Freud and non-medical analysts

From the outset, Freud welcomed lay (non-medical) people into as practitioners of psychoanalysis:^[3] Otto Rank and Theodor Reik were two such notable analysts, as well as Freud's daughter Anna. In Freud's view, psychoanalysis was a full-fledged professional field and could have its own standards independent of medicine. Indeed, in 1913 he wrote "The practice of psychoanalysis has far less need for medical training than for educational preparation in psychology and free human insight. The majority of physicians are not equipped for the work of psychoanalysis".^[4]

Thus Freud saw psychoanalysis as "a profession of lay curers of souls who need not be doctors and should not be priests"; and this new usage of "lay" (to include non-physicians) is the origin of the term, "lay analysis."^[5] Such prominent psychoanalytic figures as Anna Freud, Erik H. Erikson, Ernst Kris, and Harry Guntrip were non-physicians.^[6]

When in the 1920s Reik became embroiled in legal challenges over his right to practice psychoanalysis, Freud rose ardently to his defence, writing Lay Analysis in support of his position; and adding privately that "the struggle for lay analysis must be fought through some time or another. Better now than later. As long as I live, I shall balk at having psychoanalysis swallowed by medicine".^[7]

Opposition to Freud

However, embroiled in a struggle for psychoanalytic respectability, the plurality of Freud's followers were not at one with him on this issue, and opposition was especially contentious in the United States.^[8] The issue remained heated until World War II^[9] - a split with the American Association only being prevented in the 1920s when a compromise allowed lay analysts to work with children alone in New York.^[10]

However in 1938, the American Psychoanalytic Association (APsaA) formally began limiting membership of the association to physicians who had first trained as psychiatrists and subsequently undergone a training analysis at a (then European) psychoanalytic institute. The move has been described as initiating an official cleavage with the rest of the IPA which would not be settled until 1987.^[11]

During that period, many in the States believed, in Janet Malcolm's words, that "American psychoanalysis is a great cut above psychoanalysis elsewhere in the world...the laxness and sloppiness of English, European, and South American analysis. There are other people, naturally, who...[debate] whether too much wasn't lost by this strategy - whether too many good people who are unwilling to go through medical training aren't being lost to analysis".^[12] The policy was somewhat softened by the readiness of the APsaA to grant waivers over the decades to a number of individuals: these included, for example, Erik Erikson and David Rapaport.^[13] There was also the National Psychological Association for Psychoanalysis which Reik founded in 1946 specifically to train non-physicians.^[14]

However only when lawsuits were brought in the 1980s alleging "restraint of trade"'^[15] was the official American position finally altered, and the question of lay analysis resolved - as Freud himself always advocated.

See also

Chap 25. Psychoanalysis in North America From 1895 to the Present, by Sanford Giff, in The American Psychiatric Publishing Textbook of Psychoanalysis, ed. by Ethel Person Arnold Cooper, Glen Gabbard, 1e, 2005, pp. 400-401

In an antitrust suit filed in March 1985 by four psychologists, charges were brought against the New York Psychoanalytic Institute, the Columbia University Center for Psychoanalytic Training, the American Psychoanalytic Association, and the IPA. (ibid, p. 400)

In 1989, the antitrust suit against the American Psychoanalytic Association and the IPA was settled out of court, and in May 1990, the president of the American Psychoanalytic Association, George Allison, appointed another committee, chaired by Homer Curtis. A constitutional amendment was drafted to accept nonmedical applicants for full clinical training without a waiver! They were required to have the highest professional degree in their field, and the waiver system was still retained for nondoctoral applicants. Finally, in July 1991, the Curtis committee’s amendment was approved by over 80% of the American Psychoanalytic Association. (ibid, p. 401)