The First Step Toward the Exit of Psychoanalysis From Sweden

 Max Scharnberg

Until recently eighteen institutions or training programs in Sweden had got the right to bestow the protected title “licensed psychotherapist” on those students who had completed training. But about ten years ago a committee was appointed to evaluate the quality of the institutions or programs, with the aim of recommending whether this right should be retained or withdrawn for some of them. The institutions and programs were observed during six years. All institutions or programs whose quality was deemed to be too low got one year for improving themselves. Among those who did not use this respite for improvement was Svenska psykoanalytiska föreningen (SPF), which is the Swedish section of International Psychoanalytic Association (IPA). Since IPA is world-wide and has a strong international organisation, it is reasonable to focus primarily on the fate of its Swedish section.


The committee refers to itself as “the assessment group”, and the report it produced bears the name Högskoleverkets rapport 2007:30 R. The criticism of the SPF/IPA training is primarily found on pp. 142f. of the report. The English name of “Högskoleverket” is “Swedish National Agency for Higher Education”.


“Psychoanalyst” and “certificated psychoanalyst” are not protected titles in Sweden. Hence, the Swedish section of IPA is free to adopt its own rules as to what conditions must be satisfied for becoming a member of this organisation. But it is a very different thing to give a person the protected title “licensed psychotherapist”.


When the assessment group started its work, the SPF training course comprised six years. During the first three years the students would exclusively study psychoanalysis. But students could also start with the fourth year, and if they satisfied the criteria after the sixth year they would become “licensed psychotherapists”.


Here the assessment group observed the first anomaly. “A large proportion of those applicant who are admitted were already before the admission licensed psychotherapists. (Out of those 20 students who were admitted in 2003 and 2005 eight were already licensed psychotherapists.)” If the aim of the training is to make the students “licensed psychotherapists”, it is astonishing that applicants are admitted to this course, although they have already obtained this license. Or, in the words of the assessment group: “Since the aim of the training course is to make the students pass the psychotherapist examination, the assessment group perceives it as a highly strange feature to admit persons who do not have the aim to pass this examination.”


(My own reflection is, what motives could those licensed psychotherapists have, who are applying for the last three years of the SPF/IPA training? It is difficult to imagine any other motive than their wish to become certified members of SPF/IPA.)


The ordinary pattern within the academic world is that students who prior to their admission had undergone some other equivalent training do not need to repeat the same subject. For instance, a person may have studied musical harmony for two years at The Royal College of Music, and he may afterwards take a university course in which the same quantity of musical harmony is one of the subjects. Then he will usually be exempt from studying the same thing all over again. By contrast, SPF/IPA practices the rule that literally nothing that the student has learned in any context outside IPA will give him or her any reduction in what he/she must study. This is the second anomaly.


The assessment group goes on explain a third anomaly: “The psychotherapist examination is supposed to make the student competent to perform psychotherapy within the medical service. [But] this training course differs as to both form and content from [all] other psychotherapeutic training courses, because it includes very much more than the prevalent norms both as regards the amount of hours, supervision, and literature. A psychotherapist training cannot be accepted, in which the students solely perform protracted psychoanalyses, without the request that any of the cases must be finished before the training is finished. In addition, training in short-term therapy is missing, although this is what the public medical service asks for. [Missing is also] broader psychiatric diagnostics as for instance the DSM- or ICD systems.


Since the size of this association is small the teachers have several roles at the same time, e.g. teacher and supervisor, and sometimes also the student’s teacher and his/her psychoanalyst. This is improper, and it must be redeemed by the engagement of more persons in the training.


The training course of SPF/IPA is wanting in those features that are essential in higher education, e.g. an open attitude to the more recent trends within psychotherapeutic research outside one’s own tradition. Here there is no connection with any kind of research. And however much a student may have learned at courses given by other institutions or programs than those run by IPA, such knowledge is considered null and void, and will give the student no reduction of the IPA courses he must undergo. The principle that all training at the university level must be performed in a critical and creative setting is not satisfied.


Moreover, the part concerned with the general theory of science covers a very narrow area, and solely qualitative methods are applied.


The assessment group goes on to say that “Since the size of this association is small the teachers have several roles at the same time, e.g. teacher and supervisor, and sometimes also the student’s teacher and his/her psychoanalyst. This is improper …”


“A strange circumstance is the absence of teachers who have a permanent attachment by written contracts or some comparable forms. The teachers are appointed for each single training task. … The students will pay the teachers individually for each session of seminars and supervision; a pattern that does not produce stability for the training course and for the student. What happens, for instance, if the student is not passed on one part of the course and must repeat the latter? It is the right of the student to know what the training course will cost, when he or she begins the training course.”


It should not come as a surprise that SPF/IPA took no measures toward improvement. As a consequence, it lost the right give the title “licensed psychotherapist”. In Sweden you can no longer undergo the training offered by SPF/IPA and on this basis obtain a license as a psychotherapist.


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