by Loong Kwok, Psy.D.



Psychoanalysis is in the process of changing. This is true in a philosophical sense, in that we're always in a state of change. It is also true that we're caught in the overall push towards cost efficiency and proof of change that is called managed care. At the recent Division 39 Conference, many speakerscommented on the fact that the "old model" of psychoanalysis, in which we pursued analytic training, taught at an institute, and then waited for the resulting referrals, is no longer working. These days, fewer people are pursuing analytic training, and fewer people are entering analytic treatment. Both facts lead to justifiable concerns about the future of psychoanalytic thought.


However, there were also several discussions that examined the ways in which psychoanalysis has been taken out of the consulting room. One panel, sponsored by the Applied Psychoanalysis Section of Div 39, featured analysts who are working in the school system, on a community level, with law enforcement agencies, with hospitals, with social workers, and with the courts. Here in the Bay Area, we have our own Reflective Spaces, Material Places group that meets monthly to discuss ways in which we can apply analytic ideas in community settings.


For me, this struggle has been one I've faced throughout my graduate training. Practicums and internships are often year-long treatments at most, and clientscome once a week or, if we're lucky, twice a week. Reading articles about insights and breakthroughs that came after five years of thrice-weekly meetings were both intimidating and implausible. My relationship with psychoanalysis has always been one in which translation was necessary.  I had to find the elements of analytic thinking that could apply to my work with what could be described as non-analytic clients and settings.


What I take from that effort is that psychoanalysis is a living thing. People are thinking and talking to each other, and these conversations are accessible to me. What psychoanalysis was and is -- these are ideas that are being negotiated, and these are discussions in which I can participate. I can go to meetings, I can present on a panel, I can write papers, and in these ways I can have my ideas heard and discussed (hopefully). As an early career professional, this is a rather novel and exciting idea. I encourage all of you, all of us, to try it on for size.