ACADEMY FOR THE STUDY OF THE PSYCHOANALYTIC
ARTS:
A
RESPONSE TO THE NARROWING SCOPE OF PSYCHOANALYSIS AND
PSYCHOANALYTIC PSYCHOTHERAPY
Patrick B. Kavanaugh, Ph.D.
Premised in a paradigm of
biology, medicine and the natural sciences, psychology and psychoanalysis have
developed in the United States as empirically based health care professions concerned
with repairing and normalizing pathological structures, states of mind,
behaviors, and ways of thinking. Infused with a medical ideology,
psychoanalytic psychology has become a medical psychology. And the scope
of psychoanalysis increasingly narrows as the analytic practitioner and
educator are subsumed by the ever-changing and restrictive rules and
regulations of the healthcare professions. Some years ago, a group of
practitioners and educators formed the Academy for the Study of the Psychoanalytic
Arts, organized around the scholarly objectives of participating in the project
of rethinking psychoanalytic epistemology, theory, practice, education, and
ethics situated in philosophy, the humanities and the arts. And, actively
advancing this rethinking in the marketplace of ideas.
Since
its beginnings in the early '80s, the Michigan Society for Psychoanalytic
Psychology (MSPP) has provided a philosophical and professional home for those
in Michigan interested in psychoanalytic psychology. In the mid '90s, the MSPP
provided the space to develop a different conceptual and philosophical home for
psychoanalysis and psychoanalytic psychotherapy through the formation of a new
section, the Academy for the Study of the Psychoanalytic Arts.
By act of Congress in ’89, the ‘90’s had been declared
to be “The Decade of the Brain” and, literally, billions of dollars were
channeled into research and development focusing on the bio-medical basis of
human behaviors, and emphasizing the neurosciences and bio-chemistry. The
Academy’s formation was prompted by the ensuing institutional discourses -cultural,
political, legal, social, and economic- that were coming together during the
mid-‘90’s to transform the healthcare sector into an increasingly centralized
system having the authority and decision-making powers to implement and require
adherence to a uniformity of healthcare policies and procedures, thereby impacting
and redefining our educational philosophies and programs, therapeutic
philosophies and settings, and healthcare objectives and delivery systems.
While the conceptual understandings of human behavior were being reductively and scientifically
redefined, our graduate
school programs in psychology were
being revised and reshaped in accordance with this bio-medical scientific
vision by accrediting institutions. Future generations of practitioners were to
learn the new core bodies of knowledge(s) and practice from within the managed
care model" of service delivery. A bio-chemical imbalance model was favored
and advanced by the major pharmaceuticals, medical insurance programs, and various
governmental entities in the newly designed healthcare delivery systems: The
bio-chemical model was more time- and cost-effective. The ‘90’s witnessed the medical-scientific
narrative gaining dominance in
healthcare.
The industrialization of the healthcare professions,
including the mental health professions, came to define for the educator and
practitioner how to conceptualize and practice within the emerging healthcare
matrix. And an emphasis on outcome-based education led to an emphasis on outcome-based
therapy The "appropriate"
and "necessary" types of treatment for individuals were prescribed through the
establishment of treatment guidelines for specific diagnostic conditions; the
empirically established “best practices” were encoded in manuals prescribing
the appropriate treatment. And conformity and compliance with the approved
“best practices” was advanced as the standard of excellence in the learning and
practice communities.
And, the Decade of the Brain witnessed the beginnings of
the various re-definitions of the mental healthcare professional’s
‘professional standards:’ ethical standards and principles, standards of
education and training, standards of practice, and standards of care. The duties, functions, and responsibilities of the mental
health professional as educator and practitioner continue to be re-defined and
revised by various governmental entities, institutional entities, and
accrediting bodies.
Formation of the
Academy
Responding to the emerging trends of the healthcare
reformation, a small group of concerned educators and practitioners met in ‘95 to
form a new section within the MSPP, the Academy for the Study of the
Psychoanalytic Arts. The formation of the Academy was based on the
growing concern that these powerful cultural discourses were restrictively
defining psychoanalysis and psychoanalytic psychotherapy as exclusively a function or specialty of the healthcare
professions, and as being "appropriate" for only certain diagnostic
conditions or for.
In ’27, Freud made the observation that
"Psychoanalysis falls under the head of psychology; not of medical
psychology in the old sense, nor of
psychology of morbid processes, but simply of psychology." And yet,
medicine appropriated psychology –and psychoanalysis- in this country. Or,
perhaps more accurately, psychology and psychoanalysis fought to be
appropriated. Either way, psychology and psychoanalysis have become institutionalized and deeply entrenched
as a medical profession and practice. Specifically, understandings of the human
condition and mental phenomena traditionally have been conceptualized and
taught from within the contextual metaphor of mental health and illness, diagnosis
and treatment, and various theories of cure and curative factors. And,
understandings of people and their ways of being are understood and interpreted
within medicine’s organizing conceptual framework of symptomatology, etiology
and psychopathology. And the beat goes on… With congressional passage of such healthcare legislation as HIPPA (1996) and, more recently, the Affordable Healthcare Act
(2009), it becomes increasingly difficult for psychoanalytic practitioners to
conceptualize and practice outside of the healthcare matrix and its evolving standards
of practice. And given the advent of electronic medical records and “the need
to know” by so many institutional and governmental entities, confidentiality
becomes more and more difficult to maintain in a therapeutic discourse.
The Academy’s project centers on the rethinking of the
psychology of psychoanalysis as fundamentally other than a medical psychology, and the practice of
psychoanalysis and psychoanalytic psychotherapy as being fundamentally other
than a specialty
of the mental healthcare professions. The project involves rethinking psychoanalysis
and psychoanalytic psychotherapy from within a psychological –as opposed to a
medical-scientific- framework and to articulate a humanistic way of
understanding and working with people, the understandings of which are premised
in philosophy, the humanities, and the arts: for example, the philosophy of
language, semiotics, linguistics, narrative story, and the performance arts.
The Academy's project includes the presentation of an
ongoing series of forums and symposia, and a cyber presence, to which those
from other disciplines such as philosophy, the theatre, and the anthropic
sciences, for example, are most welcome to come and participate in the ongoing debate,
deliberation and discourse (www.academyanalyticarts.org/).
The Academy’s project also includes presenting through
its website to the community-at-large that there is a confidential psychoanalytic
discourse and space available in the community that does not require that the
participants make quasi-public declarations of sickness, illness, disease,
disorder, or disturbance in order to participate in its discourse of
self-discovery and self-determination and, in so doing, addressing one's
quality of life, and in which discourse the length, duration, and objectives of
the endeavor are based upon mutual agreement between the participants.
Lastly, the Academy’s project includes the opportunity
for interested individuals to participate in student-centered programs of study
that are self-designed and self-implemented –as opposed to the more traditional
Institute-centered programs in the medical–scientific tradition- for the
practice of psychoanalysis and psychoanalytic psychotherapy.
An
earlier version of this article was originally published in the February 1995
newsletter of the Michigan Society for Psychoanalytic Psychology (MSPP).
