New Training Model: Child and Adolescent Psychoanalytic Candidates training together in integrated classes (Integrated Training Track)
This is a model that can be used by all IPA Institutes and Component Organizations as an optional track for the training of child, adolescent and adult analysts.
The most important feature of this proposed model is that each Society and Institute will have the freedom to design a program in the spirit and reality of their local professional environment.
An integrated curriculum may not have to mean adding more courses. The courses would ideally be taught in such a manner that demonstrates theory and clinical practice relevant to both adult and child analysis. Institutes are open to choose a number of ways to proceed which could also include additional courses as electives. Supervision is an important component of learning to become a child/adolescent/adult psychoanalyst.
This model can be used in alignment with the pre-existing models of training already in place in the individual Institutes. We also propose that some parts of the training should be open to those candidates who do not follow the Integrated Training track as well as members of the Society. Ideally it would be most efficient and economical for Institutes to design their seminars so that the maximum number of their candidates can attend the same seminars.
The model also proposes the minimum standards as a base already agreed upon by the Committee and approved by the Board.
The following subjects are strongly recommended as part of the ITT.
- Freudian and post-Freudian models of development, psychic structure and functioning.
- Theories of technique and clinical seminars that include children, adolescents, and adults.
- Infant Observation
- Psychopathology of Childhood, Adolescence and Adulthood.
- The child in context: parents, family, community and culture.
- Ethics: child and adolescent
Proposals from Institutes and Societies for an Integrated Training Program should be sent initially to the COCAP chair, which in collaboration with E and O will review the proposals.
Suggestions for implementing the program:
-Co-teaching courses and seminars by adult and child analysts
-Creation of a shared database of literature relevant to an Integrated Training Program.
- Collaborative structures of teaching and supervising via telecommunication. This would allow for various Societies and Institutes to share instructors and bring together classes of candidates from smaller institutes.
International Psychoanalytic Association (IPA) report on Integrated Training Track (ITT)(2017)
Listening for Echoes of the Child in Adult Psychoanalysis
Chair: Justine Kalas Reeves (USA)
Panelists: Kerry Kelly Novick (USA), Jack Novick (USA)
Discussant: Jani Santamaria Linares (Mexico)
This timely and stimulating panel introduced us to the Integrated Training Track (ITT), a didactic curriculum newly approved by the IPA and now available to all component Societies and Institutes, affording candidates a unified training in Child, Adolescent and Adult Psychoanalysis. An overview of an adult analysis was given and then discussed, grounding in clinical work the panelists’ developmental, ‘life-cycle understanding of the psyche’ perspective. Ample time was afforded for a lively and wide-ranging discussion, in the course of which the audience was further introduced to the clinical heuristics and terms which Jack and Kerry Kelly Novick have developed over decades, rooted in and building beyond the work of Anna Freud, with reference to recent and forthcoming work in which they present and discuss in greater depth their theoretical and clinical work along the lines sketched out in this panel.
In her opening comments, Justine Kalas Reeves set the tone and situated us within historical, contemporary and future contexts. She began by recalling Anna Freud’s unsuccessful attempt, forty-six years ago at the international congress in Vienna, to have child psychoanalysts gain membership to the IPA. From issues such as membership decline and training demands, to theoretical and technical cloistering of discourse, Dr. Reeves argued that the separation between child and adult analysts has been hurtful for both. With innovations such as the ITT, future analysts can learn much more about analysis throughout the life cycle, together with contemporaries, or colleagues older and younger. Development specific to middle and late life can and needs to be fruitfully be brought to bear on the treatment of younger patients. “In the future, if all psychoanalysts are trained in the life cycle — in other words can work with any human of any age, from cradle to grave — that enriches . . . the dynamism of the developmental point of view.”
Kerry Kelly Novick then took the lead in explicating the integrated training curriculum more fully. ITT emerged from years of work by the IPA’s Child & Adolescent Psychoanalysis Committee (COCAP) under the former leadership of Virginia Ungar and Mrs. Novick herself. Their worked aimed to address questions such as how a developmental approach to clinical work with all ages might become part of every analyst’s repertoire, how this might be operationalized.
Mrs. Novick provided a clear statement of her and her colleagues’ foundational assumptions. These include the following: Psychoanalytic developmental concepts are an integral part of all analytic theories and have an important place in the ‘general theory’ of psychoanalysis as well as in the education of analysts. Clinical work may be specialized to various populations, but training benefits from the broadest and deepest possible inclusion of knowledge for all; that is, analysis benefits from a large pool of shared knowledge, in contrast to fragmentation. Our contributions to and collaboration with neighboring disciplines, other professions and the broader world are strengthened by a depth understanding of the whole life cycle.
In most places today, analysts who wish to train and integrate both child and adult analysis must take on the work individually by pursuing sequential training. Drawing on her own experience, Mrs. Novick described what she called “the psychic work of listening to resonances from all levels, forward and back in time.” For candidates, teachers and supervisors, knowledge in each field and the interplay across them is ever-evolving. ITT affords contemporary analysts the opportunity in training to learn not just content but also process: for one example, how to talk with colleagues across potential areas of focus consistently and rigorously. And ITT responds to other pressing challenges in our field: concurrent training in adult and child/adolescent analysis may save time and money, significantly impacting candidates’ career planning. The IPA has concerns about the aging of its membership, and many younger people are interested in work with children. Whereas changes and tensions in the field of psychoanalysis have at times produced splits and rivalry, an ITT by its very nature fosters the development of dialogue as well as shared identity — namely, as a “life-cycle psychoanalyst,” rather than allegiance to a child, adolescent, or adult sub-specialty.
Mrs. Novick then described what was involved for a local component IPA Society to establish an ITT. The most important feature is that each Society and Institute has the freedom to design a program ‘in the spirit and reality of the local professional environment.’ Within the guidelines described in the IPA Procedural Code for the ITT, Societies have flexibility in defining the details of their final format. An ITT can coexist with the models of training already in place in individual Institutes. An integrated curriculum may not have to mean adding more courses; on the contrary it might be more efficient and economical for certain Institutes to design seminars so that the maximum number of candidates from all training tracks can attend. In calling on examples from ITT implementations, Mrs. Novick stressed that faculty development and enrichment were central, both providing a fruitful avenue for change in certain institutions, as well as pleasure and intellectual expansion through mutual learning between adult and child colleagues. Interestingly, the lack of focus on adolescence was noted — as theoretical narratives and discourse suffers from an emphasis on infancy, thereby diminishing the importance of other developmental stages. Dr. Reeves and Mrs. Novick encouraged interested parties to direct their comments, inquiries and applications for recognition to the incoming chair of COCAP.
Jack Novick picked up the discussion and provided an introduction to his clinical material by way of the observation that there has been a decline in a developmental point of view in which each phase contributes to and transforms the others, forward and backward in time. He related this decline to hypertrophied interest in earliest infancy and in ‘the here-and-now,’ both of which seem to have narrowed what is included as psychoanalytic in theory and technique. He underscored two component ideas of his working developmental model: first, that earlier is not necessarily more potent; second, that no one phase of life has pre-eminence over any phase. In his clinical work with an adult woman, work with a core screen memory of her three-year-old self mothering her mother became central to the analysis and transformation of a woman whose adolescent traumas were legion and led to collapse. His treatment model emphasized the recapitulation of development with a new object in an environment of safety, creating a developmental story within the analysis. The way in which her pre-life, her conception, her childhood, and her future had been woven together into repeating and compounding patters was narrated, as well as the dominant themes of the analysis and how there was an emphatic movement toward “reality” so that ‘closed-system modes of self-regulation and functioning gave way to more open-system modes and possibilities.’ Dr. Novick described aspects of the change that involved ‘recovering memories of mutual pleasure and love; building a reality-based self; the patient’s repeating to herself “self-care is not selfish” as a necessary step to adulthood.’ In her rich and poetic discussion, Jani Santamaria Linares opened up numerous aspects of Dr. Novick’s clinical presentation and point of view.
Much is omitted in this panel report, and the clinical aspect has been minimized here. A thirty-minute, well-moderated discussion ensued. In the course of this discussion, the panelists brought everyone back to the theme of the congress, Intimacy, and Mrs. Novick talked about pathological intimacy as a closed-system, reviewing the clinical material from that point of view. Returning to ITT, Mrs. Novick stressed the value of bringing to bear on analytic listening and response a knowledge of what ‘normal developmental capacities’ capacities are across the life cycle. Responding to questions about their technique, Mrs. Novick noted that details can be found in their recently published work Freedom to Choose; but one example in which thinking developmentally alongside a closed-system, open-system framework informs her technique is in her organization and selection process — ie, what she picks up in any given clinical moment, attempting to work in both systems and at their borders.
Integrated Training Programs within APsaA Affiliated Institutes
The Michigan Model of Integrated Training (MITT)
The Michigan Model of Integrated Child and Adult Training was the first fully integrated analytic training and provides the basic model for other such trainings in North America and the Integrated Training Track of the IPA. It was implemented in the late 1980’s and has now been in place for close to 30 years.
The following is a summary of the components and steps:
All applicants to the Institute are told that they are applying to an integrated child and adult psychoanalytic training program; depending on their choice of training cases they can graduate as a child and adult analyst, an adult-only analyst (with the option of doing child cases later), or a child-only analyst.
The success of the program depends on the enthusiasm of the faculty. This comes into play immediately at the point of application. Child analysts are part of the admissions committee and it is their charge to be in touch with all applicants and explain the advantages both to their training and to their later work as an analyst to do the integrated training.
Those who opt for the combined clinical program can have either a child or an adult as their first case, since the MITT instituted the policy of “first case best case.”
Number of cases
MITT requires 5 cases for combined training, 2 children, 2 adults and one adolescent or young adult as a swing case.
In addition to regular case summaries each student is expected to write a scientific paper good enough for professional presentation. One paper can fulfill the graduation requirements as both child and adult analyst.
Since child cases often move faster than adult ones, a student can graduate as a child analyst while still meeting clinical requirements as an adult analyst. The child analyst can become a full member of the faculty and can teach, mentor, and start taking the steps to become a supervisor while still an adult student.
A major component of the MITT is the alternating child/adult continuous case conference led jointly by a Child and an Adult supervisor. This weekly course starts in the first year and continues each year to the end of course work. This ensures that every student is exposed to both adult and child analytic clinical material and techniques.
All other courses have child and adult components integral to the content, for example, a course on dreams includes children’s dreams and how they are handled in clinical work; a course on latency has the application of latency functioning and defense analysis to work with adults. The current shift to include concurrent parent work in analysis of children and adolescents makes adult analytic work essential to the work of a child analytic student. Note that in the MITT model there is no need to dramatically change the curriculum, which is often an obstacle to creating an ITT.
The C/A students requested an additional monthly seminar with alternating presentations by students and child faculty on child analytic topics. Adult-only students and faculty are welcome. This seminar is an opportunity for students and faculty to hear each other’s clinical work and it facilitates child analytic identity formation in the MITT students and faculty.
Integrated Training Programs at IPA Institutes in North America
The Integrated Training at the Contemporary Freudian Society
The training of the Contemporary Freudian Society is offered in NYC and DC. Our trainees come from locations across the East Coast, including Baltimore, Miami, Connecticut, Norfolk and Charlottesville. Training provides in-depth instruction in multiple theoretical perspectives, including Contemporary Freudian, Contemporary Kleinian, Bionian, Winnicottian and Kohutian. For more information about training to become a psychoanalyst and other training opportunities, and to learn more about our current candidates and faculty, please visit instituteofcfs.org.
Our Integrated Training in Psychoanalysis reflects our conviction that exposing all candidates to developmental theory, analytic listening and the possibility of treating all ages will enrich and deepen the competencies of our graduates. We encourage candidates to treat analytic cases from all age groups in order to become ‘life cycle analysts,’ hence it integrates child and adult psychoanalytic training. In so doing, it also enables candidate analysts who plan to only treat adults to have a more detailed understanding and ear for hearing the echoes of infant, toddler, latency and adolescent development as it appears in adult psychoanalytic work.
Candidates can become child analysts after they have completed their adult cases though we encourage candidates to treat children and adolescents under supervision alongside their adult cases. Our new integrated training permits graduates of the adult psychoanalytic training to become child/adolescent analysts after their didactic portion is finished, so they do not have to do a separate child analytic training. Experience of treating patients from all phases of development is more likely to ensure a varied and diverse psychoanalytic practice as well as a more nuanced developmental understanding of the individuals we are trying to help.