Table of Contents
Preface
This handbook provides an overview of SPSI’s policies, programs, schedules, and organizational structure. This handbook’s aim is to encourage you to understand and participate as fully as possible in the process of your training. SPSI’s procedures and policies are often re-evaluated and occasionally revised. You will be notified about changes to these policies by email, posts on Discord, relevant areas of SPSI’s website and periodic revisions of this handbook. You should feel free to approach your Consultants, Progression File Reviewer, or the Director concerning any matter that requires further clarification.
All of the processes and requirements in this handbook are derived from the Policies and Procedures of SPSI’s Board, faculty, and committees.
This handbook also includes material from “Standards and Principles for Psychoanalytic Education (February 11, 2022),” the principal guidance document for institutes of the American Psychoanalytic Association (APsA). SPSI is a member institute of APsA.
Candidates are expected to be familiar with APsA’s Code of Ethics. This code was last updated in February 2024. It is available on APsA’s website at https://apsa.org/wp-content/uploads/2024/02/APsA-Code-of-Ethics_Feb-2024-2.pdf. All Candidates will receive a copy upon entering SPSI.
Introduction: Psychoanalytic Training
Goals of Psychoanalytic Training
The primary goal of psychoanalytic training is to facilitate the development of psychoanalytic competence and a psychoanalytic identity. A psychoanalytic identity requires emotional and intellectual openness toward understanding the full complexity of the human mind, including psychological distress. Essential to this identity are an attitude of curiosity, a spirit of inquiry toward new observations, and a wish to acquire a comprehensive understanding of the accumulated and growing body of psychoanalytic knowledge. A psychoanalytic identity also includes a lasting dedication to continuing study and development as an analyst, to consultation and community with colleagues, and a deep commitment to patient care.
From APsA’s Standards and Principles for Psychoanalytic Education
The American Psychoanalytic Association (APsA) approaches psychoanalytic education as a scholarly and clinical discipline, emphasizing critical thinking, conducted in a comprehensive, creative, and flexible manner. Psychoanalytic education fosters knowledge and understanding of theoretical and clinical psychoanalysis, as well as proficiency in psychoanalytic clinical practice. Classroom teaching and clinical consultation help Candidates open to new ideas, question, exchange, and evaluate competing views, and apply them in response to the changing world in which psychoanalysts practice. Continuing professional education and involvement in institutional life are essential components of psychoanalytic development throughout an analyst’s career.
APsA is responsible for creating a frame and a foundation for psychoanalytic education in its Institutes. APsA Standards establish principles of psychoanalytic education and provide guidelines for institutes to implement those principles. APsA’s model of education respects the integrity and competence of its Institutes to implement the principles of psychoanalytic education and recognizes that each Institute has the right to adapt procedures to its culture, environmental circumstances, and practical needs, providing they are consistent with APsA Standards. APsA uses the International Psychoanalytic Association’s training requirements as a baseline for its standards for qualification and admission to membership. APsA standards are primarily qualitative; where quantitative requirements are necessary, they should be regarded as threshold standards indicating that psychoanalytic education continues, rather than concludes, upon graduation.
APsA recognizes the cultural and social surround as constitutive elements of mental life and as essential to psychoanalytic education. The tendency of psychoanalytic theory and education to discount the effects of the social world and its inequities has contributed to systemic discrimination. Sustainable progress towards transformative goals requires an organizational commitment to recognizing, studying, and respecting cultural and individual differences, and the varied psychosocial determinants of identity and diversity. To maintain vitality and relevance APsA is focusing on contemporary issues of race and racialization including the study of privilege, group identity and difference in the clinical setting, as well as applications in marginalized and fractured communities. Integrating intersectional perspectives on the diversity of social identity extends this focus to include other biases and inequities.
To meet this challenge, a contemporary psychoanalytic curriculum should integrate a theoretical understanding of group dynamics, specifically regressive behavior in groups and the psychical transmission of destructive aggression, from enslavement to holocaust and genocide, and all forms of deferred action in the transgenerational transmission of trauma. This will position psychoanalysts to be more effective in addressing the varying expressions of otherness and discrimination in psychoanalytic education, clinical practice, and organizational settings beyond the consultation room including, but not limited to, inter-ethnic conflict resolution and community-based practice in marginalized communities. Integrating community psychoanalysis and the social determinants of health and justice into the psychoanalytic frame should also include the natural world and prepare psychoanalysts to work with psychological resistances to recognizing climate catastrophes and injustices, as well as varying forms of entitlement, as manifestations of environmental racism within individual and community settings.
APsA Standards for Psychoanalytic Education will continue to evolve. Institutes are encouraged to appeal as broadly as possible to their APsA membership for input on educational matters. As the APsA Standards are applied locally, the Department of Psychoanalytic Education (DPE), in the spirit of advancing excellence in psychoanalytic education, is available to consider and consult on questions that arise. When appropriate, or requested, the DPE will make recommendations to the Institute Requirements and Review Committee (IRRC) and the Board of Directors will make final decisions about changes to the Educational Standards. (APsA Standards and Principles for Psychoanalytic Education, 12/21/2021, revised 2/11/2022, pp. 2-3)
SPSI Organizational Structure
SPSI Organization Chart (revised March 2024)
The International Psychoanalytic Association (IPA), now based in London, was established in 1910 by Sigmund Freud and his followers, and remains the umbrella organization for most psychoanalytic training bodies worldwide. The American Psychoanalytic Association (APsA), a member organization of the IPA, was chartered by the IPA in 1911 and has numerous training facilities in the United States with the national office in New York City.
SPSI began as an APsA Study Group in 1946 and became an accredited institute of the American Psychoanalytic Association in 1964. As a Washington State not-for-profit corporation, SPSI has a Board of Directors that oversees all activities of the Institute. The Board is comprised of psychoanalysts and community members.
The faculty is generally responsible for the governance of SPSI and for creating and maintaining policies and procedures. Candidates may vote on educational matters at the monthly community business meetings. The Director and all other officers and committee members are elected by the Faculty. Candidates are included as members of most SPSI committees and have their own organization, the Candidates and Academic Associates Organization (CAAO) whose representatives participate in institute business deliberations and decisions. The instructors in the Adult Psychoanalytic Training Program are members of the Faculty and are unpaid volunteers, as are all SPSI officers.
Please refer to the SPSI website for the current rosters and descriptions of faculty, committees, and leadership roles.
Technology
SPSI Website
Active use of the SPSI website is required throughout training. For most uses, a login is required. Class readings are available as pdfs or other electronically available forms. All syllabi, reading lists, course evaluation forms and other course materials are distributed online. The SPSI online calendar includes links to meetings and events that are conducted online. The website includes various links to SPSI’s committees, resources, forms, and policies and procedures.
Dropbox
SPSI uses Dropbox for Candidate records. Your course evaluations, personal analysis forms, Progression committee correspondence, and, importantly, your case write-ups, consultation reports and other records are all maintained in Dropbox by the SPSI Administrator. Only the Administrator may add items to your Dropbox. You, your Progression File Reviewer, and the Chair of the Progression Committee have access to view your file. We strongly encourage you to actively review the contents of your Dropbox periodically. Dropbox is an app and may also be accessed through a web browser window.
Zoom
SPSI uses Zoom for online business and committee meetings, scientific sessions and community events, and online and/or hybrid class meetings.
Discord
SPSI hosts a Discord server with several channels, from open forums to private text channels for committees, workgroups, Candidates, cohorts, or faculty.
PEP-Web
The Psychoanalytic Electronic Publishing (PEP)-Web is a searchable, cross-linked online library of psychoanalytic journal articles, books, and videos. SPSI uses PEP-Web to provide access to many of the readings for didactic courses; you’ll find links to the readings on PEP-web in your course syllabi on the SPSI website. As a Candidate, you receive a subscription to PEP-Web.
The Tripartite System
Psychoanalytic training integrates three components: your personal psychoanalysis, the didactic curriculum, and the practice of psychoanalysis under consultation. The strength and uniqueness of psychoanalytic training lies in the combination of your personal analysis, being in classes and case conferences with your cohort and other Candidates, and eventually, conducting analysis. The interweaving and reinforcing of these three elements is a fundamental aim of the psychoanalytic educational process. Together the elements are referred to as the tripartite system.
Element 1: Personal Psychoanalysis
Your personal psychoanalysis supports the development of character stability, openness, flexibility and maturity. It is essential that you strengthen those capacities for self-observation, self-reflection, and ultimately, ongoing self-analysis that are necessary in maintaining a psychoanalytic stance, including creative openness to what the analyst learns and experiences. Your personal analysis should contribute to direct appreciation of the nature and power of conscious and unconscious processes, including conflicts, affects, defenses, and their interrelationship. It should also contribute to conviction as to the therapeutic value of psychoanalysis, including working in the transference. A principle of analytic training is that the best ways to learn about analysis are to be in it and to do it.
We strongly recommend beginning your personal psychoanalysis before you begin training. Delays in starting analysis will limit the effectiveness of your training and may delay your progression. If your analysis is not under way by the beginning of training, please seek out your Progression File Reviewer or a member of the Admissions Committee for assistance with finding an analyst.
Once a year, all SPSI Candidates are required to attest in writing as to the start date of their analysis, the status of their analysis and the qualifications of their analyst. This form will be sent out by the administrator as a fillable pdf, and is reproduced at the end of this section for reference. This attestation form is sent to the Chair of the Progression Committee, which tracks the participation of Candidates in all aspects of training. Other than this requirement, all aspects of your personal psychoanalysis are completely confidential.
Who Serves as a Psychoanalyst to a Candidate?
SPSI’s faculty includes designated “Analysts of Candidates.” These are experienced, seasoned clinicians who are at least five years post graduation and who have demonstrated special interest in conducting analysis with Candidates. They have been evaluated for their experience and immersion in conducting psychoanalysis.
Your personal analysis must be undertaken with either a SPSI-designated Analyst of Candidates, or a non-SPSI analyst who has been designated as an Analyst of Candidates at their home institute (at other institutes the designation “Training Analyst” is sometimes used), or, a psychoanalyst who has graduated from an APsA- or IPA-affiliated institute (or a substantially equivalent one), has at least five years of post-graduation experience conducting psychoanalysis, and is in good legal standing as a licensed clinician.
If the psychoanalyst with whom you wish to work for your personal analysis does not meet these qualifications, please contact the Progression Committee Chair to discuss the potential of a request to waive the above requirements. In some cases the Progression Chair will convene an ad hoc committee to review such requests, respecting the confidential nature of your analysis as much as possible.
Frequency and Duration of Your Own Analysis
Your personal psychoanalysis must be conducted at a frequency of at least 4 times a week for a majority of the treatment. The duration of your own analysis is a private matter, but the importance of an analysis that allows you to grow, to deepen your self-awareness, to experience the working-through and work in the transference, and that supports the evolution of your identification with psychoanalysis cannot be overstated. Every analysis is unique, but no analysis can be rushed. Optimally, your personal analysis will continue throughout your training, and should be ongoing as you conduct advanced work with your own analysands.
You must be in your personal analysis for at least six months before requesting permission to start your first control case. A minimum of six months of your personal analysis must overlap with your didactic classes and your first control case under the guidance of a Consulting Analyst.
At the time of this writing (Spring 2024), APsA is evaluating its policies about teleanalysis. When possible, we strongly encourage in-person treatment.
Element 2: Academics:
Curriculum, Seminars, and Case Conferences
The didactic curriculum is a series of weekly Friday afternoon seminars (12:00 — 5:00 PM), from September to June, over four years. Each academic year consists of four terms: a 9-week and 4-week “intersession” term in the fall, and two 9-week terms in the winter/ spring. Each term is comprised of two didactic courses or seminars and either a case conference or a writing seminar. Classes are generally in a small-group discussion format, and active participation in the group discussions is expected. Readings consist of up to 100 pages each week in preparation for class.
The didactic seminars integrate the fundamentals of psychoanalytic theory, clinical practice, human development, psychoanalytic conceptions of psychopathology, ethics, community and group dynamics, and sociocultural dynamics and context. The four years of immersion are designed to enable you to develop a comprehensive understanding of these aspects of psychoanalysis and the interrelationships among them.
The case conferences provide an opportunity to present your work and and hear about ongoing cases from fellow Candidates, in order to learn about analytic process. Candidates often report that the case conferences are where they notice their own growth and consolidation the most. All Candidates are required to present an ongoing analytic case in a 9-week case conference at least once before graduating. We encourage Candidates to present frequently; presenting one’s work is viewed as a core competency (see Appendices).
Attendance in Case Conference After Didactics
You are required to attend case conferences until you graduate, unless you receive written permission to be excused. The time frame for graduating from psychoanalytic training is highly personal, and depends on many factors and contexts. Post-didactic Candidates with two credited cases may petition the Progression Committee to be excused from attendance at case conference. We strongly encourage your full participation in case conference until graduation in part to promote opportunities for Candidates to hear about cases in advanced phases of treatment.
Element 3: The Practice of Psychoanalysis:
Immersion, Consultation, and Writing
The practice of psychoanalysis is the laboratory and the heart of psychoanalytic training. The following is adapted from APsA’s Standards and Principles for Psychoanalytic Education (2022, pp. 8-9):
Conducting analytic cases under consultation aims to teach the relationships between theory, clinical process, and technique, and thereby impart the knowledge and skill to conduct effective psychoanalysis. SPSI requires for graduation the completion of at least three acceptable consultations of psychoanalytic treatment of adults.
Candidates shall initially have a different Consultant for each case. The consultation will occur over a length of time that allows the Candidate to develop sufficient knowledge and skill to conduct psychoanalysis independently and competently. Demonstration of competency is a prerequisite for graduation (see Appendix B). The length of time of consultation will vary but the Candidate should meet with the Consultant of each case weekly for one year or longer. The cumulative total hours of consultation for all cases shall be at least 200 hours. This minimum is a threshold standard and additional consultation during training, and/or consultation post-graduation is encouraged.
Ongoing assessment and feedback are crucial dimensions of the Candidate’s supervision and learning. Each Consultant is expected to periodically assess the progress of the Candidate’s ability to conduct psychoanalytic treatment through written reports or evaluations; such assessments will be communicated to the Candidate and the Progression Committee. This evaluation will address Candidates’ understanding of didactic material and ability to apply it in their clinical work. Clinical competence is expected to evolve as Candidates progress through their psychoanalytic education. Assessment of progress will begin at the first opportunity and continue until graduation.
Candidates are expected to work with cases that reflect a diversity of identity characteristics, including but not limited to gender, sexual orientation, age, religion, race, ethnicity, culture, ability status and socioeconomic status. At least two cases should have reached the mid-phase of analysis; it is preferable that one case is near termination prior to the Candidate’s graduation. One of the cases may be seen at 3 times a week; the other two cases should be seen at 4 or more times at week.
Who Serves as a Consulting Analyst to a Candidate?
SPSI’s faculty includes designated Consulting Analysts (sometimes called Consultants). These are experienced, active members of the faculty who are at least five years post graduation and who have demonstrated immersion in conducting analysis. These Consulting Analysts are identified in the SPSI roster. Fees for consultation are decided on between the Candidate and the Consultant.
From time to time, SPSI Candidates may wish to work with a Consulting Analyst who is not a member of SPSI’s faculty — for instance, to learn more about a particular theoretical approach, or for expertise or support in a sociocultural context, or for geographic reasons. A non-SPSI Consultant should be formally designated as a Consulting Analyst at their home institute. In some cases, the potential non-SPSI Consultant may need to work with the Faculty chair-elect to confirm the necessary qualifications before beginning consultation. Because of the need for such Consultants to work and provide evaluation for the training needs of a SPSI Candidate, it is important to coordinate closely with the chair of the Progression Committee if you wish to work with a non-SPSI Consultant.
Frequency of Consultation Sessions
For your first and second cases, consultation should occur on a weekly basis for at least the first year of analysis, and preferably throughout the course of treatment. However, if after the first year, you and your Consultant agree that a lesser frequency is indicated, consultation may continue on an alternate week basis. Starting with the third case, consultation should still start at a weekly frequency, but may be reduced to bi-weekly or monthly sessions after treatment is well established.
For details on the writing aspect of control cases, please see the Progression section and Appendix B, “Guidelines and formats for writing.”
Annual Training Analysis Report Form
Progression
In psychoanalytic training, “progression” refers to your ongoing development as a Candidate, and also to the system that tracks and supports your achievements. The Progression Committee oversees this process.
When you begin training, you will be assigned a File Reviewer who acts as a liaison between you and the Progression Committee. File Reviewers are members of SPSI’s faculty who are either members of the Progression Committee or who volunteer to participate in progression. You and your File Reviewer will work together to continually track your progress through training. Once a year, the Progression Committee surveys the status of every Candidate by reviewing course evaluations, case write-ups and Consultant reports, and by inviting each Candidate to self-assess their progression through training; this is the “File Review.” The Progression Committee also approves your readiness to start cases, awards credit for cases, and certifies graduation. The latter actions may be requested by you at any time during an academic year, not only at your annual File Review. The steps for all Progression requests are described below.
When you approach any of the progression checkpoints here, you should initiate contact with your File Reviewer to help you communicate with the Committee. Any requests or action items need to be complete and submitted for the agenda one week prior to each meeting. Progression meetings are usually on the third Thursday of each month during the academic year.
The Context of Progression: General Principles of Training
The overlap of your analysis, classes, and control cases
Psychoanalytic training at SPSI integrates three elements: your personal analysis, the didactic seminars and case conferences, and the practice of psychoanalysis, which includes consultation and writing about your cases. At least a six-month period of overlap of all three of these elements is required. (As described in the “tripartite system” section earlier, you should begin your personal analysis before the start of your first didactic term.)
Psychotherapy consultation before beginning control cases
We strongly recommend that you engage in regular consultation on your psychotherapy cases with a member of the SPSI faculty when you begin training. In some cases, Candidates beginning training may already be working with a Consultant or supervisor in the community. If so, we recommend talking with your Progression File Reviewer about how that consultation may intersect with training. If needed, your File Reviewer can help identify a potential psychotherapy Consultant from SPSI’s faculty, based on your needs, background, work setting and clinical experience. A SPSI faculty psychotherapy Consultant is well positioned to help you identify possible control cases, formulate recommendations for analysis, help you assess your readiness to begin conducting psychoanalytic treatments, and identify, if necessary, a Consulting Analyst for the first case.
The importance of immersion in control cases while in didactics
The first two years of classes are designed to prepare you to begin practicing psychoanalysis. By the end of the second year, you should have least one control case in consultation with a Consulting Analyst. The third-year classes assume some experience with middle phase analysis. It is useful to have reached that phase with one or more of your analytic patients by that time. Seminars addressing advanced work and termination are in the fourth year, and will be most relevant if you have conducted treatments to the point where termination seems likely for at least one of your analysands. If you have not begun a psychoanalytic case by the end of your second year, the Progression Chair and your File Reviewer will invite you to assess your progression.
Progression Checkpoints
There are five situations for which you need contact with the Progression Committee. It is your responsibility to make all Progression requests, with the help of your File Reviewer. You will need to contact your File Reviewer to request Committee approval:
- Before beginning your first control case
- When you begin your second control case
- Before beginning your third control case
- For credit for each case
- For graduation
Each of these situations is addressed separately. Please work with your File Reviewer to prepare these requests.
Before beginning your first control case:
- You must have completed the first term of the program.
- You must have been in your personal analysis for at least six months. You must have completed the “Personal Analysis Report Form,” and it must be in your Dropbox file.
- You must have presented the potential case to two SPSI-designated Consulting Analysts. One of these should be the Consulting Analyst you will see for ongoing consultation on the case. If necessary, that Consultant can recommend a second Consulting Analyst to present the potential case to for approval. The latter step can take the form of a one-time meeting where you present the potential case and discuss beginning the analysis.
- Ask both of these Consulting Analysts to send an email to the Progression Chair, your File Reviewer, and you, confirming their support for you starting the case. It is your responsibility to ask the two Consulting Analysts to send these messages.
- Once you have obtained approval from the two Consulting Analysts, send an email to the Progression Chair and your File Reviewer, indicating that you have met all of the above requirements, and requesting permission to begin your case.
- The Progression Chair will inform you of the committee’s approval, or of any other required actions or clarifications, via email to you and your File Reviewer.
- The above process starts the documentation that is required for every control case. The documentation of control cases is described in further detail below.
- For your second case, you must again present the prospective case to two Consulting Analysts as described above, but it is not necessary to request clearance from the Progression Committee unless otherwise notified.
- If you plan to work with a non-SPSI Consulting Analyst (see p. 10), please consult with your File Reviewer and the chair of the Progression Committee before beginning the consultation.
Before beginning your third control case:
By the time you intend to begin your third case, there should be evidence of ongoing growth in your work, as documented in your write-ups and Consultant reports from the first two cases and your course evaluations. Your file must be current with all write-ups and reports before the committee will consider the request to start the third case.
- Present your potential third case to the Consulting Analyst you have chosen for the case, and ask this Consulting Analyst to send an email to you, your File Reviewer, and the Progression Chair, confirming their support for you starting the case. It is your responsibility to ask the Consulting Analyst to send this message.
- If you plan to work with a non-SPSI Consulting Analyst (see p. 10), please consult with your File Reviewer and the chair of the Progression Committee before beginning the consultation.
- Once the Consulting Analyst has sent their message, send an email to the Progression Chair and your File Reviewer, indicating the start date of the case and the Consulting Analyst, verifying that you have completed the above requirements, and requesting permission to start the case.
For detailed information on the kinds of psychoanalytic skills we look for in your write-ups, Consultant reports and course evaluations, including conceptualization, listening, intervening and self-awareness, at different levels of training, please refer to the Appendices.
To request credit for a case:
For a case to be credited, the following requirements must be met:
- A minimum of one year of analysis conducted at 4 or 5 sessions per week. One of your three cases may be seen at 3 times a week.
- A minimum of one year of weekly consultation.
- All write-ups must be completed. Required write-ups include an initial write-up, completed shortly after the start of the analysis, and write-ups completed every six months after that for the duration of the treatment. Three write-ups (initial, 6-month, and 12-month) are the minimum required for a case to be credited. The Consulting Analyst must submit their written recommendation of credit, as well as written evaluation of your work and your participation in the consultation.
- To request credit for a case, send an email to the Progression Chair and your File Reviewer, verifying that you have completed the above requirements, and requesting credit for the case. The completed form “Record of Educational Consultation,” a tally of all treatment and consultation hours for a case, must accompany all requests for credit. This form is available as a pdf on the SPSI website, and is reproduced at the end of this section for reference.
Regarding the crediting of cases:
- The Progression Committee awards credit for cases, but the crediting of a case is a joint process among the Committee, the Candidate, and the Consulting Analyst. We look to you to show the analytic process that has taken place in a case, and we look to your Consultant to describe your growth and participation in the consultation. We look for (and ask you to articulate) evidence of increasing competence in analysis (see Appendix D) when considering credit, not only whether the minimum quantitative requirements have been met.
- While an individual case may be credited after a year of treatment and consultation, the graduation requirements are intended to encourage you to sustain at least one of your cases in longer-term treatment. We encourage consultation on at least one case through termination when possible.
- Please note that graduation requires that two of your cases be in “advanced middle phase” at the time you request graduation. “Advanced middle phase” ordinarily translates into, on average, several years of treatment. The graduation requirement of a minimum of 200 hours of consultation is also met by immersion of at least one case in longer-term treatment (for instance: one case at 50 hours of consultation, another case at 65 hours, and another at 85 hours). Historically, SPSI Candidates have graduated with an average of 270 hours of consultation, acquired voluntarily beyond the minimum, as advanced cases evolve into deeper phases of analysis.
Graduation criteria:
- Completion of the didactic curriculum.
- All writing responsibilities completed, including any class assignments or make-up work.
- A minimum six-month overlap of all three components of training: your personal analysis, psychoanalysis under consultation, and didactic seminars.
- Three credited cases, with all write-ups completed. Your cases must include diversity with respect to gender identity.
- At least two cases must show advanced middle phase work in the view of you, your Consultants, and the Progression Committee.
- A minimum of 200 hours of consultation, across three cases, from at least three different Consultants.
- At least one presentation of an ongoing psychoanalytic case to a continuous case conference for the entirety of one term.
To request graduation, email your File Reviewer and the Progression Chair, indicating that you have met all of the above requirements and requesting a review for graduation.
Records and write-ups
You must maintain accurate records of the starting date of treatment, the frequency of sessions at different stages of treatment, the dates of and reasons for any interruption or termination, and reports of the consultation experience as to commencement, frequency, interruptions, change in Consultant, etc. In all write-ups, protect the patient’s confidentiality by removing identifying data. Each case should be assigned a number in sequence with identifying initials or a pseudonym to be used consistently in all reports. For formatting of your write-ups, please see the Appendices.
When you begin a control case, submit your initial write-up as soon as possible, but no later than two months after beginning the case. Write-ups are then due every six months until the case is credited. After a case has been credited, write-ups are still required, but may be completed at yearly intervals, until the case terminates or you graduate. Email each write-up to your Consultant, your File Reviewer, and the SPSI administrator, who will add it to your Dropbox file.
Learning to convey your work in writing is an important aspect of psychoanalytic training. Write-ups should be discussed with your Consultant as to the quality and clarity of the writing. The Consultant’s evaluation of the case write-up is an important part of their report to the Progression Committee. You are encouraged to seek assistance from your Consultant or other faculty members in regard to writing up cases.
Please make every effort to stay up to date on your write-ups. These reports are essential to your development, and to the Progression Committee in their evaluation of your work. They provide a window into the treatment and into your understanding of the case. They are the means by which you demonstrate your developing clinical skills and development as an analyst, and they can provide a basis for the write-ups required by some post-graduation certification programs. Failure to stay current with your write-ups will delay your progression through the program.
The Progression committee wants to facilitate your advancement through the program. If you have any questions, please contact your File Reviewer or the Progression Chair for clarification.
“Closed” cases
Occasionally, a Candidate may begin a control case with 1) a clinician or the family member of a clinician in our professional community, or 2) an individual or the family member of an individual who is a public figure or is well-known in the larger community. In these cases, protecting the confidentiality of your analysand or their family member may be difficult, especially if the factors that make the individual or their family member identifiable are salient to the treatment.
If you are treating such an individual, please discuss with your Consulting Analyst whether to make this a “closed” case. In closed cases, your initial report and six-month write-ups are submitted only to your Consulting Analyst and are not included in your Progression file. You should not present a closed case in a case conference, and you should carefully consider disguising any clinical vignettes you share in class.
Record of Educational Consultation
Mechanisms for feedback and support
The class advisor/mentor (CAM)
The CAM is a faculty member appointed by the Curriculum Committee to each cohort of Candidates to serve as a resource for them throughout the four-year didactic period. The CAM can help Candidates as a cohort navigate systems at SPSI, assist with cohort group dynamics, and be a bridge between Candidates and faculty.
The newly-assigned CAM meets with their cohort prior to the beginning of the first academic year in order to assist with their introduction and orientation to training. The CAM and cohort then meet at least twice during each academic year.
If at any time either the CAM or the cohort wishes to end the relationship, a request should be made to the Curriculum Committee to consider a replacement.
Evaluations of instructors by Candidates
At the end of each didactic seminar and continuous case conference, you are asked to evaluate, anonymously and in writing, each course and each instructor. The evaluations are returned to the Curriculum Committee and to the individual instructors. The evaluations help to improve the quality of the curriculum and classroom instruction. Completing these evaluations is a requirement for receiving continuing education credits for a course.
Evaluations of Candidates by instructors
At the end of every term, instructors provide written evaluations of each seminar group as a whole, and of you as an individual class participant. All individual evaluations become part of your training file and are reviewed periodically by the Progression Committee.
Candidates and Academic Associates Organization (CAAO)
The CAAO is made up of the current Candidates and Academic Associates. The CAAO represents the common interests, goals and concerns of its members to the administrative and educational leadership of SPSI, APsA, national Candidates’ organizations (the Candidate Council), and other relevant parties.
The CAAO provides a regular forum to consider and conduct Candidate business and to promote and support the educational experiences of members. It fosters communication, collegiality and social activities among its members. The leadership of the CAAO work closely with other SPSI leaders.
APsA
There are programs, publications, committees and activities designed specifically for Candidate members of the American Psychoanalytic Association. You are encouraged to join APsA as a Candidate member. Participation in APsA offers opportunities for you to become involved in decision-making processes with regard to matters directly affecting Candidates. All APsA member institutes have representatives on the APsA Board of Directors.
SPSI Collective Scholarship Committee
The SPSI Collective Scholarship Committee’s goal is to expand access to psychoanalysis in the broader community, particularly for individuals who have been harmed by trauma, marginalization, racism, bigotry, and poverty. Our Scholarship Program will primarily provide funds to Candidates who work with patients of color who otherwise could not afford psychoanalysis.
Ombuds, Ethics, and Colleague Assistance Committees
The Ombuds Committee is the first point of contact for confidential consultation and facilitation regarding all potential conflicts brought to or coming from within the institute. It works in a consultative, facilitative manner, and is able to address issues before they rise to the level of grievance, dispute, or complaint. The Ombuds may attempt to directly resolve problems, or may refer involved parties to other resources, or offer mediation, further investigation, or escalation. For a full description of the Ombuds function and process, please refer to the policies and procedures on the Ombuds committee page on the SPSI website.
The Ethics Committee is available to consult on ethical matters, and advises the faculty on the outcomes of ethical situations that have been adjudicated by the Washington Department of Health.
The Colleague Assistance Committee is also available for confidential consultation and facilitation. At times the CAC may seek assistance from or refer matters to the Ombuds Committee. This committee facilitates a monthly open discussion forum for all SPSI members, “Reflective Spaces,” a space for sharing and processing about the subjective experience of being part of the institute.
Distance and Hybrid Learning Policies
“Distance Learning” refers to the physical home location of a Candidate relative to SPSI’s physical location, and expectations around in-person attendance.
“Hybrid Learning” refers to an integrated classroom experience with a mix of in-person and off-site participants. SPSI’s Hybrid Learning Policies and Guidelines cover norms and expectations around the actual class environment.
Distance Learning Policy
- Designation as a Distance Learner is available to those applicants and Candidates who live more than 70 miles from Seattle Psychoanalytic Society & Institute.
- Distance Learners are expected to attend in-person for approximately 25% of the first trimester. Distance Learners are expected to attend in-person once per trimester for the remainder of their education.
- The proportion of Distance Learners in a cohort should be no more than one-third of the total cohort at the time of cohort class formation.
- Exceptions to the in-person attendance requirements can be sought on a case-by-case basis and will be decided in collaboration as needed with the Progression, Curriculum, and the Diversity committee.
- In rare cases, a Candidate may be admitted to the Adult Psychoanalytic Training Program whose location or life experience precludes meeting the in-person attendance expectations. Such instances will be addressed between the Candidate and the Curriculum, Progression and Diversity Committees.
Hybrid Learning Policy and Guidelines
Introduction
Hybrid learning refers to an integrated classroom experience with a mix of in-person and off-site participants. Successful hybrid learning requires a spirit of flexibility, creativity, and patience. In a sense, it calls upon us to attend to each other carefully as a group to ensure a vibrant, rich, and engaging learning environment for all—remote and in-person. The confidential nature of clinical material and the vulnerability of discussing unconscious processes make visual interaction amongst group members very important, whether in-person or off-site. Instructors will begin each course by discussing with the group how to invite and encourage participation by everyone.
Hybrid Learning Guidelines
For participants who attend in-person:
- Assist with balancing participation from those in-person and those on-screen. We recommend that someone from the in-person group (or the in-person group as a whole) assist in calling attention to those on-screen who are waiting to speak.
- Please bring a device capable of Zoom connection to class (like a laptop, tablet or iPad). This will allow for the possibility of more closeup viewing of faces by both off-site participants and in-person participants. In addition, this will allow off-site instructors to share their screens effectively with in-person participants. (Make sure to mute your microphone (in Zoom) and also turn the speaker volume on your device all the way down. Otherwise you will get audio echo and feedback.)
- When using a device in the classroom, please turn OFF all incoming texts, emails, or other non-class related windows on your browser to allow you to be fully present.
For participants who attend from off-site:
- Please arrange a quiet, private space that allows you to participate in class with high engagement and full confidentiality.
- Participate with your video ON at all times. If unusual circumstances prevent you from having your video on for a portion of a class, please contact your instructors to let them know. If there are extenuating circumstances that interfere with your video participation over the longer term, please contact the Curriculum Committee chair to discuss your situation.
- Turn OFF all incoming texts, emails, or other non-class related windows on your browser to allow you to be fully present.
- Use Zoom MUTE and inform the class via the message function if you need to take a brief break for any reason.
Tech and Attendance Instructions:
Links to join classes and meetings can be found on the calendar on the SPSI website. You must be logged in to be able to see these calendar events. Those attending remotely will click the “Join via Zoom” button to join the meeting. Full instructions on attending classes and meetings remotely can be found in the Member Area of the website.
Each classroom has printed instructions on how to turn on the equipment and use it during the class/ meeting. People attending in person should turn on the TV, the wireless speaker, and the mouse. Then they should click the meeting name to start it. When the meeting is over, click “End Meeting”. If you are the last class/meeting in the room, turn off the TV, the wireless speaker, and the mouse.
Those attending in person will sign in via a paper attendance sheet. Attendance of those attending remotely will be taken by the instructor (or someone else designated by the instructor, if the instructor is remote).
Absence policy
Psychoanalytic training is a rigorous endeavor that entails substantial commitment. The curriculum is carefully planned, and attendance at each scheduled class is expected. While some absences may be unavoidable, you are asked to weigh the following issues when deciding to miss class:
Due to the small size of the classes, and the intimate nature of many of the discussions, the presence of every Candidate is valued. Thus any absence has an impact on the continuity of the process. Instructors plan the curriculum of their classes carefully, and missing a class can limit your ability to fully integrate material in subsequent classes.
Case conferences are particularly problematic in this regard. They represent an opportunity for you to follow the unfolding process in a psychoanalytic treatment. As such, missing a session may compromise your grasp of the case material and your ability to contribute in ongoing sessions. Absences also disrupt the group dynamic that is an important element in case conferences.
You are expected to inform the instructors and your classmates in advance of absences.
SPSI and its accrediting organizations require a minimum of 450 hours of didactic coursework for graduation. SPSPI’s four-year didactic curriculum totals 558 hours. If you are absent for more than five weeks per academic year, you run the risk of not meeting the minimum didactic hours required for graduation. Therefore, in each academic year, you may be absent for no more than a total of five weeks without requesting accommodations.
If you miss more than two classes in a 9- or 13-week course or one class in a 4- or 5-week course, you are responsible for discussing your absences with the course instructor(s) and arranging means to demonstrate that you have covered the course material from the classes missed in excess of those allowed. If deemed necessary by the instructor(s), the matter may be brought to the Progression and Curriculum Committees. In some cases, you may be asked to complete additional work to receive credit for a course; in other cases, you may be asked to repeat a course.
Religious holidays scheduling policy
SPSI does not adjust the academic calendar for religious holidays. If Candidates observe any particular religious holiday by abstaining from class without making prior arrangements, that absence would fall under our regular Absence Policy. The policy was conceived with the following points as rationale:
Candidates must complete a certain number of hours of didactic training to meet the graduation criteria of the national and accrediting bodies. The current absence policy allows for a maximum of five absences per year (up to two classes in a 9- or 13-week course or one class in a 4- or 5-week course). With more absences than this, a Candidate is at risk of falling below the minimum graduation requirements.
This policy is independent of any particular faith tradition. SPSI’s goal is an increasingly diverse faculty and student body. With this diversity comes an increasing number of cultural and religious traditions which may have their own holidays and observances. It is prohibitive to accommodate all potential faiths’ days of religious observance, and privileging one or more faiths above others is would be insensitive and unfair. Observance of holidays is often practiced differently among individuals of a particular faith tradition — there may be no standardized or well-accepted method of observance on which to base a policy. In instituting this policy, we wish to acknowledge that groups and individuals have often been persecuted for observing their religious holidays. We hope that a standardized policy will treat all groups equitably. We also acknowledge that the Christmas holiday, with its Christian roots, is already privileged within American culture, and that this is not just or reflective of the diversity of the American people.
Accommodation for religious observance
SPSI will reasonably accommodate Candidates’ religious observances in accordance with Washington State laws. Candidates who expect to miss a class for reasons of faith or conscience or for organized activities conducted under the auspices of a religious denomination, church, or religious organization, and who wish to request accommodation for this, must make the request of the Curriculum Committee within the first two weeks of a course. The Curriculum Committee and the instructor may require the Candidate to complete make-up work or make other arrangements for the missed class.
Accommodation and leave of absence policy
SPSI has two categories of leave from training: accommodation, intended as a short-term absence while remaining matriculated, and leave of absence, a suspension of active training status. Each type of leave has a different process and different pathways for making up or resuming work.
Accommodation
In the event of serious life circumstances, a Candidate may request an accommodation. These circumstances include, but are not limited to:
- Birth or adoption of a child
- Serious health condition
- Spouse/partner, child, or parent who has a serious health condition
- Death in the family
- Other stresses that preclude a Candidate’s ability to participate
An accommodation is defined as a request to be excused from or alter participation in case conference and/or didactic classes for one term only. It must be reapplied for each term. An accommodation means that the Candidate is otherwise fully matriculating.
Accommodation requests should be made to the Chair of the Curriculum Committee as soon as the Candidate is aware of the need. The Chair will inform the Candidate of the decision, and will notify the Chair of the Progression Committee, the File Reviewer, the relevant instructor(s), and the Administrator that an accommodation has been granted or if another approach is recommended.
In general, an accommodation for missing a case conference may be made up by:
- Participating in the case conference remotely
- Making up the case conference at the end of training
- Obtaining an exemption
An accommodation for missing a didactic course may be made up by:
- Retaking the class when it is given again
- Making arrangements with the instructor and fulfilling the agreed upon plan.
Leave of absence
Leaves of absence are processed by the Progression Committee. A leave of absence is defined as taking at least one term fully off from all aspects of training. Longer leaves may be approved on a case by case basis. Control case immersion hours and consultation hours accrued during this period are not eligible for credit toward graduation, and the Progression committee cannot process requests for case credit or graduation while a Candidate is on leave. If you are on a leave of absence and wish to apply for credit for a case or graduation, you must resume active Candidate status.
Leaves of absence in excess of one term during the first year of training will likely require that the Candidate withdraw from the cohort and restart training with a subsequent cohort.
Requests for a leave of absence should be made to the SPSI Progression Chair. Candidates are asked to contact the Chair as soon as they know that they will need to take time off. The Chair of the Progression Committee will inform the Chair of the Curriculum Committee, the Candidate, and the Administrator when a Leave of Absence has been approved.
Adult Psychoanalytic Training Program
Tuition — 2023-24
Didactic program (the four-year curriculum)
Trimester: $1,089 Annually: $3,267.
Post-Didactic (active status; case conferences)
Trimester: $363. Annually: $1,089.
Didactic program, Adult and Child Training Psychoanalytic Training Program
Trimester: $1,320. Annually: $3,960.
Post-Didactic, Adult and Child Training Psychoanalytic Training Program
Trimester: $440. Annually: $1,320.
The tuition structure will change beginning in fall 2024 with the change in curriculum from three trimesters to three 9-week terms and one 4-week term.
Candidates on Leave of Absence or Accommodation pay one-third the standard tuition of the program they are in. Candidates on Leave of Absence for the entire year pay $200.
Faculty members who are also post-didactic Candidates do not owe tuition.
All tuition and fees can be paid in monthly installments by arrangement with the Administrator.
Academic Training Program
A limited number of professionals from non-mental health fields may participate in SPSI’s Adult Psychoanalytic Training Program as Academic Associates. Training alongside Candidates, Academic Associates study psychoanalysis to enhance their teaching, research, or other activities in their profession.
Academic Associates participate in all activities of the Institute that are open to Candidates, except for clinical consultation and the practice of psychoanalysis. Academic Associates are expected to engage in a personal analysis during the program. Academic Associates attend and participate in seminars and case conferences, attend scientific meetings, join committees, and undertake independent study projects in consultation with SPSI faculty.
Academic Associates are admitted to the Adult Psychoanalytic Training Program as part of an entering class (by the Admissions Committee) and progress through the program as members of their cohort. The Progression Committee assists Academic Associates to develop mentor relationships and will form a small committee to design and evaluate the required thesis or project. To graduate from the Academic Training Program, Academic Associates must complete the full four year didactic curriculum and submit a thesis (or its equivalent as established by the Progression Committee and the Academic Associate’s coordinating committee), to be submitted in written form and presented to SPSI members.
The Academic Training Program is not intended as an alternate pathway to become a psychoanalyst. Academic Associates who wish to transition to Candidate status should approach the chairs of the Progression and Curriculum Committees for more information.
Appendix A:
Guidelines and formats for Write-ups
Presenting your work with colleagues, peers, and Consultants is a necessity throughout your career. During analytic training, we verbally share our work in classrooms and in the case conferences. Writing up your work with your control cases serves to refine and master your ability to communicate as well — to show your work, to show your learning, and to help you understand your own process as a growing analyst.
At SPSI, you share your write-ups with your Consultants and with your Progression File Reviewer, who is your representative and advocate on the Progression Committee. We strongly encourage you to share your written work in progress with your Consultants and with your File Reviewer.
How to submit your write-ups
Please submit your write-ups as emailed Word, Pages, or pdf documents to your File Reviewer, your Consultant, and the SPSI Administrator, who will make sure they are filed in your Progression record.
For every write-up, please make sure the following information is clearly indicated on the first page:
- Your name
- Date of the write-up
- Control case number and identifying initials or pseudonym
- Date the treatment began, and, if different, date of the start of the control case Write-up number or period covered by the write-up. Example: “6-month write-up no. 4” or “Months 25-30”
- Name of your Consultant
- Hours of consultation to date
The initial write-up
Writing an initial report of your thoughts regarding a new analysand can be quite valuable as you embark on a new treatment, even for the most experienced analyst. To begin the process of writing, we ask you to pause shortly after the analysis begins and organize your thoughts about the patient and the treatment you have begun. Writing the initial report should help you answer a few key questions with confidence:
- What is the nature of the patient’s problems that will be a focus of treatment?
- How do you imagine these problems may have developed?
- How might psychoanalysis be able to help the patient?
The length of the report should be about 3 pages. It should be organized as follows:
- Identifying information (approx. one paragraph), including how your patient came to you, and, if relevant, details about the setting and any collateral contact.
- Chief complaint (approx. one paragraph)
- A short developmental/social history of the patient (1-2 paragraphs).
- Your initial diagnostic assessment of the patient (what’s the nature of the patient’s problems) including DSM-V diagnoses.
- Your initial working psychodynamic formulation (How did the patient come by these problems? What maintains them? What are the obstacles to addressing them?)
- Your understanding of the indications for psychoanalysis (why psychoanalysis and how might it help?).
- Your speculation about what the treatment might hold in store for the two of you.
- Your sense of what it’s like to work with this patient; your initial countertransference.
- How you and your patient discussed the beginning of analysis.
Six month write-ups
The six-month reports build upon your initial report, and each successive 6-month report builds on those that come before. Taken as a whole, your write-ups tell the story of the analysis.
Six-month write-ups are required until you receive credit for a case. Write-ups are required as long as your patient is in analysis with you, even after you’ve received credit or ended consultation, until graduation. After receiving credit, you may submit write-ups yearly rather than every six months.
The 6-month write-ups are an opportunity to fill in key pieces of history that you have learned, refine your assessment and formulation, and most importantly, describe the course of the analytic treatment. The 6-month write-ups should be about 3 pages in length. They should be organized as follows:
- Chief complaint, if it has changed since initial report, and/or other significant history that has become apparent since the initial report. (approx. one paragraph)
- The treatment: This section should be the bulk of the write-up and should tell the story of the treatment to date. Focus on synthesizing the significant aspects of the work that has transpired, rather than trying to provide every detail of the treatment.
A successful write-up generally includes the following:
- A trajectory. We want to hear how things have changed between and within your patient and you over the course of the treatment. How does the transference change? Has the transference changed? How does the countertransference change? What about the way in which you two relate to each another?
- Verbatim examples of dialogue. This might include dreams, fantasies, interpretations, reactions, etc. — the moment-to moment exchanges that we sometimes call micro-process. Please describe not only what you heard and said, but what you understood about it or not, and how you made your choices about your interventions.
- Experience-near descriptions that take your reader into the room with you and your patient. Countertransference descriptions tend to be especially effective.
- Your reflections about the process material that you present and how it illustrates the themes in the analysis.
- Your understanding of the analytic process. What stage of analysis is being presented?
Appendix B:
Phases of analysis
At SPSI, successful training depends on learning not only how to conduct analysis, but also, importantly, how to describe psychoanalytic process. Graduation requires that you have conducted and written in depth about at least two analyses that have reached at least an “advanced middle” phase of treatment in the view of you and your Consultants. This term will mean something unique in every treatment, and should be an area of ongoing discussion in your consultations. While much about analysis is subjective, your write-ups should clearly describe the process and evolution of your work with your analysands and your own understanding of it.
The material below is adapted from the Candidate manual of the Psychoanalytic Association of New York, an APsA institute. We offer it as one example of how to think about the process and the development of your cases. We wish to stress that your learning, your own evolving analytic attitude, your own ideas about analytic theory and process, the role of your Consultants, and your connections with your patients should always be the primary sources for your work.
The following schematic description delineates many key aspects of a developing analytic process. It is characterized most importantly by processes that focus on the analysis of transference manifestations in relation to the person of the analyst. However, this does not imply that all analyses follow a linear course; few analyses are “typical” and many variations occur in successful analyses. For example:
- There may be sudden shifts in the balance between expressions of transference and resistance, temporary advances and/or regressions, unexpected enactments, crucial insights that are seemingly lost, and external events that impact the analysis (e.g., insurance issues, job changes, educational requirements, marriages, births, deaths, the patient’s and/or the analyst’s health, and the like). These and many other occurrences require the analyst to be flexible, patient and open to the unexpected with patients and with his or her responses to these situations.
- Transference elements may often be effectively analyzed in relationship to significant others in the patient’s life; work with some patients may involve exploration of challenges to the frame repeatedly throughout the analysis or at later phases rather than being restricted to the opening phase.
- The analyst’s increasing confidence and clarity of understanding in midphase may alternate with periods of uncertainty or even perplexity. Furthermore, the technical emphasis of the opening phase may differ for some patients with more severe pathology.
We offer the following description of the phases of analysis to Candidates as an educational tool that can be useful in discussion with Consultants, peers, continuous case instructors, as well as for personal reflection, while simultaneously recognizing that there can be multiple perspectives about what constitutes an analytic process.
Opening Phase
The analyst and analysand begin to experience being with each other in this new and unusual relationship in which the patient is invited to share whatever comes to mind while (typically) lying on the couch without face to face contact with the analyst. The patient begins to learn that it is useful to share with the analyst not only symptoms, but a variety of data, such as childhood experiences, what is going on in the here-‐and-‐now, dreams, slips of the tongue, visual images, bodily sensations, and thoughts and feelings about the analyst. As the patient starts to appreciate that meanings attached to these experiences may be inter-‐connected, they also begin to understand how to work with this material. A major aspect of analytic work in this beginning period involves helping the patient to become aware of his or her resistances, and to begin to realize the power of these manifestations of defense in order to become attentive to and understand the ways they may appear, as well as the conscious and unconscious affects they are intended to avert. In other words, the patient begins to become aware of the existence of internal conflict. These resistances are often expressed in challenges to the frame in contexts such as establishing analytic frequency, the fee, free associating, using the couch, and the handling of missed sessions and personal questions about the analyst. In addition, both analyst and patient begin to recognize some elements of their transference and countertransference reactions, and the patient becomes increasingly aware that there is a dynamic unconscious. The time period necessary for this beginning work varies widely for different patients; in rare instances it may take months, but more often one to two or three years, and even longer with some patients.
Early Mid-Phase
The analysis and analyst become more and more central emotionally to the patient, and the analysis as a structure and process can become increasingly stable. An initial focus on reporting of symptoms begins to give way to a greater emphasis on the meanings of symptoms and on character. Transference-‐ countertransference manifestations are gradually clearer as more and more derivatives offer evidence that support the analyst’s interpretations, especially as resistances are worked with analytically. They may be experienced in fantasies and enactments expressed verbally or in action. These provide useful material for both patient and analyst to explore, and result in both the patient’s fuller awareness of transference and the analyst’s greater awareness of both transference and countertransference. The analyst often experiences more confidence in understanding the analysand’s psychology and in his or her interventions. This, too, is subject to vicissitudes and challenges to certainty – as evidence may emerge that requires revision of previous interpretations. Some modifications are often observable in the patient’s defensive style and ability to reflect on internal states and motivations – including the patient’s reflecting upon the internal state of the analyst ‐ as well as resistances to doing so. As this phase develops, with its deepening of the transference (and the patient’s fuller appreciation of it), the analyst’s interventions may place a greater emphasis on the here‐and‐now of the patient’s mind within the session and less on the external life of the patient.
Advanced (or Deep) Mid-Phase
Typically, the analysis and analyst have become of central importance to the patient. The patient-analyst pair engages in increasingly productive analysis of transference‐countertransference patterns that have become more clear, interpretable, and workable, as well as reconstruction of the influence of childhood experiences, including traumatic events that have shaped childhood and current experience. Interpretations of specific content in these areas may become more prominent relative to work on defense and resistance. The patient’s productions are usually more coherent, so that links between transference and extra‐transference, and past and present become more evident and accessible to the patient and analyst. This may contribute to the analyst’s increasing pleasure and/or freedom to interpret. Core conflicts are worked on over and over again in an affectively vivid way in the here‐and‐ now and there‐and‐then, as various facets of these conflicts become manifest in the patient’s life as well as in the analytic situation; the patient can also better appreciate connections between the two. Some significant changes in the nature of the relationship with the analyst, and/or in the patient’s life outside the analysis, usually take place. The patient also evidences greater ability to engage in self-analysis; the patient notices new resistances as well as the old defensive patterns and some increased flexibility to use a greater variety of defenses, and a more developed and differentiated affective life.
Termination
The patient has achieved a significant capacity for self‐analysis and an appreciation of the conflicts that underlie manifest complaints, although the latter may not always remain conscious. By this time the patient has a fuller, more complex, and nuanced view of the personal narrative presented at the beginning of the analysis, and there is significant improvement in the problems that brought him or her into treatment. Core conflicts and complaints are inevitably revived, although usually ‐ but not invariably ‐ with less intensity, as termination is anticipated. This period offers an opportunity to further elaborate these core conflicts in the context of the impending loss of the analyst as a representative of old object relationships, as well as a real person and a daily presence. This work is done with a greater sense of independence from the analyst, including a greater capacity for self‐analysis. Emotional appreciation of the reality and meanings of loss is inevitable (and necessary for an internalization of the analytic relationship and process to become structured). Themes of loss and mourning are common, as the patient relinquishes idealized fantasies that pertain to the analyst and to him or herself, even after the completion of a successful analysis. The analyst also deals with the loss of the patient and countertransference responses that often mirror the patient’s experiences of object loss. Both parties develop an awareness of the limitations of the treatment and an appreciation of what it has accomplished.
Source: Psychoanalytic Association of New York, Psychoanalytic training program Candidate manual 2021-2022.
Appendix C:
Psychoanalytic Competencies
Within the world of psychoanalysis, there are many models and approaches to the development of psychoanalytic knowledge, skills and attitude. The concept of competencies can be especially useful during training and beyond, as you actively learn and grow towards independent practice. You should expect to acquire core psychoanalytic competencies in training by undergoing your own personal analysis; by participating in didactic learning of psychoanalytic theory, concepts, and skills; and by conducting analysis under consultation, which includes conveying your work verbally and in writing.
The following descriptions of psychoanalytic competencies may help you assess your own capacities. We note that within each of the domains described here, competencies and skills will look different at each stage of your training. This list should be read as a guide and a set of prompts for reflection — not a litmus test. With that said, we hope that throughout your training, you will be able to track your development in all the areas described here.
The list of core psychoanalytic competencies below has been adapted from materials shared by several APsA institutes, including but not limited to the Minnesota Psychoanalytic Institute, the Columbia University Center for Psychoanalytic Training, the Institute of Contemporary Psychoanalysis, and the Michigan Psychoanalytic Institute.
Sociocultural and multicultural areas of competence are rapidly evolving areas within psychoanalysis. Psychoanalysis increasingly integrates engagement with the sociocultural context and how it shapes interpersonal processes as well as intrapsychic life and the therapeutic relationship.
These ideas are offered here as a tool for your ongoing self-assessment. We hope that they will also help you find your own voice and grow the best language for communicating your ideas.
Assessment, diagnosis, and starting an analysis
- Evaluate patients for analysis with attention to diagnoses, character structure, and suitability for psychoanalytic treatment.
- Make appropriate clinical diagnoses and treatment recommendations, considering the patient’s history, symptoms, level of functioning, and psychological capacities- both strengths and vulnerabilities.
- Identify unconscious organizing principles, ways of being, beliefs, and patterns of experience and expectation. Understand the effects and interplay of various factors, such as internal object relations, attachment dynamics, deficits, traumas, phenomena of self-experience, central conflicts, and defenses.
- Consider the person in context – including developmental, biological, and sociocultural influences.
The treatment: technique
- Working alliance and frame – establish and maintain a working relationship with the patient, addressing issues related to handling of fees, frequency of sessions, and communications outside of session.
- Interventions – choose appropriate interventions to facilitate the deepening of a psychoanalytic process, such as: empathic inquiry, interpretation, free association, exploration of fantasies and dreams, clarification, confrontation, following affect, noticing what’s avoided, containment, and holding.
- Working through– conduct ongoing work with the patient’s unconscious dynamics as they are revealed over time in the transferential and extra-transferential material.
The treatment: theory and process
- Transference– use the therapeutic relationship as a central vehicle for understanding and change and show ability to work with positive and negative transferences. Understand the differences and inter-relationship between the repetition of old patterns in the transference, the need/hope for new relational experience, and the way experience is co-created in the present by two interacting subjectivities – the patient’s and the analyst’s.
- Countertransference – use countertransference to facilitate understanding of patients ’unconscious processes, demonstrate a capacity to contain reactivity in response to countertransference pressures, and explore how countertransference reactions stem from one’s own dynamics and are co-created out of intersubjective experience.
- Resistance– address fears and defenses (self-protective measures) that interfere with understanding, change, or the analytic process.
- Enactments – explore and work through impasses and consider unconscious factors emerging from both the patient and the analyst.
- Termination – be able to recognize characteristics that may indicate readiness for termination and describe the termination process.
Analytic listening
- Listen on multiple levels for multiple meanings.
- Develop and demonstrate an analytic attitude – such as, listening empathically and being reflective, nonjudgmental, curious, open-minded, tolerant of ambiguity/ uncertainty/complexity, sufficiently flexible, interested in discovering and/or co-constructing the “truth” about the patient’s emotional experience, and being respectful of the patient’s individuality.
Evaluating the process and outcomes
- Demonstrate the capacity for ongoing self-reflection: understand the analyst’s contribution to the process, be aware of feelings/fantasies/reactions to the patient, avoid imposing personal agendas on the patient or the treatment, and be able to admit possible mistakes or misjudgments.
- Use feedback from the patient: assess the effects of interventions, noticing what deepens or disrupts the process, adjust the wording and timing of interpretations to accord with the patient’s readiness.
- Outcome: describe your understanding of what helped the patient (therapeutic action) and what changed in the patient (e.g., development of new capacities and insights, improved relations, more integrated sense of self, etc.). Assess what was accomplished and what was left undone.
Use of consultation and group experience
- In consultation, case conferences, and group settings, remain open to feedback from Consultants, as well as from peers and other mentors. Be able to consider alternative interventions and theories.
- Develop ideas independently, using consultation more for discussion than for direction.
Writing
- Write clinical reports that demonstrate a psychoanalytic understanding of the patient, his or her major dynamics, and the analytic process – including important transference themes, countertransference experience, and an assessment of what changes.
- Demonstrate coherence, without rigidity, between your theory (or theories) and one’s understanding and approach.
Ethics
- Conduct oneself professionally, with uncompromising commitment to the patient’s well-being.
- Act with integrity, upholding boundaries, and ethical standards. Seek consultation when needed.
- Protect the patient’s confidentiality and anonymity in all communications.
Appendix D:
Basic Candidate Task Checklist
Before beginning didactics:
-
- Begin your personal psychoanalysis. (required by the end of the first term of didactics)
- Identify a psychotherapy supervisor. (recommended)
Every year:
-
- Submit the Personal Analysis Form to the Administrator when prompted every fall.
- Work with your File Reviewer for your annual Progression file review.
Before you begin your first control case:
You must have completed your first term of didactics.
You must have been in your personal analysis for at least six months.
- Present the potential case to two SPSI-designated Consulting Analysts for approval. (One of these will be the Consulting Analyst you will see for ongoing consultation for the case.)
- Ask them each to e-mail the Progression Chair, your File Reviewer, and you, confirming their approval of the case for analysis.
- Send an e-mail to the Progression Chair and your File Reviewer indicating that you have met the above requirements and requesting permission to start your first case.
The Progression Chair will inform you of the committee’s approval, or of any other required actions or clarifications, via email to you and your File Reviewer.
For every control case:
- Submit the first write-up within two months of beginning consultation.
- Submit successive write-ups at six months intervals until the case is credited. After that, submit write-ups yearly until graduation or termination, even after concluding consultation.
- Email all write-ups to the administrator and your file reviewer.
- Maintain your own ongoing record which includes:
-
-
-
- the starting date of treatment
- the two approving analysts for the treatment, for the first two cases
- “closed case” status if applicable
- ·the frequency of sessions at different stages of treatment, or the dates of and general reasons for any interruption or termination
- any changes in Consultant or consultation frequency
- when the case is presented in a continuous case consultation
-
-
Write-ups must be formatted according to the guidelines in Appendix A.
Before you begin your second control case:
- Present the potential case to two SPSI-designated Consulting Analysts for approval. (One of these will be the Consulting Analyst you will see for ongoing consultation for the case.)
Once you have obtained the two analysts’ approval, you do not need to wait for approval from the Progression Committee to begin the analysis.
Before beginning your third control case:
You must be current with all write-ups on your first two cases.
- Present your potential third case to the Consulting Analyst you have chosen for the case, and ask this Consulting Analyst to send an email to you, your File Reviewer, and the Progression Chair, confirming their support for you starting the case.
- If you plan to work with a non-SPSI Consulting Analyst (see Student Handbook, p. 10), please consult with your File Reviewer and the chair of the Progression Committee before beginning the consultation.
- Send an e-mail to the Progression Chair and your File Reviewer indicating that you have met the above requirements and requesting permission to start your first case.
The Progression Chair will inform you of the committee’s approval, or of any other required actions or clarifications, via email to you and your File Reviewer.
To request credit for a case:
Please refer to the section “Regarding the crediting of cases” in this handbook. The crediting of a case is not accomplished with only the steps below. It is the shared responsibility of the Candidate, the Consultant, and the Progression Committee.
-
- The case must have been conducted at a minimum of 4 or 5 sessions per week. One case may be conducted at 3 sessions per week.
- The case must have had a minimum of one year of weekly consultation.
- All write-ups must be completed, including an initial writeup submitted within two months of the start of the case, and then write-ups every six months.
- Send an e-mail to the Progression Chair and your File Reviewer verifying that you have completed the above requirements and requesting credit for the case.
- The completed form “Record of Educational Consultation” (from the SPSI website) must accompany all requests for credit.
To apply for Graduation:
- You must complete the didactic curriculum, including all class assignments or make-up work.
- There must be a minimum six-month overlap between your personal training psychoanalysis, your consultation on cases, and the didactic seminars.
- You must have three credited cases. (two in advanced middle phase)
- Your cases must show diversity with respect to gender identity.
- All case writeups must be completed.
- You must have a minimum of 200 hours of consultation, across at least three cases, from at least three different Consultants.
- You must have presented an ongoing psychoanalytic case to a continuous case conference for the entirety of one term.
- Send an e-mail to the Progression Chair and your File Reviewer indicating that you have met all of the above requirements and requesting a review for graduation.
For more information on any of these milestones or requirements, see previous sections of the Candidate Handbook.