D. D GUTTENPLAN filed this interesting report from Britain in today’s NYT. I have one recommendation for British vacationers in Spain and Portugal, age 18 and above, who are thinking about seeing a psychotherapist. Look up the local catholic priest. He does not charge any money for a talk therapy.

LONDON, May 28 - Who owns psychoanalysis? That question is
at the center of the most recent battle here in the Freud
Wars, the epic (or as the man himself might say,
interminable) struggle over the legacy of Sigmund Freud,
pioneer psychotherapist, cartographer of the unconscious
and former resident of Hampstead, the leafy corner of
Northwest London where the concentration of therapeutic
couches per square mile may be even higher than on the
Upper West Side of Manhattan.

Late last year a new group calling itself the College of
Psychoanalysts sent out a letter inviting British
therapists who met certain qualifications to list
themselves on the organization’s “register of
practitioners.” The British Psychoanalytical Society,
headquarters of classical Freudian analysis, responded with
a statement accusing college members of “misleading the
public about their training and qualifications.” And then
the fireworks really started. One founder of the college -
which is a professional organization rather than a training
institution - countered with a letter describing the
society’s action as “a phobic response to growth as
symbolized in the Oedipal myth.” An opponent of the
college, on the other hand, described the new group as “an
association of wannabes and poseurs.”

More recently, the society’s Web site included a disclaimer
describing the college as a device for allowing therapists
“to pass themselves off to the public as though they were
trained psychoanalysts.” In British law, “passing off” is a
form of fraud; this was a declaration of war.

Susie Orbach, a therapist, an active member of the college
and the author of the best-selling “Fat Is a Feminist
Issue” and other books, says the dispute has already had “a
chilling effect” on British intellectual life. To her, the
society’s argument that the title psychoanalyst “refers not
to what the practitioner does, but what they have been
trained to do” is nonsensical, a spurious restraint on
trade.

“I do the work,” she said. “My contributions are
contributions to psychoanalysis, its theory and clinical
practice, not to some other field.”

On the surface, this is a parochial argument about labels
and credentials, a tempest in a Viennese teacup - or at
most, a professional turf war. But you don’t have to probe
the protagonists too deeply to discover that this is also a
battle over the nature of therapy itself - what it is, what
it does, how it works. And it quickly becomes apparent that
alongside the intellectual controversy is a bare knuckles
fight over money, power and prestige. These people, after
all, are professionals of the ego.

The roots of this battle are in some ways peculiar to
Britain. Unlike American psychotherapy, which is regulated
by states (with some states, including New York starting
next year, licensing psychoanalysts as a separate
category), British psychotherapy is completely unregulated
by the government. Also, until recently, most
psychoanalysts in the United States were required to have
medical degrees. The British analysts, however, like others
in Europe, follow Freud’s view in his essay “On Lay
Analysis” and have never required medical training or
graduate study in psychology. And because almost all
psychotherapy in Britain takes place outside the National
Health Service, the government has remained neutral.
Legally, anyone with sufficient chutzpah can call himself a
psychoanalyst here.

Still, the arguments and effects of the dispute are likely
to reverberate on both sides of the Atlantic.

“The same conflict exists in the United States,” says Jaine
Darwin, president of the American Psychological
Association’s division of psychoanalysis. “There are the
same arguments about standards within the profession,” she
added, having to do with licensing, training requirements
and government registration.

Some of these battles have been raging for years. In 1989
the American Psychoanalytic Association - which had
required members to have a medical degree - agreed to
settle an antitrust lawsuit and allow psychologists, social
workers, nurses and other mental health professionals to
enter analytic training. That opening to the outside,
however grudgingly done, probably saved American
psychoanalysis from extinction. (In Britain the members of
the British Psychoanalytical Society have an average age of
65.)

The flow of new analysts, though, raised a new set of
problems. New candidates had to agree to the traditional
training regime: a personal analysis four or five times a
week lasting several years, and a number of supervised
training analyses where the candidate saw patients, again
four or five times a week, under supervision. What is so
magical, some wanted to know, about four-times-a-week
analysis? Why not three times a week, or two? Is there a
real difference between analytic psychotherapy and
psychoanalysis?

These questions are now being asked in Britain, along with
some others. What began, said Joseph Schwartz, as “a simple
jurisdictional dispute - like a fight between rival unions”
- has the potential to become something far more
interesting. An American transplant to Britain and the
author of “Cassandra’s Daughter: A History of
Psychoanalysis” (Penguin, 2001), Mr. Schwartz is a
Berkeley-trained physicist as well as a therapist on the
register of the College of Psychoanalysis.

Ever since the day in 1911 when Alfred Adler and his
followers left the Vienna Psychoanalytic Society, the
history of psychoanalysis has been notoriously divided.
Even so, all psychoanalysts share certain beliefs: the
importance of the unconscious, for example. And Freud’s own
legacy is still central. His sense of mistreatment by
Viennese academics is one reason psychoanalytic training
still goes on mostly in private institutes rather than in
university departments.

Shaped partly by their divergent histories and partly by
differing national cultures, British and American
psychoanalysis became quite different enterprises. In
Britain, the encouragement of lay analysis and the
influence of Bloomsbury figures like Virginia Woolf, who
published Freud’s writings in English, and whose brother
Adrian Stephen actually trained as an analyst, gave
psychoanalysis a distinctly literary flavor. The Hungarian
refugee Melanie Klein, with her emphasis on internal
experiences, envy and aggression, became the dominant
figure in postwar British psychoanalysis.

During the same period in the United States the vast
majority of psychoanalysts were also medical doctors. One
consequence of this was that much more psychoanalysis in
the United States took place in institutional settings like
hospitals or asylums. Another was a gradual loss of
prestige as psychiatry, with its growing armory of
antidepressant and antipsychotic drugs, turned toward the
pharmacy and away from the talking cure.

Both sides of the current dispute in Britain put clinical
practice at the heart of psychoanalysis. Here the
differences are as much political as theoretical. Analysts
today are already free to discount Freud’s focus on
instinct. And though the requirement of analysis four or
five times a week for candidates does guarantee steady work
for the training analysts, their trainees are going to have
to compete for patients in a world enthralled by quick
fixes, whether out of a bottle or in a behavioral
therapist’s office, and where the superiority of
psychoanalysis - once commonly described as the “gold
standard” of therapy - is no longer taken for granted.

Julia Fabricius, incoming president of the British
Psychoanalytical Society, says, “Psychoanalysis as an
academic discipline is open to anybody,” but she defends
the society’s qualifications for membership. She adds that
she does not regard psychotherapists who aren’t analysts as
“second-class citizens.”

Robert Maxwell Young, a Yale-educated British-trained
psychoanalytic psychotherapist and former Cambridge
historian of science, is outside both camps. Though he
points out that he held the first chair of psychoanalytic
studies in Europe, at the University of Sheffield in
England, he is not a member of the society. And he has no
desire to join the college. “I don’t go to parties where
I’m not invited,” he said of the college’s claim on the
label psychoanalyst. “Even so, I have nightmares,” he
confesses, about not being allowed into psychoanalytic
meetings.

What gives the dispute over the College of Psychoanalysts
even more urgency is the sense that, in the next few years,
psychoanalysis in Britain will soon be regulated. Lists and
standards are going to be drawn up. Battle lines are
forming over who who sets the standards and who keeps the
lists.

http://www.nytimes.com/2004/05/29/arts/29PSYC.html?ex=1086846149&ei=1&en=76bb7f71a6f5c6b8