Ferenczi , trans. Balint, M. & Jackson, N. Cambridge, MA: Harvard University Press, 1988.
Foulkes, S. H. (1948). Introduction to Group-Analytic Psychotherapy. London: Maresfield, 1984.
Foulkes, S. H. (1964). Therapeutic Group Analysis. London: Maresfield, 1984.
Foulkes, S. H. (1975). Group-Analytic Psychotherapy. London: Gordon and Breach, 1978.
Freud, S. (1937). Analysis terminable and interminable. Standard Edition 23: 211-253.
Hernández de Tubert & Tubert-Oklander, J. (2005). Operative groups: A reply to Macario Giraldo. Psychologist-Psychoanalyst, 25 (1) : 4-7.
Pichon-Rivière, E. (1971). El proceso grupal. Del psicoanálisis a la psicología social (1). Buenos Aires: Nueva Visión.
Tubert-Oklander, J. & Hernández de Tubert, R. (2003). Operative Groups: The Latin-American Approach to Group Analysis. London: Jessica Kingsley.

Reviewer Note

Juan Tubert-Oklander is a physician, psychoanalyst, and group analyst, with a private practice in Mexico City.

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