PSYCHOANALYSIS TODAY
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psychoanalysis point to various developments, which they interpret
as evidence that psychoanalysis is no longer appealing, relevant or
valid.
One thing analysts have learned is that things are seldom as they
seem. Accordingly, if I avoid simplified pronouncements, if I em–
phasize the complexity of the phenomena we are discussing, and if I
suggest that the changes we observe regarding psychoanalysis consti–
tute in large measure an index of profound social and political
transformations that have taken place in recent years, I hope that I
will not come to be regarded as an automatic apologist.
The verdict concerning the fate of psychoanalysis is usually
subsumed under three headings: psychoanalysis, it is said, no longer
appeals to physicians as a specialty to be pursued, nor to patients as a
mode of treatment, nor to the public at large and to the intellectual
community in particular as a body of knowledge or as a vision of
man. In our discussion, it would be well to separate the first two
statements from the third, inasmuch as they pertain to psychoanaly–
sis as a profession.
It is a fact that in the past ten years the number of students
enrolled in the psychoanalytic training programs of the American
Psychoanalytic Association has risen only from 1,000 to 1,100, that
is, ten percent. Given the much greater rise in the number of
graduates from medical school, this figure represents a decline in the
proportion of graduates entering psychoanalytic training. The same
holds true for the number of graduate physicians entering the field of
psychiatry, and of these a smaller percentage are seeking training as
psychoanalysts. There are many reasons for this development. I will
mention only those known to me directly from my experience with
undergraduate students of medicine and with psychiatrists. Psychia–
try and psychoanalysis today, compared with those professions
during the heady days following World War II, are no longer the
areas of medicine where the new and exciting developments are
taking place.
It
is in fields like cardiac surgery and the new biochem–
istry of internal medicine that the imagination of today 's medical
students is stirred. The field of medicine today, compared with that
of forty years ago, is so complex and difficu lt a body of knowledge to
master that few students are willing to relinquish a skill so arduously
acquired to enter a field where this knowledge ultimately becomes
either peripheral or largely irrelevant.
In addition, there are . weighty practical problems. For the
medical graduate to become a psychoanalyst entails the pursuit of
