|J E P - Number 12-13 - Winter-Fall 2001|
The time of Illusions and Hopes|
The Approaches of the National Psychoanalytic Federation to the Problem of Psychoanalytic Education and Training in Russia (1)
Keywords: Russian psychoanalysis - Training in psychoanalysis - Russian Psychoanalytic Federation - History of Russian psychoanalysis - Foreign Psychoanalysts in Russia
This paper is a subjective survey of the history of psychoanalysis in Russia, and the current activities of various schools of psychoanalysis in Russia. The author speaks of the special problems of the revival of psychoanalysis in Russia, with a special plea to the world-wide psychoanalytic community to continue to provide theoretical and methodological support.
In this report I intend to highlight the recent achievements, the current situation and the planned activities of the National Psychoanalytic Federation in Russia. I am no objective observer of our project. I have initiated and/or participated in most of the work I will describe. However, my report will mainly be a summary of the management of the work, and not an analysis of our progress.
Freud maintained in Interest in Psychoanalysis (1913) not every analysis of psychological phenomena has the right to be called psychoanalysis. (2) While it is possible to conduct a psychological survey of our project without using psychoanalysis, any serious socio-psychological phenomenon requires psychoanalytic research. The revival of psychoanalysis in Russia is such a phenomenon, and it begs for psychoanalytic research. Since this kind of research is possible only with specialists in the discipline, at this stage in our evolution we need to maintain the goal of adding a substantial number of psychoanalytically oriented professionals to our managerial personnel.
When we began our project ten years ago, we had great enthusiasm for it, but very little understanding of the difficulties we would face. Now, though we have no less enthusiasm, we have a far better understanding of the real difficulties of our project. From the beginning, we were aware of the need to evaluate our programs to determine how effective they were in reviving psychoanalysis in Russia, in order to help us develop strategies for greater progress. Thus, this has not only been an experience for us, it has also been conducted as an experiment. The aim of our experiment was to learn how to speed up the development of psychoanalysis in our country. Freudian psychoanalysis was liquidated by force in the 1920s. For seventy years it was prohibited from reformulating. And, as a result of this seventy-year gap, the link between Russian analytic generations and the transfer of knowledge through relations with the world-wide psychoanalytic community was destroyed. Thus we have begun with no pre-existing structure and no cultural status.
Happily the remnants of these lost links have begun to remerge, as if waking up from a long sleep. But even with the emergence of a previously hidden community of psychoanalysts, the reformulation of psychoanalysis has been a difficult and a painful process. We, as well as our foreign colleagues who have been trying to assist us, have had to cope with many difficulties. We have noticed ambivalent feelings about the prospects for the rebirth of Russian psychoanalysis, on both sides. Nonetheless, relations between Russia and the world psychoanalytic communities are being developed, although Russia seemingly remains unattractive to foreign professionals, both in the area of long-term cooperation as well as in the transmission of theoretical and practical knowledge.
We have found that it is impossible to encourage a flow of psychoanalysts from foreign nations into Russia, as once happened with England and the US. Russia never could ever become a haven from repression for beleaguered foreign psychoanalysts. However, we did not expect that attracting analysts and scholars would be as difficult as it has been. For one thing, we continue to suffer from continuing chilly relations with our closest neighboring countries. The past decades of perceived and actual threat to our neighbors from the former Soviet Union did not generate a positive ground for amicability and cooperation. However, we did not expect it to be a continuing problem. For example, over the past ten years more than one hundred psychoanalysts from the US have provided consultation for us (a few of whom have stayed on for a few years to work with us), while only one psychoanalyst from Finland has come (and for just one day) even though Finland is only two hours away. Thus these political factors have had to influence our strategy and our tactics for reviving psychoanalysis.
Additionally, even though psychoanalysis is no longer prohibited in Russia, it is far from embraced, particularly by governmental bodies, which continue to strongly disapprove of it. In particular the educational, medical and psychological establishments, which are in the best position to either assist us or to hinder us, have maintained very negative reactions to psychoanalysis. The politically acceptable ideology of the psyche remains conservative, and will probably change only when the heads of some of these agencies reach retirement age.
In fact, disapproval of psychoanalysis, as well as attempts to discredit it, are still vibrant in our country. This is because the chiefs of the highest governmental bodies have been indoctrinated with a contempt for psychoanalysis. But these very bodies have the authority to grant state licensure and accreditation, without which any activity related to psychoanalysis remains illegal. The concept of professional accreditation as an alternative to governmental accreditation is quite new in Russia. Thus, the National Psychoanalytic Federation is a pioneer in working to develop a professional (rather than governmental) public accreditation institution in Russia.
We now better understand these many and complex external and internal difficulties. We have realized that we have to become more oriented toward developing our own capacities and possibilities. We are now focused on our own therapeutic experiences and on our own teaching and training institutes, because there is no other choice.
When the revival of psychoanalysis began in Russia ten years ago, we first viewed it as one of the substrates of clinical psychotherapy. At that time the concept of psychoanalytic treatment (as opposed to pure theory) was not well known. Even some of my closest friends and colleagues thought that psychoanalysis was something purely theoretical and thus not useful for the treatment of mental conditions. Fortunately Freuds ideas alone were adequate to overcome this lack of imagination. In this way, the reinstitution of psychoanalysis in Russia ontogenetically resembles its phylogenesis, in transformation of theoretical concepts, as well as in the various deviations from the theory and in the organizational splitting.
Psychoanalysis was not the only psychotherapeutic treatment unavailable in Russia. Until 1975, no psychotherapy existed officially in Russia. Before 1975 the various neuroses were merely considered to be typical features of decaying Western society. This changed in 1975 when the Ministry of Medical Care created (as an experiment) two hundred openings for psychotherapists in the USSR (which works out as one psychotherapist per one million people). This first experiment lasted ten years. In 1985 by decree of the Ministry of Medical Care, psychotherapy was finally registered, but as a medical profession. In the beginning any medical doctor could choose to become a psychotherapist.
However, this was quickly revised and limited. Instead of remaining a possibility for the general medical profession, psychotherapy came solely under the psychiatric profession. This decision had a negative impact on the early development of psychotherapy in Russia.
First, not many psychiatrists were willing to become psychotherapists. By December of 2000 there were only 2,000 psychotherapists in Russia (which works out to be one psychotherapist per 75,000 people). Second, because not many psychiatrists thought that practicing psychotherapy was important, our profession came to be viewed as a second-rate. This view started to change about five years ago, largely because of the interest shown in our training institutes. Psychologists can now train to be psychotherapists, although they must practice under the supervision of a psychiatrist: but this supervision requirement is vexing, because the required training for psychologists is far more stringent than the training required for psychiatrists.
The requirements for psychiatrists to practice psychotherapy have never been revised or upgraded. In accordance with current legislation, a psychotherapist must be a medical doctor who specialized in psychiatry, and who has had at least three years experience in psychiatric institutions, as well as additional training in psychotherapy. This additional training for psychiatrists consists of a total of 700 hours; 422 of which are designated to a refresher course in general psychiatry. The 200 plus remaining hours must include a survey of more than forty methods of psychotherapy, which works out to be seven hours for each method. The entire training can take place in a little as three months, and in no more than one year. However, a psychiatrist who has completed such limited training is then certified in all methods of psychotherapy.
About five years ago neither a personal (or training) analysis, nor supervision were familiar concepts in Russia. Now they are known solely in psychoanalytic context. When we opened the first institute of psychoanalysis—where we decided as an experiment to teach only psychoanalysis for four years—initial reactions were skeptical. We heard such sarcastic comments as, Who do you think would want to study that? Some of our early detractors were later amazed when our institute did attract students. Each year the number of students studying psychoanalysis has increased. Last year the number of first-year students doubled. Moreover, the percentage of students who are also qualified medical doctors or psychologists has been increasing.
In spite of its official prohibition over many years, a culture of psychoanalysis did remain in Russia, although in an underground form. There have always been people reading Freud; the few existing texts were exchanged between them. Discussions were held. There was even a psychoanalytic practice, although under a different name. This was during the long clandestine period. The time of fear of being identified as a psychoanalytically oriented psychotherapist ended just recently, in 1989.
It ended when the first psychoanalytic society, founded by Professor Aaron Belkin, opened in Moscow in 1989. Although his later concept of psychoanalytic endocrinology was extensively criticized, his achievement as an organizer of the first psychoanalytic society cannot be minimized. His brave example proved to us that this kind of project was possible, mainly because no one from his group was arrested or imprisoned by the KGB. One year later the first Psychoanalytic Society was founded in St. Petersburg under the leadership of Valery Zelensky. I have been a Vice-President of this society for some time.
In 1991 we opened the first Russian Institute of Psychoanalysis in St. Petersburg. This was a strategic decision, aimed toward the creation of a national system for professional education and training, and a national standard for certification and accreditation. This system has been partially formed, is active and will be further developed. Around the same time Sergey Agrachev formed his own group that later became the Moscow Psychoanalytic Society, now headed by Igor Kadirov. The Russian Psychoanalytic Association published the first issue of the Russian Psychoanalytic Bulletin.
The creation of these institutes allowed relations to develop between Russian students of psychoanalysis and leading international psychoanalytic centers (mainly in England, Germany and the US). However, in our honeymoon period, we did not have a clear idea about the differences between trends and schools. We welcomed everybody related to psychoanalysis.
We also had the romantic hope of quickly receiving both methodological and financial support from our foreign colleagues. But although we received less support than we expected, we were not disappointed. In our country financial assistance often leads more to dogmatism than to fostering freethinking, and we were later glad that we did not take on obligations through accepting financial assistance. Methodological support of course only requires an addressee, and until recently we did not have one. This addressee is now the Russian psychoanalytic community, which is only now prepared to utilize methodological support.
Around this time various approaches to psychoanalytic training and education began to arise. However, there were a few psychoanalytically oriented professionals who were absolutely against the idea of organizing training institutes in Russia. In their opinion this kind of education could only be obtained abroad. During the International Conference in St. Petersburg 1996, one of them, addressing our institute, sarcastically commented that, It is strange, we do not have psychoanalysis, but we have the Institute of Psychoanalysis and we organize conferences. However, his comment became ironical when he was appointed dean at one of the Moscow institutes of psychoanalysis.
Three more institutes of psychoanalysis have been opened in Moscow since then, and during the years 1999-2000 the members of NPF have opened three more institutes in different regions of Russia—Moscow, Novosibirsk and Khabarovsk. This is a confirmation that the decision we took in 1991 was both timely and welcome.
Still, differences in approach to the problem remain. Our opponents, having quietly admitted the necessity for psychoanalytic institutes in Russia, found a new motto, namely that no one can practice psychoanalysis unless s/he has been trained abroad and is a member of a foreign analytic society. This is absurd, even to them, and it seems to be merely a strategy for impeding and delaying the growth of Russian psychoanalysis. For one thing, we now have a long enough tradition of practicing psychoanalysis. Moreover foreign societies and institutions can accredit only a handful of professionals. Nevertheless, what they say may be understandable, in that we may still need to borrow authority from abroad, because we do not yet have an authoritative psychoanalytic society in Russia. This gaining authority by looking abroad has already taken place, for example in Germany. However, it is clear that this is not and cannot be the only way. Through using our own resources with whatever international assistance is available, we have been training psychoanalysts, who are now practicing and teaching—this is the normal way to gain authority, and hence the main reason our organization is oriented toward creating Russian professional accreditation.
All this has not been easy. I have mentioned the biased attitudes of governmental bodies. In addition to that, the activities of our rapidly growing psychoanalytic society (at the moment NPF has about one-thousand members) were recently called dangerous by a relatively small psychotherapeutic society in Russia (of two-thousand members). Our organization was required to prove that we are not dangerous. At the present time we have managed to build some trust, understanding and cooperation between our National Psychoanalytic Federation and the leading Russian psychotherapeutic societies. For example, the current President of NPF is a board member of all the leading psychotherapeutic societies in Russia as well as a member of the psychotherapeutic problem-solving committee of the Russian Academy of Science and the Ministry of Health Care. I view this as confirmation of progress in developing warmer relations with the psychotherapeutic community.
When we started our work ten years ago, we defined two areas of concentration:
- Psychoanalytic theoretical training (academic seminars), which we wanted to become widely available in Russia,
We recently separated the concept of psychoanalytically oriented psychotherapy from the concept of psychoanalysis, although we did not create any real distance between them; they are viewed within the same spectrum of professional training. We now view psychoanalytic psychotherapy and consultation as a possible first step toward training in psychoanalysis. Thus every professional now has a choice between accepting our psychoanalytic therapy standards and meeting international standards of psychoanalysis. To show our respect to the world psychoanalytic community, we call ourselves psychoanalytically oriented therapists and psychologists.
- The 3rd book of the edition Modern Psychoanalysis, by Prof. Horst Kächele and Helmut Thomä. This book describes one of the more important issues of modern psychoanalysis—analytic process research,
In 1994, our Institute of Psychoanalysis, together with the leading psychoanalytic societies of Moscow and St. Petersburg, adopted the First (and temporary) National Standard of Psychoanalytic Training. This was an important step toward improving the professional level of our psychoanalytic community. However, improving our professionalism is a continuous process. We will need at least a few more years before it gets close to the level we desire.
I will now list the most notable events of the past five years:
- 1996 – the First International Conference in Russia, The First Ten Years of Psychoanalysis: Russian Roots, Repressions and Russias Return to the World Psychoanalytic Community (St. Petersburg, 6-8 May, 1996). About thirty foreign professionals from England, Germany, Israel, Poland and the United States took part in this conference. Long-term contracts and projects were discussed with American and European psychoanalytic associations.
- 1996 – the first class of students graduated from the four-year program of our institute. At present our graduates work in nearly every Russian region. They are teachers, scientists with master and PhDs, heads of the state institutes and university departments, and managers and professionals working in psychotherapeutic institutions and serving in many different regions of Russia.
- 1996 – Honorary Russian Freud certificates were awarded to a number of Russian and foreign public figures as well as to psychoanalytic institutions in Russia and abroad for their contribution to the development of Russian psychoanalysis. Some people found it ‘pretentious that a barely known organization should ‘award leading specialists and world leading psychoanalytic societies. But for us it was the only possible way of expressing our gratitude for their support of our activities. We have decided to give such awards every five years. The new honorary award is named To Russia.
- 1996 – A Russian Presidential decree, 19.06.96 N1044, On the revival and development of philosophical, clinical and applied psychoanalysis was issued. This seems to have significantly changed the attitudes of governmental bodies to psychoanalysis. Moreover, the unpredictable situation that followed from this presidential decree created some dangerous developments, which we managed to successfully overcome.
- 1997 – A multi-disciplinary scientific program Revival and development of psychoanalysis in Russia was developed and accepted by the Russian Ministry of Medical Care, the Russian Ministry of General and Professional Education, the Russian Ministry of Science and Technology and the Russian Academy of Sciences. Since then the study of psychoanalysis has been included for medical doctors and psychologists in every Russian institution of higher education. Psychoanalysis is now viewed as one of the most important schools in Russian psychotherapy, together with behavioral, humanistic and integrative psychotherapies. However the required course on psychoanalysis is rather superficial. It consists of twelve to sixteen academic hours of introductory lectures. It at least presents the general concepts of psychoanalysis to future professionals.
- 1997 – the EEPI Educational-methodological Training Center opened, where for the past four years approximately 10,000 sessions per year of didactic analysis and supervision have been held. At the same time we introduced a temporary status for students of analysis and their supervisors.
- 1997 – we received the first Russian Ministry of Education license allowing activities in the field of higher professional education. It is impossible to function in Russia without a license (Russia is a country with an exceptional number of governmental regulations).
- 1997 – The National Psychoanalytic Federation (NPF) was founded. It united eleven psychoanalytically oriented organizations and societies in Moscow, St. Petersburg, Khabarovsk and other cities. Between 1998 and 2001, new psychoanalytic societies were formed in the largest industrial and cultural centers of Russia, including Vladikavkaz, Volgograd, Voronezh, Kaliningrad, Kemerovo, Krasnodar, Velikiy Novgorod, Novorossiysk, Novosibirsk, Norilsk, Perm, Ribinsk, Sverdlovsk, Smolensk, Cheboksari and Yaroslavl. In addition new psychoanalytic institutes were opened in three more cities.
- 1998 – The national concept of psychoanalytic revival and development was formulated. The main purpose is to focus on Russian national priorities, psychoanalytic education and professional training in Russia, to initiate a competent psychoanalytic movement in Russia, to create a sound system of professional education and professional information and knowledge exchange, and to create a public and state accreditation system for psychoanalysis in Russia aiming toward the gradual integration of psychoanalysis into Russian culture, science and psychotherapy.
- 1998 – International Conference ‘Psychoanalysis – Literature – Art (St. Petersburg, 3-5 July, 1998). More than 100 psychoanalysts from seventeen countries, including Australia, White Russia, Hungary, Germany, Israel, Canada, Mexico, Russia, USA, Switzerland, Sweden, Finland, France and South Africa took part in this conference.
- 1998 – The National Psychoanalytic Federation began publishing, in its own journal, historical, methodological and informative articles, latest editions by leading modern foreign writers and the first summaries of the clinical experience of Russian professionals. Over the past few years there have been more than 150 scientific articles published in this journal, among them classical papers by Freud, Fenichel and Abraham, as well as some publications by our foreign colleagues and outstanding modern professionals such as Vladimir Granov, Helmut Thomä, Horst Kächele, Harold Stern, David Sachs, Homer Curtis, John Kafka, Garry Goldsmith and Alexander Nepomiaschti. More than 50 articles by Russian authors have been published in this journal and all NPF members receive a copy of it. Since 2000 we have also been publishing an appendix to the journal (referred to as the 2nd journal) called Transfer-Express. It has become an intra-university student journal.
- 1998 – Opening of our psychoanalytic website with an e-version of our magazine and Freud Museum website.
- 1998 – The first Russian public psychoanalytic library opened. There are more than 4,000 books and magazines and more than 50,000 audio and videotapes in this library, which includes most of the important books on psychoanalysis written between 1924 and 1994. Approximately thirty people visit the library daily. I thank our British, American, French, German and Austrian friends for their priceless gifts to the library.
- 1999 – NFP organized our first summer school in Repino. The topic was Clinical and applied psychoanalysis – Russian-specific issues. 62 regional psychoanalytic societies and NPF organizations participated in the seminars and it has since become an annual event. The second NPF Summer school was held in 2000 in Yaroslavl and its topic was: Dynamic and structural models of supervising process. The participants of the second summer school noticed a substantial improvement in our methodological and professional standards. I will report just two telling statistics: (1) in 1999 the clinical experience of the participants averaged 1,700 hours, while one year later it was 3,600 hours; (2) in 1999 participants had an average of 91 hours of personal analysis, while one year later it was more than 202 hours.
- 1999 – In order to maintain a continuous supervision process, the regional NPF organizations introduced a temporary in loco status.
- 1999 – NPF was affiliated to the Russian Psychotherapeutic Association, which is headed by the chief psychotherapist of Russia, Prof. B.D. Karvasarsky. Thus NPF has identified itself as an inseparable part of the Russian psychotherapeutic community.
- 1999 – The Sigmund Freud Museum of Dreams opened. This museum quickly became one of the most popular cultural centres in St. Petersburg. Over the first 18 months there were more than 3,000 visitors and it held more than 50 seminars, lectures and discussions, in which both Russian and outstanding foreign scientists and artists took part. The latest seminar was dedicated to Jacques Lacan.
- 1999 – The first draft of the Ethical Psychoanalysts Regulations was developed and provisionally accepted by the NPF board. This draft was also adopted by a few other Russian psychotherapeutic societies. The very issues regarding the NPF Ethics Committee are currently being widely discussed. In September this topic will be further debated with the regional societies.
- 1999 – In association with the Russian Psychotherapeutic Association, we have been working on a Russian regulation, called On Psychotherapy. This regulation is based on the German model of psychotherapy.
- 1999 – NPF started to develop the field of child psychoanalysis with German psychoanalysts actively supporting this process.
- 2000 – The NPF Training Committee was formed. NFP made the decision to grant the status of NPF Methodological Center to EEPI. This gives our institute a greater responsibility in the improvement of organizational and human resources. The teaching staff of EEPI includes 17 teachers with a masters degree and seven teachers with a PhD. The goal of obtaining teachers with higher degrees in medicine and psychology remains a high priority for the regional organizations, especially concerning staffing of the institutes of psychoanalysis.
- 2000 – A memorandum by H. Thomä and H. Kächele called On psychoanalytic educational reform played an important role in the formulation of NPF strategy. This memorandum, published in our journal, encouraged us to re-evaluate the NPF statements On professional psychoanalytic training and On national standards for the psychoanalytic NPF training. We forwarded it to regional organizations for discussion in autumn 2001. The main highlights of this proposed reform include decreasing pressure on professionals from governmental institutions. (Note that this has nothing to do with the national professional education and training standards. These standards, as well as other standards for professionals, may actually become higher.)
- 2000 – The Russian-Austrian Conference Sigmund Freud in the Austrian and Russian cultural context was held by the NPF, Russian Academy of Science and the State Linguistic University in Moscow. This conference initiated new relations and international projects, including the publication of Sigmund Freuds complete works in Russian (translated from German with comments on differences from the English language standard edition, and remarks and references to both the English and the German editions); the organization of a Freud Festival for 2003 in St. Petersburg, and the foundation of a Russian-Austrian psychoanalytic center.
- 2000 – Regional organizations initiated one-year post-graduate training for practicing psychoanalytically oriented specialists. There are four types of training available, including clinical psychoanalysis, child psychoanalysis, and group psychoanalysis. These methods can co-exist within one organization and actually complement each other.
- 2000 – New NPF professional certificates were issued and granted to professionals who met the standards of psychoanalytic education and professional training (didactic analysis, supervisions and practice). The first group of NPF personal (training) analysts and supervisors was publicly accredited and qualified.
- Since 1998 there have been similar programs by Drs. H. Curtis and G. Goldsmith (with more than 20 leading specialists from the American Psychoanalytic Association),
- Since 1999 – there has been a similar program by the Mid-Manhattan Institute of Psychoanalysis (led by Dr. Charles Bershadsky, NAAP),
- Since 2000 – English program by Drs. Catherine Crouser and Jan Winner (IAAP),
- Recently the 10th seminar of French programs in Russia was completed. Dr. Alexandre Nepomiaschti (lately together with Dr. Nathalie Zaltzman) has held it since 1998.
- An effective professional training system;
- An effective professional informational system;
- An active implementation of scientific research approaches into psychoanalytic practice;
- Countering actions discrediting psychoanalysis as well as attempts toward illegal and wild psychoanalytic practice.
We remain open minded and prepared for free discussion with representatives from all Russian psychoanalytic societies, without fixed conditions or privileges for any of these societies.