psychoanalysis in the university: the natural home for education and research

Psychoanalysis in the university: The natural homefor education and research1

Robert S. Wallerstein

290 Beach Road, Belvedere, CA 94920, USA – [email protected]

Psychoanalysis as a theory of human mental functioning and a derived therapeuticfor disturbed functioning would have its natural home in the university, and Freudgave evidence of harboring such an ambition. But the sociopolitical structure ofthe early 20th century Austro-Hungarian Empire precluded this, and analysisdeveloped, by default, its part-time, private practice-based educational structure.Psychoanalytic penetration of academic psychiatry in the United States afterWorld War II made possible a counter-educational structure, the department ofpsychiatry-affiliated psychoanalytic institute within the country's medical schools.This paper outlines, beyond these, other more ambitious vistas (David Shakow,Anna Freud, The Menninger Foundation, Emory University [US], APdeBA[Argentina]), conceptions even closer to the ideal (idealized) goal of full-timeplacement within the university with strong links to medicine, to the behavioralsciences, and to the humanities.

Keywords: independent psychoanalytic institute, medical school department ofpsychiatry-affiliated institute, psychoanalytic research, autonomous psychoanalyticinstitute within the university

Psychoanalysis as a discipline that comprises both a foundational theory (ofnormal and abnormal mental functioning) and a profession that is its thera-peutic application (ameliorating the disorders of the mind) would naturallyfind its proper home within the university, which I described in 1972 as‘‘that unique court of last resort in matters of truth or error in humanaffairs, the university’’ (p. 597). That this was Sigmund Freud’s vision fromthe start seems evident in his 1919 paper, On the teaching of psycho-analysisin universities, published first in Hungarian translation, to mark the 19March 1919 installation, by the Bolshevik government which temporarilycontrolled Hungary, of Sandor Ferenczi as Professor of Psycho-Analysis inthe medical school at the University in Budapest (Freud, 1919).

In that short paper, Freud stated that: ‘‘This training [medical and aca-demic training] has been quite rightly criticized during the last few decadesfor the one-sided way in which it directs the student into the fields of anat-omy, physics and chemistry, while failing, on the other hand, to make plainto him the significance of mental factors in the different vital functions as

1This paper summarizes a professional lifetime of concern with the issue of the most proper educationalstructure for the discipline of psychoanalysis as both a science and a helping profession, and it chroniclesmy own shifting perspectives on this issue as the cultural and academic world context within whichpsychoanalysis is embedded has itself altered over my own six decades of involvement in it. The paperhas therefore drawn from a significant number of articles that I have written on that subject over theyears (Wallerstein, 1972, 1974, 1977, 1980, 1983, 1991, 2007, 2009; Wallerstein and Weinshel 1989), andrepresents overall, my current (somewhat zigzaggedly) evolved hope and conviction for our discipline atthe 100th year celebration of the IPA.

Int J Psychoanal (2011) 92:623–639 doi: 10.1111/j.1745-8315.2011.00459.x

Copyright ª 2011 Institute of PsychoanalysisPublished by Blackwell Publishing, 9600 Garsington Road, Oxford, OX4 2DQ, UK and350 Main Street, Malden, MA 02148, USA on behalf of the Institute of Psychoanalysis

�e International Journal of

well as in illnesses and their treatment’’ (1919, p. 171). And he added furtheron: ‘‘Psycho-analysis, in fact, more than any other system is fitted for teach-ing psychology to the medical student’’ (p. 172) (clearly not just in theteaching of mental illness within the department of psychiatry or neurology).Ending with: ‘‘To sum up, it may be asserted that a University stands onlyto gain by the inclusion in its curriculum of the teaching of psycho-analysis’’(p. 173).

This led Freud to state that: ‘‘The inclusion of psycho-analysis in the Uni-versity curriculum would no doubt be regarded with satisfaction by everypsycho-analyst’’ (p. 171). Unhappily, Freud’s vision on this issue was one-sided. He did not appreciate, at that time, the enduring benefits in thereverse direction, to psychoanalysis, for its education and for the accompa-nying psychoanalytic research that the history of psychoanalysis over thesucceeding century would so clearly evidence the need for. Of thesepotentialities, Freud said dismissively: ‘‘At the same time it is clear thatthe psycho-analyst can dispense entirely with the University without anyloss to himself’’ (p. 171).

But, in any case, Ferenzci’s appointment was short-lived, and though overthe years since, a fair number of analysts, and of psychoanalyticallyinformed scholars have, in increasing numbers, obtained places within medi-cal schools, and, within the university at large, within the humanities andthe behavioral and social sciences, the dream of psychoanalysis as a disci-pline securing a proper place within the university, for its teaching acrossdisciplines, and for its own education and its own scholarly growth, hasseemed an illusory pipedream. It was clear, within the Victorian Vienna ofFreud’s day, that the marked revulsion of the academic and the medicalestablishment against Freud’s scandalous theories of infantile sexuality, aswell as the almost official anti-Semitism of the Austro-Hungarian Empire,faced with Freud’s new ‘Jewish science’, together worked to deny Freud(and his followers) the academic position to which he lifelong aspired, andin which he was lifelong disappointed.

After some two decades of psychoanalytic work, with its spread acrossthe European heartland, and the establishment as far back as 1910 at a sec-ond International Congress, in Nuremberg, of the InternationalPsychoanalytical Association, the organization of the practitioners of thisgrowing discipline, education for it was needed in order to transcend itsvoluntaristic and haphazard beginnings, to become formalized and institu-tionalized. It was then that the concept of the autonomous and independentpsychoanalytic institute came into being, first in Berlin, in 1920, the creationthere of Max Eitingon and his Berlin colleagues. There, the so-called Eitin-gon training model evolved, the tripartite structure, consisting of the per-sonal (training, or didactic) analysis, the theoretical and clinical seminars,and the treatment by the candidate (the student), under supervision, of sev-eral control cases.

This model spread rapidly through Central Europe, with other institutessoon established in Vienna, Budapest, and Zurich. Both the students (physi-cians and non-physicians), and the faculty, earned their livelihoods mostlyin full-time clinical work, while acquiring psychoanalytic specialization in

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the evenings in their part-time educational program, operating on theenergies of tired men and women. Daytime clinical earnings paid for the stu-dent’s living expenses, plus the personal analysis as well as the supervisionhours for the ‘control cases’, and the seminar teaching was contributed bythe faculty. This has been the established norm ever since as psychoanalysis,and the training for it, have literally spread around the world, and it hassucceeded in the transmission of established psychoanalytic knowledge andof a secure psychoanalytic identity to the successor analytic generations,albeit with countervailing inadequacies that have become increasinglyevident over time (and will be outlined further on).

Such is the very condensed tale of the historical development of psycho-analysis in its European homelands where it had no place, and for severalgenerations never actually won a place, never really penetrated into the uni-versity at large, nor into the medical schools nor even in its seemingly mostlogical point of entry, academic psychiatry, which remained firmly plantedin the organicist and nosologically descriptive world of Emil Kraepelin andhis followers. It was only with the rise of Hitler to power in Germany,and the extension of his seizure across Central Europe, that psychoanalysis,in the transplantation of its focal power from Europe to America, borne onthe tide of Hitler refugees, found a very different set of contextual circum-stance and therefore a very different opportunity available to it in Americathan had ever theretofore been dreamed possible in Europe.

Alongside then the rudimentary psychoanalytic beginnings in America,which actually went back even to before World War I, and which establishedfirm roots in the inter-regnum between the two World Wars, leading to theestablishment and evolution in America of the first training centers andinstitutes in the established European institutional form of the independentinstitute – in New York, in Boston, in Chicago, in Philadelphia, in Balti-more–Washington – alongside these, another equally compelling currentwas gathering and intensifying, less in defensive, more I think in adaptive,response to the accession to psychoanalytic ranks in America, of the largenumbers, and the established psychoanalytic prestige, of the psychoanalystEuropean refugees.

Whether self-consciously thought out and planned in terms of the fullarray of consequences that subsequently eventuated, or, as is more likely,more the result of only partial and partisan perspectives imposed uponevents, leading through the clash of contention and compromise to out-comes in part unforeseen, and for the rest only dimly thought out, and tothat little extent entitled to be called clearly planned, however this was, cer-tainly in retrospect it is as if a major strategy was deliberately evolved andpursued. And this was that psychoanalysis would follow a different path inAmerica from the proud and at the same time lonely isolation that hadmarked it in Europe, to penetrate into what was the then receptive soil ofAmerican psychiatry, to capture academic psychiatry and its formal trainingcenters, and to become its prevailing psychology, and thus to be firmlyplanted in the midst of medicine, the medical school, and, at least via thisroute, the university as well. Here I speak not specifically of the university-based psychoanalytic institute, which was a close subsequent development in

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time, but of the far wider effort to transform the departments of psychiatryin the array of medical schools and teaching hospitals of our nation intobulwarks of psychodynamic thinking and of psychodynamic therapy.

This story, the success of this effort, in the sense of the radical transfor-mation of American psychiatry which reached its high watermark throughthe decades of the 1950s and 1960s, in which in one after another of themajor departments of psychiatry in the country, the retiring chairman, char-acteristically an Adolf Meyer-trained psychobiological psychiatrist, wasreplaced by a psychoanalyst or a psychoanalytically-sympathetic psychia-trist, is in its broad outlines well enough known (Wallerstein, 1974, 1980).And these now psychoanalytically-oriented departments of psychiatry,helped by psychoanalytic clinicians recruited to teaching and supervisoryroles, made the teaching and learning of psychoanalytic principles, and thederived psychoanalytic psychotherapy, the central activity of the departmentof psychiatry.

And a logical extension of this campaign, alongside the earlier free-standing psychoanalytic institutes in the United States, created within theestablished original European model, was the conception, in some receptiveacademic centers, of a university-based psychoanalytic institute as an admin-istrative division, quite autonomously governed, within the department ofpsychiatry, with at least some of its psychoanalytic teachers part of the full-time faculty of the medical school’s department of psychiatry – with, ofcourse, their significant involvement also in the department’s wider missionand training obligations beyond the psychoanalytic institute itself. The newpsychoanalytic institutes at Columbia, Cleveland, Pittsburgh, Downstate(now moved across town to New York University) and Colorado were all inthat early wave of medical school-based psychoanalytic institutes establishedin the first post-World War II decades.

The structure of these medical school department of psychiatry-based psy-choanalytic institutes represented what, at the time, seemed to be the mostfeasible compromise between the previously existing independent institutemodel, part-time (in the evenings), minimally financed, dependent largely onvolunteer time and teaching commitments, and what, ideally a universitybase could mean – a full-time student and faculty undertaking, amplyfinanced between student tuition and university support. The department ofpsychiatry placement has entailed at least a portion of the psychoanalyticinstitute faculty being full-time academic faculty members, but with only aportion of their time available for institute functioning since they also havehad, properly, major commitments to their psychoanalytically-guided widerteaching and their scholarly research activities within the host departmentthat underwrites their salaries.

And the institute itself would have only a part-time student body, somefrom the psychiatry department’s faculty and students, having to squeezetheir institute training obligations out of the time needed for the carryingout of their departmental academic obligations. And most of both the insti-tute faculty and its student body would consist of private mental healthpractitioners making their part-time, independently financed commitments



to the psychoanalytic educational process on much the same basis as theirconfreres in the independent, non-university-based institutes.

This still current2 arrangement for the embedding of psychoanalysiswithin the university by way of the medical school’s department of psychia-try is thus, of course, far from the ideal. But clearly in its early days it wasseen as a first important step, perhaps a harbinger of a more comprehensiveuniversity entr�e, and it excited a significant number in America – of whomI was one – to envision a much fuller university placement of a truly aca-demic psychoanalytic education for this 20th century new intellectual andprofessional discipline, psychoanalysis. It does have – at least partially – theputative advantages of a university home, at least some full-time faculty,access to department of psychiatry resources for psychoanalytic researchsupport, and of opportunities for cross-disciplinary contact and mutualenrichment, certainly within the medical school, and, to a variable extent,within the wider university community, with the social and behavioralsciences, and even the humanities – and, in the most recent years, withneuroscience and cognitive science.

But, at its best, this overall model still leaves psychoanalysis as the onlyserious discipline that thinks of itself as a growing science and professionthat has an entire educational enterprise that is part-time, and that rests, stillfor the most part, on a volunteer, and essentially unpaid, teaching staff, withthe exception of only some of the faculty in medical school-based instituteswho have full-time salaried positions.

Nonetheless, these university-based institutes did stir fantasies of anexpanding academic home for psychoanalysis. All this colored my report(Wallerstein, 1972) of the reach, but also the limitations, of the then existingoverall psychoanalytic educational enterprise in the United States, whichnoted our essential isolation from the other sciences of human mental lifeand behavior, as well as from the main social issues of the day (crime, drugs,youth unrest, etc.) towards which we could engender presumably helpfulinsights, as well as deficiencies in the seriousness of the academic aspects ofour training enterprise, and the lack of the multiple tracks and multiplecareer models that an intellectually expanding psychoanalysis could – andshould – provide. And when in those same heady days, Herbert Gaskilland I co-chaired the Planning Committee for the first ever AmericanPsychoanalytic Association-sponsored Conference on Psychoanalytic Educa-tion and Research (COPER) in 1974, it was created with nine Commissions

2Over the more than a half-century since the first of these department of psychiatry-basedpsychoanalytic institutes was established at Columbia, two of them (Pittsburgh and Cleveland) havefailed, in the sense of unreconciled conflicts arising between the institute and the parent department,with the institute choosing then to leave the department and revert to the earlier model, part-time,independent status. In the one instance (Pittsburgh), a new biological psychiatrist department chair,hostile to psychoanalysis and dismissive of its academic credentials, replaced the psychoanalystdepartment chair, who had fostered the institute placement, and precipitated the institute’s withdrawalfrom the now unfriendly department. In the other instance (Cleveland) the struggle was between thepsychoanalyst department chair who was a member of the institute’s education committee and hadoriginally helped establish the institute in the department, and the current education committee chairwho was backed by the committee majority. The other three departments of psychiatry institutes stillexist, along with a newer one at Emory University, with the Columbia, the Denver, and the Emoryinstitutes noted for their significant academic scholarship and their formal research.



dealing with all major aspects of the overall training structure, one ofwhich was specifically about the then present, and the hopefully far wider,prospective relationship to the university. In my summarizing report at thatConference (Wallerstein, 1977), in pulling together recommendations fromfive of the nine Commissions, including, of course, that directed specificallyto the university, in its potential, and clearly hoped for, ‘ideal’ venue for ourdiscipline, I included the following paragraph:

Why not be content to stick as long as we can with what we know well and havetested thoroughly? [the independent institute] Let me put the question in reverse, as itwas brought up at one of the small discussion groups. If the university is truly man’sbest-devised repository for learning and scholarship in all areas of human knowledge,and if psychoanalysis is truly a science as we wish and declare it to be, then isn’t theburden of proof on the one who says that this branch of science has such a specialuniqueness that it alone, of all of them, can flourish best outside the university?

(Wallerstein, 1977, p. 321)

(For a full account of the COPER conference, see Goodman, 1977).But times and the prevailing Zeitgeist change, and often, all too quickly.

With the stunning growth of neuroscience with its derivative psychophar-macology, and the community mental health movement, and also theburgeoning of other and competitive psychological models, the behavioraland cognitive–behavioral, and also the existentialist–humanist, the psycho-analytic tide which had engulfed academic psychiatry in the 1950s and 1960sreceded rapidly in the following decades as other equally prestigious careerpaths opened up in psychiatry – biological psychiatry, social and communitypsychiatry, addiction psychiatry, forensic psychiatry, geriatric psychiatry, con-sultation-liaison psychiatry, all with little, if any, psychoanalytic underpinning.Beyond the initial cluster of five academic departments of psychiatry-basedpsychoanalytic institutes – with two splitting away in subsequent years – onlyone additional such institute, at Emory University (sponsored by the one atColumbia) has come into being in all the years since.

And the promised increase in psychoanalytic research productivity, imbri-cated with all the cognate disciplines of human behavior and intelligence,though indeed significant, has been far from what was initially envisioned –and promised. Psychoanalytic research, especially into the central arena oftherapeutic processes and outcomes, indeed carries baffling problems ofmethodological complexity and prolonged duration, which have been welldescribed from its earliest days. (See, for example, Escalona, 1952). GeorgeEngel, himself a major early university-placed psychoanalytic researchermade a heart-felt plea to mitigate these problems in a 1968 article devotedto what he described as both the internal, and also external, obstacles to theproper development of psychoanalytic research. The internal obstacles, thoseinherent in the nature of psychoanalytic data knowledge, like thosedescribed by Escalona and others, posed of course the essential issues forpsychoanalytic research to have to deal with.

But Engel focused centrally on what he called the external obstacles, notwithin the university, but within the way the psychoanalytic educational



enterprise had been organized, and had grown, privately, separately, outsidethe university structure. He described how it was organized essentially forthe transmission of established psychoanalytic knowledge and the creationof a firm psychoanalytic identity even when in the university, with the prod-uct a competent practicing psychoanalytic clinician – and in this it wasindubitably successful – but with no real research tradition, none of theneeded research infrastructure, and with all too few emerging researchersand research mentors for succeeding generations, especially with the, at thattime, exclusion of non-physicians from regular psychoanalytic trainingopportunities in the American Psychoanalytic Association (APsaA).3 Engeldeclared it incumbent upon the APsaA to alter its training structure and itstraining philosophy (whether in independent or in university-based insti-tutes) if it truly expected psychoanalytic research to flourish properly.

Four psychoanalytic contributors were asked to comment on Engel’sheartfelt cri de coeur on this underdeveloped state of psychoanalyticresearch, and three of them strongly defended the organized training systemagainst Engel’s charges. I was the fourth, and the only one – also the onlypsychoanalytic researcher among the four – who fully supported Engel’sdour assessment, beginning my discussion with the declaration: ‘‘GeorgeEngel’s passionate discourse touches a raw nerve of the body psychoanalytic,the state of crisis in psychoanalytic research’’ (Wallerstein, 1968, p. 215).

In any case, and for multiple reasons that I have chronicled elsewhere(Wallerstein, 1980), quite apart from the organizational constraints that havehampered its research development even under university auspices, thedevelopment of the department of psychiatry-placed psychoanalytic insti-tutes in the first post-World War II years did not prove the beginning of aprogressive march towards a true (and full-time) university psychoanalytictraining that those, like me, envisioned at the time as an ideal to whichFreud had aspired first in his own visionary statements. His few piecesabout psychoanalytic education indicate those wishful longings quite fully.His chief statement of his own ideal structure for psychoanalytic educationwas set forth only in the latter part of his professional lifetime in The Ques-tion of Lay Analysis (Freud, 1926), and then in the context of his spiriteddefense of the psychoanalytic bona fides and impressive credentials of afavorite non-medical adherent, Theodor Reik. In that monograph Freudventured his ideal prescription for training in the new discipline of psycho-analysis as follows:

If – which may sound fantastic today – one had to found a college of psychoanaly-sis, much would have to be taught in it, which is also taught by the medical faculty:alongside of depth psychology, which would always remain the principal subject,there would be an introduction to biology, as much as possible of the science of sex-ual life, and familiarity with the symptomatology of psychiatry. On the other hand,analytic instruction would include branches of knowledge which are remote frommedicine, and which the doctor does not come across in his practice: the history of

3This exclusionary policy was undone with the passage of the Gaskill Committee report by the APsaA in1985 and the subsequent settlement of the lawsuit against the APsaA in 1988. (See the lengthy history ofthis issue in Wallerstein, 1998.)



civilization, mythology, the psychology of religion and the science of literature.Unless he is well at home in these subjects, an analyst can make nothing of a largeamount of his material. By way of compensation, the great mass of what is taughtin medical schools is of no use to him for his purposes.

(Freud, 1926, p. 246, my italics)

A few pages further on, Freud stated this university-like conception evenmore tersely: ‘‘A scheme of training for analysis has still to be created. Itmust include elements from the mental sciences, from psychology, the his-tory of civilization and sociology, as well as from anatomy, biology, and thestudy of evolution (p. 252, my italics). Embedded in these statements isFreud’s implicit acknowledgement of the insufficiency of the alreadyestablished part-time and private practice psychoanalytic institute structurecreated just a half decade earlier by Max Eitingon and his colleagues, firstin Berlin in 1920 and, by the time of Freud’s writing, already spreadingacross the Central European heartland. Freud’s acknowledgement of thisinsufficiency is evident in the 1926 quotation: ‘‘A scheme of training foranalysts has still to be created’’.

Clearly, Freud’s stated ideal can be realized fully only within the academicuniversity structure. As presented by Freud, it seems distinctly a call for thecreation of a full-time (postgraduate) psychoanalytic training institute –full-time would be necessary if Freud’s programmatic message were to befulfilled – to which psychiatric physicians and other properly qualified indi-viduals would come for education and training into this new discipline andidentity of clinical psychoanalysis. But nothing in it specifies Freud’s visionof the particular relationship of the analytic training enterprise to the exist-ing medical school structure, or to the cognate disciplines of human mentalactivity within the university at large. But altogether without explicit refer-ence to the university, Freud’s 1926 statements are clearly a plan for theoptimal academic placement of this new discipline.

But, also clearly, the creation in America of the department of psychiatry-based institute did not prove to be the hoped-for first step in that direction,that had been its original promise. The initial cluster of such institutes didnot grow, and as indicated two of them collapsed due to built-in conflictingforces and priorities. Nor was the psychoanalytic wave that captured somuch of academic psychiatry in the post-World War II aftermath sustained.Out of the rise of new dimensions in psychiatry – neuroscience and psycho-pharmacology (the ‘remedicalization’ of psychiatry), social psychiatry andthe community mental health movement, competing psychological para-digms, etc. – the overall psychoanalytic tide receded and the academicdepartment of psychiatry became by and large less psychoanalytic, less inter-ested in psychoanalytic conceptions or therapies (Wallerstein, 1980).

And gradually my own intellectual ambitions for psychoanalysis and itsoptimal educational arrangement altered. Although the university remainedthe ideal (and idealized) placement, I finally tried, with the medical school(and the university) decreasingly hospitable to the acceptance of institutionalpsychoanalysis within its ranks, to envision as close as possible a university-like academic structure for psychoanalytic education as the independent



institute could encompass. I saw this possibility in the recent evolution of ahalf dozen psychoanalytic societies within the APsaA into the multifacetedconcept of the independent, university-like psychoanalytic center (Waller-stein, 2007). The fullest structure that I outlined in that article for such apsychoanalytic center comprises a central governing board of directors, withperhaps a majority of non-psychoanalyst members, a full-time administrativedirector and an array of component units: (1) an institute for the training ofpsychoanalytic practitioners; (2) a psychoanalytic psychotherapy training pro-gram (with participants at times seeking full clinical psychoanalytic trainingupon completion); (3) an office of professional affairs, responsible for thecenter’s scientific programs, its archives and library, and its post-graduateeducational programs; (4) an office for outreach and collaboration, with alow-fee treatment clinic, including consultation and referral services, as well asextension courses for mental health professionals, for the legal and educa-tional communities, and for the interested public; (5) an interface programinvolving collaborative scientific and educational activities with academicsand public policy makers, including formal university linkage to the extentfeasible; (6) a formal research component including participants from any ofthe aforementioned programs, with relevant sponsorship and mentorship; (7)a foundation with fundraising responsibilities; and (8) a continuing long-rangeplanning component.

This outline of a comprehensive psychoanalytic center was my composite,hopefully realizable, optimal educational structure, comprising together whatI felt to be the requisite array of vital elements – and at the time of mywriting, 2006, closest to actually being achieved in the then earliest and bestorganized of the six American centers in which this transformative processwas under way, in Philadelphia. Yet not even this structure can fully promisethe kind of psychoanalytic educational system to which I had long aspired.It would still be a part-time system, privately financed, dependent on thefull-time clinical practices of both students and faculty. And it is not thatthe full-time academic dream for psychoanalysis as a consolidating disci-pline had ever completely died.

Various proposals had been offered over the intervening years sinceFreud’s call in 1926 for ‘a college of psychoanalysis’. The first model wasthat of David Shakow, offered in 1962. Strongly supported by David Rapa-port, it was proposed particularly for the training of behavioral and socialscientists for careers in psychoanalytic scholarship and research. Shakow’sproposal was simple and radical: unfortunately, it was quite unrealizable in itstime, certainly as compared with what seemed then the growing possibilitiesfor psychoanalysis embedding itself enduringly in medical school departmentsof psychiatry. Shakow began by stating that our institutes, organized aspart-time activities, whether independent or ensconced in medical schooldepartments of psychiatry, could not train proper cadres of scholars andresearchers in psychoanalysis. He argued therefore:

Not only for the greater recognition by institutes of the importance of research inpsychoanalysis, but for emphasis on educational programs that are oriented towardsthe development of persons who can contribute effectively to research … Suppose



medical schools over the country no longer had basic science faculties, merely con-sisting of medical practitioners who devoted a part of their time to teaching. Howlong could medical schools prevent themselves from becoming vocational schools …rather than professional schools, to say nothing of centers of research and scholar-ship.

(Shakow, 1962, pp. 151–2)4

Shakow’s solution was to move psychoanalysis, and psychoanalytic educa-tion, into the university more generally, which he considered a better andmore logical home for our discipline than the medical school department ofpsychiatry. He considered the latter an improvement over the independentinstitute, but still far from what was optimal or even necessary. His proposalwas that: ‘‘The psychoanalytic institute should be an independent institutein the university setting associated with both the graduate school and themedical school’’ (p.155), since ‘‘the optimal arrangement would be an auton-omous institute intimately related to the graduate school and the medicalschool … The psychoanalytic institute could then be an important center ofintercourse between those who are primarily clinically oriented and thosewho are primarily theoretically oriented’’ (p. 156). He went on to adduce anarray of other beneficial consequences of this arrangement.

Shakow, given his political savvy regarding the academic world, was stran-gely optimistic about the practical possibilities for such a development atthat point in time:

Because of the reluctance of universities to set up independent institutes [in anyrealm of knowledge] on their campuses … and because the suggestion here is thatthe institutes have considerable autonomy and especially close relations with thetwo quite separate parts of the university, it is most important that the administra-tion of the university as a whole and that of the medical school and the graduateschool in particular, be strongly committed to such a program.

(1962, p. 157)

He did not address the need for such commitment to endure, despite theshifting priorities and obligations of departmental and university adminis-trations over time, not did he address the major financial requirements ofsuch an undertaking.

Perhaps in the psychoanalytically heady days of the early 1960s, within afiscally expansionary climate for programs disinterestedly devoted to clear-cut social and intellectual good, one could understand such an expression ofconfidence. In today’s climate (2010s), a half-century later, such confidencewould seem hopelessly out of touch with today’s reality, with any currentpossibility for the required programmatic and financial support.

4Quite explicit here is that psychoanalysis seems to be the only serious discipline that thinks of itself as agrowing science, that has an educational system resting entirely on a volunteer, essentially unpaid,teaching staff, with the exception of the few faculty members in medical school-based institutes withsalaried full-time positions. Our psychoanalytic system is reminiscent of the way American medicalschools were operating before the famed, devastatingly critical, 1910 Flexner report, which led to therapid transformation of the nation’s medical teaching structure into the full-time academic system thatprevails everywhere today.



But at that time, Philip Holzman, in two succeeding papers, in 1976 andin 1985, proposed solutions to these same educational issues that can onlybe read as scaled-down versions of the Shakow proposal. His 1976 plea wasfor a university, ‘‘center for psychoanalytic studies’’, as the logical place topromote psychoanalytic scholarship and research, with faculty, ‘‘drawn fromother departments in the university – psychology, psychiatry, sociology, law,philosophy, art, literature – … [holding] joint appointments in their owndepartments’’ and in the psychoanalytic center (Holzman, 1976, pp. 271–2).What is not mentioned in Holzman’s proposal, however, is any role for theuniversity center in regard to clinical psychoanalytic training, or, in theabsence of that, the proper relationship of the proposed center to an exter-nal psychoanalytic institute. He mentions only that there are grave problemswith the proposed organization, with how to do all this ‘‘without sacrificingthat which is unique in the psychoanalytic paradigms’’ (p. 272).

In a related article, published a decade later, in 1985, Holzman’s assess-ment of the state of health of the psychoanalytic scientific and researchenterprise was even more dire, but his proposed remedies seemed evenmore ambiguous and difficult to realize. This time he offered two sugges-tions. The first was for collaborative work between psychoanalysts fromthe local institute and academics from a nearby university, and presum-ably then the construction of shared investigations, including appropriateempirical research. The other suggestion was the university creation of adepartment of psychoanalytic studies, modeled on the committee structureof the University of Chicago, with scholars from various disciplines, withprimary appointments in other departments of the university, drawntogether into a psychoanalytic teaching and research unit, with an unspec-ified relationship to the local psychoanalytic institute, to be ‘‘fashionedaccording to local conditions’’ (Holzman, 1985, p. 767). Actually with thedecline of psychoanalytic influence and presence in academia by the timeHolzman wrote, his conceptions seemed little more than wishful pipe-dreams.

A somewhat different model from Shakow’s (and Holzman’s) was AnnaFreud’s (1971) prescription for what she called, ‘‘the ideal psychoanalyticinstitute’’, and then dubbed in her subtitle, ‘‘a utopia’’. She began with a dis-claimer, describing her own childhood preference for stories that ‘‘might betrue’’ (Freud, 1971, p. 225), as against those with unrealistic or supernaturalelements. In this light she said: ‘‘The ideal psychoanalytic institute … claimsmy interest only insofar as it is capable of becoming true. Accordingly, therewill be nothing in my description of it which excludes this possibility’’ (p.226). Again, this was in the still heady climate of the 1970s.

The most radical aspect of her proposal was her vision of the ideal insti-tute as a full-time training center, an independent institute on the model ofher own Hampstead Clinic (renamed the Anna Freud Centre after herdeath), which has indeed approximated her ideal in the specific realm ofclinical training for child analysis. She contrasted the kind of training possi-ble in such a setting with that currently available in our institutes, whetherindependent or medical school-based.

Of our current training model she said:



As it was done fifty years ago, candidates still spend their working days in non-ana-lytic surroundings and non-analytic pursuits. They still arrive for their clinical andtheoretical seminars and lectures in the evenings or on weekends, i.e. tired out andunreceptive, at times when, by rights, they should be at their leisure and pursuetheir personal lives and interests within their families. They are still lectured to bysenior members of the profession, who devote some off-time to teaching, oftenagainst their real inclination, and only too often without having developed anyteaching skills. Candidates still have little or no time left for reading, apart from themost urgent course requirements, or for pursuing spontaneous theoretical interests.To the best of my belief, there is no other serious and ambitious discipline wherepart-time training schemes of this type are adopted, or where they are expected tobe effective.

(Freud, 1971, p. 230)

Anna Freud contrasted this with the ‘‘ideal institute, with full-time stu-dents, able to pursue their psychoanalytic studies intensively, leisurely, andwith enormously increased profit’’ (p. 230), and she ended with the acerbicstatement: ‘‘The present part-time system seems as out of date to me as ifchurch services were still conducted in catacombs since this is where theearly Christians were obliged to meet’’ (p. 230).

The balance of her article detailed the advantages that would accrue toour science in such a full-time educational institution. These would includethe sharing of material in group settings with faculty and fellow students,and participation in scientific workshops that pursue topics of scholarly andscientific interest: ‘‘By formulating, dissecting, summarizing, and evaluatingtheir data, and by placing them in analytically meaningful categories, theywill learn to turn the undigested mass of items as they are elicited in everyanalysis into materials which can be profitably assimilated, understood, andused by every analyst’’ (pp. 232–3).

Shakow, of course, would have added to Anna Freud’s formula a formalpsychoanalytic research component offering courses in philosophy of scienceissues relevant to psychoanalytic theory and scholarship, as well as coursesin empirical research strategies appropriate to the subjectivistic data of ourconsulting rooms. This full-time, research-focused psychoanalytic institute,this recasting, that is, of Anna Freud’s vision, would contain exactly thoseingredients that Engel found lacking in our traditionally organized institutes,and so would successfully address the ‘external obstacles’ to psychoanalyticresearch that he felt it so essential to overcome. That is, the institute wouldprepare candidates both for practice and for research. It would have aresearch ambience and tradition; some faculty of psychoanalytic researchersfrom whom to learn both by precept and by practice; and the necessarysupport of space, full-time staff, research facilities, and access to clinicalpsychoanalytic case material.

The central major obstacle to implementing this plan – the lack of anidentifiable funding base – Anna Freud left for her concluding paragraph:

I trust that I have kept my promise and that there is nothing in this blueprint of theIdeal Institute which will prevent the Utopia of today [she did not refer to her ownHampstead Clinic as representing an organized effort at present-day fulfillment of



that Utopia] from becoming a reality of tomorrow. The only serious obstacle whichwill have to be met is the financial one. Here I am confident in the idea that moneyis usually found for worthwhile purposes, and that the training of true analysts,equally versed in human understanding, clinical insight, therapeutic skill, andsearching exploration, ranks high among these.

(p. 239)

Again, surely a somewhat utopian optimism.Besides what Anna Freud was able to accomplish in her lifetime – based

on her own unique position in the psychoanalytic world, and on the majorfund-raising by her many psychoanalytic supporters on her behalf – in cre-ating her psychoanalytic Utopia for training for child analysis in London,there was a possible counterpart in the United States, certainly in the 1960sand 1970s when those of us active at The Menninger Foundation (whichhad its own intramural Topeka Institute for Psychoanalysis) viewed thatmajor center of residential and outpatient treatment for the full spectrum ofthe treatable mentally ill, both adult and child, as potentially the kind ofpsychoanalytic training and research center that Shakow and Anna Freudenvisioned (see Wallerstein, 1983). The Menninger Foundation was indeed asalaried, full-time group practice; it lacked at the time only the vital univer-sity linkage to both the natural sciences (via the medical school), and thesocial and behavioral sciences (via the graduate school faculties), and therewere dreams then of overcoming that lack through an affiliation with thenearby University of Kansas and its school of medicine.

But such a connection was never accomplished and, as time went on, itseemed ever more difficult of attainment. Ultimately the increasing pressuresfor cost containment exerted by private and governmental reimbursementsources, and the concomitant lure of lower-cost treatments using psychoac-tive drugs and ⁄ or shorter and simpler psychotherapy paradigms, weakenedThe Menninger Foundation’s finances to the point where it had to close itsdoors in Topeka. To maintain some semblance of what it had once repre-sented, it found an affiliation with a willing medical school department ofpsychiatry in another city and relocated, unfortunately having to disband itsintramural psychoanalytic institute. To my knowledge, Menninger is the onlypsychoanalytic organization in the world that – in its day – had even the pos-sibility of transforming itself into the fulfillment of Anna Freud’s dream.

It was this history of thwarted aspiration without possibility of fulfillmentthat led me finally to look for potentially realizable university-like alterna-tives and write my 2007 article on the possibility, in the burgeoning transfor-mations of some American psychoanalytic societies into the psychoanalyticcenter concept, as the closest we could come in our current world to theclaimed societal good – for psychoanalysis on as close as possible to thesame basis as cognate disciplines enjoyed in the university world. It was aretreat from the long-time grander professional aspiration for psychoanalysisthat I felt then to be unattainable. I inserted a sentence in the final para-graph of that 2007 article, stating: ‘‘But my point here is that the psychoan-alytic center model has the potential, even without the advantages ofuniversity placement and patronage, to represent our best chance [at this



time] to transcend the limitations of psychoanalytic education that havebeset us now for almost a century’’ (Wallerstein, 2007, p. 982).

But strong hopes, though deferred, may never really cease. In that sameyear, 2007, I was invited to participate in a symposium on ‘Psychoanalysisin the University: The Clinical Dimension’, to be co-sponsored in Novemberof that year by Emory University, which had an embedded psychoanalyticinstitute within its medical school department of psychiatry, together with aProgram in Psychoanalytic Studies for students in other disciplines seekingpsychoanalytic knowledge, and also by both the American and the Interna-tional Psychoanalytic Associations.

Stirred by the stated theme and the apparent success of Emory Universityin having two linked psychoanalytic components within its confines, apsychoanalytic institute and its program in psychoanalytic studies, withpossibilities for joint degrees, I revived my university aspirations andpresented a paper (Wallerstein, 2009) re-exploring not just the history ofpsychoanalysis vis-�-vis the university, but also the obstacles which stood inthe way of the logical and ready university placement for our discipline. Theobstacles I called attitudinal (on both sides, each with a long history ofbeing wary of the other) and financial (the costs to the university and to thestudents of such an expensive and long-term educational venture). Theattitudinal obstacles, historically deeply entrenched as they might be, Iconsidered more readily able to be overcome, given the goodwill and expec-tation of mutual profit that I felt had to be there to begin with, in order tomake it at all developmentally feasible. The financial difficulties I felt to bemore restrictive, certainly with today’s financial stringencies in the universityworld and in its student bodies.

My perspectives were then set much more optimistically by the conferenceitself, at least when considered for the long term. The conference wasopened by a short welcoming talk by James Wagner, the president of theuniversity. Wagner (2009) began his presentation with a summary of whathe called the academic canon. His central point was that higher educationand liberal learning had originally been intended only for the free man,mostly the aristocracy, with no expectation that professional educationwould be a part of this new education. There was no need for it; the earlystudents were members of an aristocracy whose economic futures wereassured by birth and fortune.

Gradually, over time, professions that required training arose but, to beginwith, outside the university, and Wagner used his own profession, engineer-ing, as a case in point. Engineering was certainly vital for the Romans,creating, by conquest, a vast empire, stretching far outwards from its Medi-terranean beginnings, with its required military implements, its highwayinfrastructure and its varied building needs. And at first, engineering was ofbut two kinds, military and civil, with neither requiring academic certifica-tion. It has been only since the mid-19th century that engineering hasbecome an academic discipline, with university training and certification.And this entry into the university was both reluctantly given and reluctantlydesired. Wagner gave examples of these initial ambivalences, as for example:



Even when Yale did open what became the Sheffield Scientific School in 1847,students could not sit in chapel with regular academic students. At Dartmouth,students studying sciences and modern languages attended classes in the wintertime, when the students of more noble disciplines were off campus making moneyas tutors.

(2009, p. 1099)

– and with more such, now ludicrous, examples.Wagner then made his main point. Why should psychoanalysis, if it wants

to be a serious discipline with continued incremental growth in its knowl-edge base, and with ‘‘recognition that a ‘public sphere’ of engagement needsto be constructed’’ (p. 1100), be any different or seek any different? It is ahistoric unfolding, of ultimate full placement of psychoanalysis within theuniversity that Wagner offered as ‘‘a reliable predictor’’ (p. 1100), and itshould be fostered, not resisted, by either side, psychoanalysis or academia.He began his final paragraph with the sentence: ‘‘Emory University hasbeen pleased to offer leadership in this regard by establishing in such closeproximity and relationship a psychoanalytic institute and academic instruc-tion’’ (p. 1100). Wagner wisely refrained from setting a timetable for what heoffered as this inevitable ‘‘increasing acceptance of the practice, study, andscientific advancement of psychoanalysis as an academic discipline’’ (p.1100). And there was no mention of the financial obstacles to this prospec-tive development that had bulked so large in my own focus on what waspossible today, rather than planned for tomorrow.

It was this introduction that set this frame – and the mood – of the con-ference. One of the presentations, by Hector Ferrari (2009), talked about asimilar development to that at Emory in Buenos Aires, though structuredquite differently. The Argentine legal system allows two kinds of higher edu-cation organizations, a Higher Education Institute, i.e. a full autonomousuniversity with the total panoply of appropriate academic disciplines, and anarrower University Institute with just a group of epistemologically relateddisciplines:

Psychoanalysis is a [single] discipline and, according to legal definitions could notbe on its own the exclusive object of study [even] in a University Institute.Therefore, psychoanalysis had to be integrated into a new, more extensive, and com-prehensive disciplinary field, which was determined on the basis of mental health,with an interdisciplinary approach and with psychoanalysis as an integrating axis.

(Ferrari, 2009, p. 1147)

Both kinds of Institute are empowered to award the graduate PhD degree.Ferrari’s description is of the several year effort by ABdePA, an IPA

institute in Buenos Aires, to create such a University Institute, by meetingthe various rigorous legal vetting and monitoring procedures, and to over-come the various uncertainties and ambivalences on both sides. Successwas finally achieved with IUSAM (Instituto Universitario de SaludMental) coming into being, with a Rector and Vice-Rectors chosen byAPdeBA, and a faculty of APdeBA members and Buenos Aires academics



from the disciplines of philosophy, sociology, epistemology, linguistics,history, etc. There is a (presumably full-time) student body training inpsychoanalysis, within this much broadened academic content, quite sepa-rate from the other psychoanalytic training centers in Buenos Aires, includ-ing the parent institute, APdeBA. The first classes of students are enrolledin what Ferrari calls ‘‘a qualitatively different structure’’ for psychoanalytictraining (p. 1152). Although this is far from a full university placement forpsychoanalysis, in our usually accepted sense, with all the even wideropportunities for cross-disciplinary contact and enrichment that that couldpromise, it is nonetheless a significant step in the progression that Wagnerhad outlined.

And in the most recent issue of the Journal of the APsaA, Steven Levy(2009), the psychoanalyst vice-chair of the Emory University Department ofPsychiatry, propounds the same conception of this ‘‘new model’’ (p. 1304)for psychoanalytic education with the same implication of its current birthand its future progression. He elaborates what he feels to be the inherentand essential educational advances for psychoanalysis and for the studentsin this developmental atmosphere within which he works. He wants topersuade us, the psychoanalytic world, ‘‘that profound changes in oureducational system are our best hope for the continued vitality of psycho-analysis’’ (p. 1296).

Talking of the prospective student body in this university-wide psycho-analytic offering, to the mix of potential practitioners, scholars, researchers,educators, etc., Levy states that:

A new model must appeal to them earlier in their careers, avoid requiring an all-or-nothing commitment, mix different career lines (and thus be interdisciplinary) andbe sufficiently flexible to accommodate busy students engaged in other activities …Only self-identified clinical candidates will be required to begin analysis and takecontrol cases with supervision, as has historically been the norm for everyone.

(2009, p. 1304)

Only in this way, can psychoanalysis fulfill its widest and proudest visionto be a psychology that both informs and learns from the totality of civiliza-tion’s discourse and its accumulated knowledge, archived in and transmittedby our universities, and become much more than the encompassing of ‘‘ourentire field under the leadership of the clinician ⁄ training analyst hierarchy’’(p. 1299), important as the therapeutic application of psychoanalysis is forall of us.

Such is my conviction now, after the shifting peregrinations of a profes-sional lifetime, but always with the central goal of putting psychoanalysisamong the company of all other disciplines of advancing academicknowledge and professional societal benefit, the university called by WalterLippman (1966) ‘‘that ancient and universal company of scholars’’. Today, atthe celebration of the 100th anniversary of the International Psycho-analytical Association, created by Freud and his colleagues to formalize andinstitutionalize our collective identity as a discipline and a profession, I lookto the second 100 years to come, to bring us more fully to that goal.



References

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psychoanalysis in the university: the natural home for education and research

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