In our continuing efforts to support psychoanalytic training, research, and practice in Northeast Ohio, the Cleveland Psychoanalytic Center requested and received an IPA Outreach Committee visit on November 11, 2012.  Twenty-three members of the Cleveland psychoanalytic community responded to the invitation to meet with the following visitors:

• Marvin Margolis MD- chair of IPA Outreach Committee, from Michigan Psychoanalytic
• Jim Hansell, Ph.D – North American co-chair of IPA Outreach Committee, formerly Michigan now Washington DC
• David Dietrich, PhD- Michigan Psychoanalytic Institute
• Bill Myerson, PhD- APsaA treasurer, from Houston

The meeting began with a moment of silence for Liz Daunton. She was a beloved friend, teacher, and supervisor to many of us. We are grateful to her, and will miss her.There was an immediate open invitation for us travel to Michigan to join those analysts there to see their program/community. The Michiganders want to promote sharing of ideas with CPC.  They ask what aspects may work well here.  The Committee has assisted some ten institutes/societies to date.Those visitors from Michigan told of two successful training experiences they provide. The first program is called the Clinical Moment Program, which is aimed at entry-level neophytes. In this, the instructors present their own case material, and the invited guests discuss the presentations. The issue of confidentiality in this program was broached, and answered that there is trust in the participants, and also there is the usual disguising of case material. It was mentioned that the program focuses attention on the way analysts work and think rather than the identity of the case. In this program, invitations are made to psychiatry residents and graduate students or practitioners of social work as well as psychologists. After some time in this program, those attendees who want are invited to the Early Admissions Program.The second program is the Early Admission Program. People with a desire to learn psychoanalysis, but who are clinically inexperienced may apply as early admission candidates, usually after first attending the Clinical Moment Program. Course work can be full or part time, and tailored to the individual needs of each candidate. The curriculum for this program consists of five-class seminars, six or seven of which are offered during an academic year. Candidates in this program may bring to the various seminars, friends who have not yet applied to the program. These friends may attend the seminars at no cost up to one year.  All early admission candidates are supervised on their cases by psychoanalysts and are expected to participate in low fee treatment, dynamic but not necessarily analysis at first.  Early Admissions has provided a gradual way to train, with great attention to the practicalities of each candidate.  When Early Admission candidates wish to matriculate as full candidates in the Michigan Institute, they need only have interviews.The Michigan visitors were asked how they market their programs. The answer was that one way is that they get all mailing lists of training programs all over town, and send monthly announcements of upcoming programs to the various training programs. Michigan’s recruitment is year round, even daily. Other psychoanalytic institutes are no so active in recruitment. The Houston Institute (Bill Myerson’s) recruits each year from October until the start of summer. They have more trainees now than ever before.  A formal psychology program in Chicago has given credit for coursework from their program. It was mentioned that not many training programs i.e. psychiatry training programs, have supported psychoanalytic training programs, and it was suggested that psychoanalysts “infiltrate these.”  Here in Cleveland, multiple CPC members have historically done this.The subject of the dwindling of psychoanalytic cases was mentioned. The suggestion was made that analysts with many patients should “share the wealth” and let others with fewer patients take more. Michiganders say their institute has the highest number of cases in psychoanalysis than any other psychoanalytic institute in the country (average of 6).The issue of the rightness of “seducing” potential analytic candidates into analytic training was discussed. The fact that pharmaceutical companies had long done this by providing endless amounts of free lunches to psychiatry residents for instance, was also mentioned. Many analytic programs evolve by trial and error. The invitations of candidates into analysts’ homes (for the Clinical Moments Program) was said to originate with the New York Institute.  Programs filling a particular niche, including individualized attention to candidates’ needs, have survived. Michigan uses a Distance Learning component so that people from distances can participate together. Hanna Perkins Center has successfully utilized Distance Learning for many years.The discussion also included psychoanalytic psychotherapy training vs. training for psychoanalysis. CPC has had a successful psychotherapy program for some 15 years. In each class there have been about 8 attendees. Very few have become analytic candidates.  Currently curricula for PPP and analytic training (PTP or Psychoanalyst Training Program) are different. This may be a topic to think more about. The cost of analytic training can be prohibitive for many, even though many of our training institutes offer discounted fees to trainees. At Emory University, they have psychoanalytic studies program which is connected to their institute. This is a 2 yr. program, in which upon completion, one decides if they want to begin clinical training. In addition to analytic training, however, it should be noted that one does need some kind of state granted mental health license to practice.An opinion was stated that a likely reality we will have to accept is that a PPP type of program will be what many people increasingly want rather than psychoanalysis, for financial and a number of other reasons. And there are three 3 gaps we are trying to bridge:

1. How to recruit future analysts to training;
2.  How we bridge the gap of those practicing psychoanalysis and psychoanalytic psychotherapy with their consumers who may look different, who are culturally and socio-economically different, etc.; and
3. How we seize the “clinical moment” out in the field on the street corner, using our psychoanalytic training in applied ways rather than just using our training in private consultation rooms. There was some difference of opinion in the brief discussion of this topic.

Because our CPC program is “shrinking”, we have to make major changes very soon. Our Michigan visitors challenged us to grow and get bigger.  The meeting concluded with much appreciation for the visit and a tentative plan to follow-up at meetings of APsaA in January.