Thinking about Psychoanalytic Curricula: an Epistemological Perspective

The deleterious impact of idealization and fanaticism and their underlying causes in psychoanalytic education

Acrimony, dissension, and controversy have characterized psychoanalytic education from the beginning. The usual scapegoat for this situation has been the training analyst system. But this system is seen as just a symptom of deeper, underlying conflicts about our field and preparing for it. In particular, the tendency toward authoritarian dogmatism amongst psychoanalysts is a prime contributor. This inclination derives from the defensive idealization and fanaticism characterizing many psychoanalysts. Such idealization helps us to manage the many uncertainties that characterize our theory, our practice, and our pedagogical efforts. Various methods to address these uncertainties more directly are suggested as a way to counteract the negative effects of fanaticism.

Transference-focused psychotherapy training during residency: an aide to learning psychodynamic psychotherapy

Competency in psychodynamic psychotherapy is a requirement for residency training in psychiatry. However, for a variety of reasons, learning psychodynamic psychotherapy is difficult for residents. In this article, we share our experience in an elective in Transference-Focused Psychotherapy (TFP), a manualized treatment for severe personality disorders. Originally, this elective was conceptualized as an advanced component of training, offering specialized training in treating a subgroup of patients with severe personality disorders with a specific type of psychodynamic psychotherapy. However, contrary to the expectations of the residents and the training director, the elective in TFP strengthened understanding of core components of basic psychodynamic psychotherapy with all patients, not just those with severe personality disorders. We discuss various challenges in learning psychodynamic psychotherapy and how TFP served to address them. Two case vignettes illustrate several key points.