Notícias da IPA - Transcript Closing Plenary

Presidents and Directors of Training Meeting

24th July 2007

Edited transcript of Closing Plenary

Claudio Laks Eizirk, President
I would like to welcome Prof. Daniel Widlöcher, Past President of the IPA and Prof. Charles Hanly, President-Elect. I hope this meeting will provide the opportunity for free and open discussion and the chance to explore the differences between IPA institutes. This approach reflects the spirit of the IPA by inviting openness, transparency and frankness. The IPA is a joint enterprise in which all different views are welcome. It is therefore important to listen to the reports of each discussion group.

Sven Lagerloff, Stockholm, Sweden. Reporting for Group 1
There were many different views regarding the first question, reflecting the fact that there are many different situations all over the world. On the whole, there was a sense of satisfaction that we have been given the opportunity to voice our views. Regardless of whether we like it or not, something has happened and we have the opportunity to discuss it. The recognition of the three models is done, and it had a liberating influence on the discussion. The English President explained to us the intricacies of the French model, and hopefully next time the French President can explain to us the intricacies of the Eitingon model. However the main concern voiced was that not every situation fits precisely into one of the three models. How precisely does each programme have to fit one of the 3 models? I think it was made clear in our discussion that a model is not something that everybody has to fit into completely. On the other hand there are characteristics of the model that you cannot avoid. Such incompatibilities were discussed, namely if you subscribe to the Eitingon model, it is not possible to have training analysis three times a week, but a lot of other things are possible.

On the second question, most of us thought that the IPA should exercise its obligation to supply some kind of regulatory function, and not only prior to Component Society status. Shmuel talked about the pre-Component phase and that there was a certain opposition to the name “oversight” which seems to have a legal quality to most of listeners. But whatever you call it, I think the majority agreed that there should be some kind of accreditation or quality assessment.

On the third question, the words that came up during this discussion were “dialogue” and “mutuality”. During the discussion it was frequently pointed out that there are different conditions in different Societies and Countries. However some kind of recognition, accreditation, on-going quality program was felt to be of value to everyone. It was considered that it is important to be related to a non-governmental body outside your own country.

David Rasmussen, Seattle, USA. Reporting for Group 2
First it was felt that the word “oversight” seems more applicable to a function that the IPA would have for Study Groups or Provisional Societies along with the terms “liaison” or “consultation group”. It is important that there is an atmosphere of mutual respect and encouragement of dialogue between the Component Society members and the IPA members called upon to support the society. It is important that the IPA provides an umbrella for general standards for the practise of psychoanalysis. However our group felt that specific guidelines and rules are better left to the Societies themselves. Concern was expressed about the over-simplification of what might be rule oriented adherence to the three models, where in actuality there are many nuances to training in each Component Society.

We propose that requests for IPA consultation should come from Component Societies, that societies should invite dialogue for help concerning particular problems. For example to assist a society in dealing with the Government of the county they are in.

In order to keep costs down it was thought that Regional Conferences could be scheduled by the IPA and all IPA Societies in a region could be invited to participate giving them an opportunity to voice concerns. Societies could learn from each other’s efforts and errors. Also a regular meeting for society development could be scheduled at every Congress for the same purpose, in much the same way as our format for learning today.

Alicia Leisse de Lustgarten, Caracas, Venezuela, Reporting for Group 8
The first question is a wide topic that our group feels requires greater discussion, possibly for consideration at another time. We are all fully in agreement with the need for oversight and the recognition of the 3 models. We felt that the composition of our group, Presidents, Institute Directors and Board Members, facilitated horizontal discussion sufficiently to debate the questions we were asked to consider.

As the other groups have mentioned we were also concerned about the word ‘oversight’ and the impression that this gives and we understand that there is a certain contradiction between the approval of the 3 models and the creation of an oversight function. We would welcome the opportunity to debate this point further in Presidents’ or Directors' meetings and for each Society to express how its Institute works. What has been done by way of change? What each general model consists of and what variations there are within each model? We felt that all this needs to be debated sufficiently before resorting to oversight. If a Society makes a change to its training model it is because they feel it necessary and the reasons for the changes must be debated.

Concerning oversight, we subscribe to the idea of the IPA's concern over closely following how the IPA standards are working in the different Institutes, but we are concerned about what form this function will take. What would it consist of? Who would initiate it? Would site visits be carried out by people from the same region as the Society being visited and how would socio-cultural differences be considered. Economic considerations are also of concern to us as there are Societies that would have significant problems in covering the necessary costs of an oversight visit. It is important to us to distinguish between the oversight function and a Site Visit because we all agree that we are sufficiently recognised Institutes and Societies to warrant the need to be Site Visited. Of course all of us in the group are very interested in the growth and expansion of Psychoanalysis and in defining and continuing to work with a Psychoanalytical identity that is different from so many other clinical practices which run parallel to the practice of Psychoanalysis.

Marán Himiob de Marcano, Caracas, Venezuela, Reporting for Group 9
Initially every member of the group talked about their own institute and it was agreed that each of our institutes had profound reasons for supporting the models each institute had adopted.

Concerning the oversight topic, the word ‘model’ evokes the image of casting, plaster casting. Together with the hybrid term that was used this morning, that which we initially viewed as an opening and an acknowledgement we now see as rigid and sterile.

Our view is that we do not have to look for enemies of Psychoanalytical training within the IPA, as they are outside the IPA. The IPA's presence and tutorship in the young Societies has been very positive and for that reason Component Societies are now in a position to continue following their identification methods alone because they have been through the period of supervision and graduated.

In the second part of the discussion we spoke of the following: the term ‘Oversight’ can mean surveillance, but it can also be seen as something paternalistic, something which protects us from the persecutory anxieties which have arisen from the thought of surveillance.

There was a proposal within our group that Societies could send their study programs to the IPA and all the other Societies in search of an exchange in the form of a working group.

We suggest that the Board takes its time in considering the oversight function because confusion is created when these things are carried out in haste.

Sharon Raeburn, London, UK, Reporting for Group 3
Whilst the recognition of the three models was applauded, we didn’t go into the three models in great detail. The group began by expressing some wariness about having oversight at all, but by the end of the discussion the majority were really in favour of it. There was concern about the term ‘oversight’, because they felt that it conveyed a dictatorial approach. The group felt that the development and establishment of some oversight process needs consultation and feedback between the member societies and the IPA over some years, before anything could be implemented. It was also felt that any oversight function would be damaging if it was judgemental. If such an oversight function were agreed upon, it was felt that it would be preferable to have something regular and routine, rather than just when a problem arose. It was also mentioned by some people that it would be important, if there were to be meetings or visits, that cultural differences should be taken into account so that Site Visitors understood the region rather than be completely different. There was quite a bit of discussion in the group about the fact that some societies may misrepresent their training standards and procedures, and it was thought that an oversight function might be helpful in discovering why this has happened and how it might best address the underlying issues involved. Then there was discussion about trying to differentiate between the idea of practice and training. There needs to be a coherent model of training in order to establish a secure analytic framework for future practice after qualification. There was also concern about who would pay for visits and it was felt that the IPA would not be able to pay, and it would be helpful to have this clarified. Linked to the question of payment was the whole question of how much paperwork would be involved as opposed to how many meetings would be involved and how this would work out.

Bernard Penot, Paris, France, Reporting for Group 6
There was a general consensus, that each of the models constituted a reference to maintaining coherence appropriate to each institute and that it was very logical that within a single institute there can only be one model. At the same time during the discussion it became apparent that there were numerous variations within the same model. For example the British Society, giving a much talked about example of this, but not only a different theoretical point of view within the same practical model but also a quite different theoretical practicing method. The notion of training analysis was instanced which is still a crucial point, and having abandoned training analysis is almost what defines the French model. A certain number of Eitingon institutes was instanced which extended the possibility of being the candidates' analysts to all of its full members and so was still very similar to a common model. Another key point is the question of the length of personal analysis before commencing supervision and it was instanced here also. It seems this is the case in Berlin, for example numerous Eitingon institutes prefer candidates to have several years' personal analysis before commencing their training.

We moved on to the matter of oversight. Everyone seemed to be in agreement that oversight ought to be an IPA role in so far as the IPA has a duty to guide psychoanalysis' fate in the world and thus is responsible for it. However it was also said that considering the pressure of social legislation over psychoanalytic practice in some parts of the world where psychoanalysis is deemed a refundable treatment, the IPA still has a role to play. Perhaps the IPA can help certain societies to have greater resistance against this local pressure and avoid too much disparity.

It was also said that the IPA's oversight role did not of course only concern cases of potential changes to training model, but it should above all strive to maintain the coherence of the models and their values. The term ‘oversight’ was widely discussed and it became apparent that it cannot easily be translated, in particularly into the Latin languages. It was therefore felt that it was necessary to develop the notion of consultation, recourse, advice and assistance. It was generally felt that it would be much better to keep the term ‘oversight’ in every language as at least that way the meaning was not reduced to a coercive role.

It was felt that it was important for the Board to clarify who would perform the oversight role. Upper level and lower level requests were discussed. It is possible that certain IPA Members or candidates who felt despoiled or unhappy with their training, may ask for a Society to be visited. In any case the group felt that this issue needed further clarification. Oversight must be carried out cautiously, but take on a regulatory role which ought to implement a follow-up, particularly, for example, a Study Group that becomes a Provisional Society, it would still be very normal for there to be a follow-up in the form of oversight even once the society has passed a certain point. It makes you think of an after-sales department a little.

Lee Jaffe, Santiago, USA, Reporting for Group 5
We started to realise how our own training models influenced our thinking about the questions we were trying to answer. We therefore felt that, if we are going to seek any uniform kind of oversight, it would be important to have a simultaneous discussion involving representatives of all of the models.

While a model is the basis for deriving rules and standards, it also embraces a more general set of values and a philosophy about psychoanalytic education and the rules are derived from that.

There was an overall sense that some form of oversight is desirable, and that some form of oversight would fortify the value and meaning of being an IPA psychoanalyst.

In terms of initiating oversight it was felt that this could happen in two ways; it could be voluntary or it could be involuntary. If it was voluntary it might involve the request for a consultation. If it was involuntary it might be something that is periodic and automatic. It also might be something as could arrive out of some form of complaint. It was felt that it is important to develop oversight through consultation with the societies, that there be a very strong bottom up process. It is also important not to view oversight as policing as much as possible, but a consultation with respect and trust. The regulatory role should be minimised as much as possible.

There were three methods of oversight that were discussed. One was the idea of a structured self-study that the group would do on its own. The second was the idea of the IPA establishing a database with surveys being carried out with some fundamental questions about where each society stands with respect to their model. This database might be open for all societies to view what’s being done in various societies (this was the preferred method). The third method was the idea of a site visit, and as we discussed that it become the most complicated possibility for a variety of reasons.

Heribert Blaß, Dusseldorf, Germany, Reporting for Group 7
We discussed that we must admit that there are still hardly any standards and that we should be talking more about criteria, about the criteria that we expect. It is clear that standards and criteria shouldn’t be confused.

We have placed a great deal of emphasis on competence i.e. that we would have to explain what psychoanalytical competence is and, if it can be formulated more clearly among us, we can also present it to candidates more clearly as a question that is closely related.

Question two is I think is a bit of a paradox. As we see it, the IPA should not carry out inspections, but consult and help Societies and Institutes regarding the latent authoritarianism that is upheld by the criteria that have not been clearly defined, and also to gain more power associated with personal connections to reality, where authoritarianism is correspondingly alleviated and lessened by using just such an IPA function if the corresponding standards and criteria are described. It is also thought that an opportunity would exist here to reduce the tendency to leave things undecided and therefore to exert power.

On the question of how such a function can be organised, there was the idea that we can correspondingly override the previous organisation consultation. For example, a minimal scheme can be created, according to which consultations take place. Perhaps it would be an idea, similar e.g. to staff consultations where an organisation consultant goes into the company and speaks to the staff at individual levels, in order to look at how the entire structure of the company and the operation works. Therefore one could imagine that an IPA committee could go into the Society in order to speak with individual members and candidates in order to find out how the Society as a whole interacts. That was a suggestion for orientation and could also help to mitigate the mysticism of the institute (the insularity of the institute, i.e. to make it less insular).

We also felt that there should be no police function. However, it is not clear whether it would in any case be possible, as certain criteria are not upheld at all. It was considered that the IPA could have the option of placing sanctions, but this was only touched on.

Another very important question concerned the 3 training models. Whether it would be possible to investigate how research can be integrated into the 3 models and what their stance on analytical psychotherapy is. Both systematic research and analytical psychotherapy also have a standing.

Our group also suggested that it should be noted that the IPA should only contribute if there could be innovations in training, i.e. how the definition and extension of training models can also involve the institute in a creative way.

Jim Gooch, California, USA. Reporting for Group 10
My impression was there was concern that neither models nor oversight become imposed from outside each institute. These were issues of power and authority. It was preferred that models and oversight help each society to discover itself and grow as a whole. There would be flux not stasis in life. Some societies, especially younger ones, have members who trained with different models, which can produce turbulence and growth, but may pretend pressure toward the evolution of a different model within a society or splits if not contained with resilience, respect and integrity. Collaborative consultation and discussion with the IPA worked horizontally with other societies may be helpful here. The proposal of these three models produced considerable discussions in European and Latin American societies, more so than in North American Societies. Oversight must clearly benefit the societies in order to work, for example to help society vitality, growth and self-awareness, and to assist with governmental recognition of psychoanalysis in some countries where laws govern practice and payment. Discovering the models in use is likely to be more useful than a model imposed from within a society or without a society. In other words, what is the organic nature of the group? Oversight will require time, money and personnel and perhaps utilising regional and IPA meetings and other more financially and time efficient meetings. It was the prevailing opinion that oversight should be requested by a society, not imposed. The IPA is interested in developing closer non-intrusive relationships with its societies and vice versa. In summary it might be cryptically summed up as regulation in contrast to consultation, consultation meaning collaboration and protection, parasitism in contrast to growth promoting situation.

Nadine Levinson, California, USA. Reporting for Group 4
There was a lot of anxiety around exactly what oversight meant and what the imposition of three models would mean. We initially began to focus on the question of the models of training, focussing first on frequency, asking if it is possible to have three days in a four day Eitingon model? A lot of the anxiety seemed to coalesce around that point. This discussion followed the same process that the IPA itself followed when it went through the process of developing these models to begin with. We were then able to start talking about how we work as analysts and how beneficial the acknowledgment of what the realities are of training in psychoanalysis these days could be. There was some concern about the variations of the implementation of the applications, and how that could be looked at depending upon what sort of oversight function the IPA decided to take. Our group felt that research was very important, and we talked about the Sandell paper, we talked about the Blass paper which looks at various issues that affect candidate selection and certainly the Sandell paper is much broader than that. However the point was that we felt that research could be very helpful for us in terms of deciding where to go from here. It is not that we need new research, but a better integration of the research that we already have, to help us in terms of how we move forward.

There was also an awareness that there is only so much money and how much of this can be spent in organised psychoanalysis on these issues. It is nice to have research contemplating a lot of this, but we all seemed to feel that research money was needed in outreach such as the DPPT programs.

Everybody was very concerned about the word oversight, but the group did seem to agree that some form of oversight was very important. There was the issue of how it could help us in terms of any government licensing interface that we might be facing in the various regions. One person in the group said we could have a voluntary accreditation or certification process. However what happens if there’s a de-certification, if something isn’t done right in a Society or institute? Somebody raised the idea of having more expertise concerning group organisation. When you look at a Component Organisation or an institute at an organisational level it is a very different kind of consultation and collaborative experience than how you might do supervision or how your Education Committee might function. We felt there really ought to be more sophistication around how this collaborative mediation is viewed and implemented.

One practical suggestion would be a survey with two different kinds of questions. One would be to ask what do you do in your training program? So you could get the richness of variations that occur across the regions. The second question we thought would be interesting is what specific problems do you have concerning training? The IPA could then develop a better forum to discuss our special problems. So that solutions in one area or one region might be helpful for others in another.

Dr. Eizirik thanked all the reporters and asked for questions and suggestions from the floor.

Emanuel Bermann, Haifa, Israel
The recognition of the three models is a breakthrough in the history of the IPA to recognise the multiplicity of training options. The decision to define it as three is somewhat arbitrary and we all know that the reality is that among the dozens of Eitingon systems there are huge differences. I am not sure it is important to list them, but I think if the belief is that we will now stick to exactly three strict systems is utopia or dystopia, whichever you choose, so I think that the likelihood that any society will in a year declare that it wants to shift from Eitingon to French is very low. What happens is that for dozens of years in the past and probably also in the future, societies evolve their training, and change aspects, revise aspects, reduce aspects and to me this is a very positive method. It is organic, it comes from experience, from local traditions, from local culture and I think the IPA should be very proud of it and support it.

Marilia Aisenstein, Paris, France
The group I was in was extremely interesting, recounts were given. There was much discussion about the differences between what is truly a model, with key points or cornerstones, and that within a model there can be huge variants and the model is still a reference and an abstraction. I was very interested to see practically the same development during the group reports. That is to say that from a kind of fear of oversight probably in certain regions with truly traumatic histories, the discussion's development in several groups seems to show that there is currently a new way to understand oversight not solely as a supervisory role but as a consultative and cooperative role which may be enriching.

Plinio Montagna, Sao Paulo, Brazil
I think that everybody agrees that we want good training standards. We want a strong IPA as a shelter. We want liberty, organisational and institutional independence. Liberty to decide our own destinies, interchanging ideas and consultations with the IPA. Discussion of oversight is something to be done when a society wants to change its model. We should have more information about the Societies and which of them if any would want to change their training model. It is a very good opportunity for the IPA and the Societies to get together and find out how each institute works and circulate the information that is received.

Juan Pablo Jimenez, Santiago, Chile
I believe that the most important part of this Oversight phenomenon is that the IPA acknowledges there is a wide range of training. Societies must take this opportunity to have a general mass self-reflection process. Each of the Institutes must think about the type of training they are doing and why. What are the historical and conceptual reasons and the IPA should gather that information. My view is that this first step will diminish the persecutory anxiety. After that we will have to come to an agreement on how we are going to process the information, how we are going to analyse it and then eventually we can think about some type of intervention to see how far the diversity reaches and whether it is good or bad for the diversity to be so extensive. I believe that the basis is that this is an overall self-reflection process for all of the IPA. The supervisory role is really secondary because the IPA has tried to do that from the start. If we are considering oversight now then that role has already failed. We are in the same process as Gorbachov with the Glasnost, for transparency we have to make transparency and then we can really see the scope of our diversity.

Otto Kernberg, New York, USA
On the one hand we have taken a little step and on the other a big step. A little step because after all these models, the truth is that they are so similar, they have so many common things, they are really limited, and that’s fine, that’s how it should be. It indicates that the IPA is open to study alternative ways for training psychoanalysts. Our big problem is we have no precise definition of what we expect from a psychoanalyst. We have criteria for training, but we are just beginning, very late in the game, to evaluate it. Opening up alternative models of training should stimulate the Societies into thinking not only about models of training but about the purpose and structure of the training.

Our group suggested two proposals: one that the oversight should follow the format of the Sponsoring and Liaison Committees to new groups. Not a policing role, but a joint group which evaluates what is going on, and this should be done with modern methods of consultation and education, for example: the people we are educating participate in the process, the candidates will learn how important their views are to formulate the understanding and recommendations. This is a teaching method, not a controlling position. At the same time by raising the question, how is the model performing with regard research and psychotherapy?, the IPA is signalling that if psychoanalytic institutes don’t train psychoanalytic psychotherapy to high standards we are in serious danger – I do not need to explain why as we all know. If we don’t foster a broad spectrum of research we will not be taken seriously by the University, academia or the public and psychoanalysis will not survive. So this is a step towards stimulating concern for the two big challenges we face at this time. It is true that few societies are going to change, but we need to send out the message that if you want to try a new model you will need some control to avoid a process with so much chaos that we no longer know what is going on. What should emerge eventually, in the oversight visits and exchanges, is that societies can be helped to innovate within their model, and at the same time teach the committee what they are doing. A database can be set up so the IPA can learn what is going on, consider the findings and make suggestions for innovations. So it is a circulating model in which the society takes an initiative, the IPA carries out the oversight function, helps the society, and the society helps the IPA realise what it didn’t know which leads to higher level of interaction. That is not policing, it is not everybody doing the same; it is a growth process of mutual influence that is not authoritarian and helps both sides to grow.

Stefano Bolognini, Bologna, Italy
We share the same roots, the same history, we have a common culture, but we recognise with an historic acknowledgement and we recognise that we have some differences. We are dealing with this new acknowledgment that with great effort we were able to agree. The IPA had some difficulties in recognising that the procedures do not state the full truth. We recognise there are different families with common goals. This engaged the Board in four years discussions. Is this work finished? I think not. We are now continuing with the different interpretations of the models. This morning I had an image that corresponded in some way to what is happening in the IPA’s evolution. I remember that there are two breeds of elephants. There are the Indians and the Africans. There is a Darwinian reason that they exist in different forms. In Africa they have to live in very large savannahs and the African elephant is bigger, stronger, more aggressive and valiant and so on. The Indian elephant has to live in the jungle and he has to move in a different way because his personal culture is generated by different conditions. We have to study and better recognise the reasons for the different developments in psychoanalysis. This Darwinian perspective is very helpful for me in understanding the implicit natural rationale of the different interpretations of psychoanalytic training. Nevertheless our community has the past to take into account both the danger of perverting something that is worthwhile in our history, and at the same time to distinguish what is a fruitful and creative evolution of our profession. In this sense my personal opinion is that even if we were able to overcome a disagreement and possibly a denial regarding the differences, we have to go ahead with the research. This will allow the societies to openly and frankly declare their way of working and to reconcile how they reached those achievements, perspectives, and training models.

Mira Erlich-Ginor, Jerusalem, Israel
I want to speak in my role of Chair of the European Psychoanalytic Federation (EPF) Working Party on Education. The EPF is not a regulatory body, but a more scientific and collegial body. Irrespective to the developments in the IPA we became curious about the different ways of handling education and training. Over the last three years we created a huge database, we now have data about all the training parameters in twenty seven out of the twenty eight societies and provisional societies in Europe and I want to suggest that the IPA use this as a first step. We are also publishing an article in the next EPF bulletin, and this article is also already on the internet. Our main findings will be presented in the poster session of the Congress. One of the findings is that after one hundred years and with such a group of intelligent and creative people, why are there only three models, even if there are hundreds of variations? What is there in these models that seems to work at least up till now, with the challenge of transmission of what it is to become a psychoanalyst. I want to invite whoever is interested to join a joint venture to try to do research beginning with the three distinct models. So whoever we have in the working party on education, we have twenty two interested members, some of them professional researchers, others just highly motivated psychoanalysts, but we have the machinery to begin to carry out research into the models and what they mean. What are the implications of the application and admission of these models? What are the implications of the results of these different models? Are the analysts graduating from different training models similar or different to each other? I am launching a venture and will create a group outside of the official organisation of the IPA, a group of colleagues that can think how to develop research projects that will give us better answers in three or four years time.

Bent Rosenbaum, Frederiksberg, Denmark
I don’t know whether I like the word ‘database’, and prefer ‘information base’. First of all we could be surprised and interested to know why this hasn’t been done before? All this information which each Society should have, about how we train and educate candidates, should already be in the hands of the IPA. I think it should be a requirement for Education Committees, Training Institutes and Societies to send a description of the procedures, rules and regulations that each society has for the process of admitting, working through and terminating the education of anyone wanting to be a psychoanalyst. Secondly, I think the Education Committee has carried out such thorough and important work. They have come up with possibly six different dimensions in which we compare the different education models. I cannot see why these six dimensions should not also be taken seriously. In addition to the description each society should submit about its training, they should start wondering about how we describe our own model in our society according to this dimension.

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I am very optimistic about the existence of the three models and I think this is only the beginning. We need to face that we are dealing with something very delicate and complicated. How can we grow and change and still have something in common? Do we have a psychoanalytical identity that is something that stems from our cultural differences, language differences and ways of understanding things? For a very long time the IPA recognised only one model. There were a lot of splits within groups because some parties couldn’t accept change. It was very common for someone who tried to do something that was not strictly psychoanalytical (as understood at that time) to be called an impure analyst. I think that ‘psychoanalytical oriented psychotherapy’ was created at that time so that people could treat patients that were not suitable for psychoanalysis and to avoid arguments from those who would consider that it was not psychoanalysis. Psychoanalytical oriented psychotherapy is now a problem for us. The recognition of the three models gives us a chance to look into the differences without judging each other. If we want to keep on growing and respecting each other, and having something in common, and representing the IPA, we have to be more profound, and we have to find out what we have in common by carrying out research, talking and sharing practices. When we talk about clinical cases we see that we are not all that different and in that sense the three models, not in theory, but in practice may be more similar than they at first look.

Raquel Zac de Goldstein, Buenos Aires, Argentina
What has been said contains a solid intrinsic coherence worked in a stimulating manner and I firmly believe that one of the motivations of this choice is to present it not as a model but as a work model with what the years have produced in the Institutions' analytical thinking. For many of us this work model of logical coherence is huge political progress which the IPA is making and offering; I agree with the idea of a Glasnost as our FEPAL colleague said but he is offering a work proposal, a work in progress, a work process with that diversity. I agree with the approach that Otto Kernberg is suggesting with the experience and lucidity that we need and use. Research perhaps helps us to establish that we are dealing with a new science. Much of current science is reintroducing a surprising encounter between Psychoanalysis and, for example, neuroscience; that is why we can consider that Oversight, even with its interpretation problems, could establish current dynamics and dialectics for us both to discover that what we have done for Psychoanalysis is not only for it to survive but for it to be as strong as it currently is.

Carlos Barredo, Buenos Aires, Argentina
It is an important decision to me and an important political decision for the IPA to acknowledge the diversities which we know we have been facing for a very long time. It is not only the product of the research, it is the courage to recognise what we know we are facing. I think it is important that this way of recognising and tolerating diversities deepens because I believe that is the analytical way. The analytical way is that of recognising diversities and tolerating more and not that of imposing uniformities. I think this is a change, a turn, a very important decision that is bringing significant consequences not only in this debate but in the debate that had already started in the IPA Newsmagazine with the Erlich report, the answers that were detailed in the report and the clarification of the answers. I think it is a very interesting level of debate about what we are facing.

Alvaro Nin, Montevideo, Uruguay
I agree with the spirit of what has been said about Oversight, especially what Otto Kernberg said and Stefano Bolognini and others about the nature of the work that is going to be taken forward. I think that the word ‘Oversight’, at least in Uruguay, is not very nice, not very apt. What has happened in various discussions here today also happened in Uruguay: when someone said Oversight we started to think about that term and we entered into a little paranoia over it. I would propose that since the term is causing so much ill feeling, concern, anxiety and anguish we should change it. It appears that the IPA doesn't have to learn anything from us so I would propose changing the term ‘Oversight’ and inventing another. Since we are Psychoanalysts perhaps something like a didactic exchange in the sense that the learning process goes from the Society to the IPA and returns from the IPA to the Society. The Uruguayan model, we were surprised that overnight we became part of a type of model we did not really know. The model arose from an internal movement in the Society which wanted to democratize the power issues within the Society and from there arose the interest in generating work groups in the Lion style, where the Didactic Analysts stop being Didactic and go on to be Supervisors, Teachers or Analysts or the 3 things at once but with a specific work task. They meet monthly to research and exchange the group's practice problems. Since an internal movement came about in 1974, we have carried out this practice for 33 years.. In 1980 during a visit to the Asociación Psicoanalítica Uruguaya the President of the IPA promoted a number of changes for members who had no interest in being teachers or supervisors and he himself put them forward, and therefore the IPA also took on a role of enriching Psychoanalysis in Uruguay. This is the philosophy of this Didactic exchange which I would call a Didactic Consultancy Process and not Oversight.

Gertraud Schlesinger-Kipp, Kassel, Germany
In Germany the IPA is particularly important nowadays. However, it is also important from a historical point of view, because we went through a difficult historical process by leaving the IPA in 1938 and then rejoining. I would therefore like to emphasise how important it is for us that the IPA exists and recognises diversity, rather than splitting. This is why it is important that the IPA has recognized these three models otherwise it may not be possible for the IPA to continue as an organisation. Nevertheless it is important that there is also a paradoxical effect when new rules are introduced. If attempts were made at universities to find new, more democratic, open and friendlier rules in the past 30/40 years, it normally resulted in there being a new examination, because it has a paradoxical effect. I am slightly concerned that we will set up too many rules because we’ve now become more open. I believe we shouldn’t regulate too much, but that we find clear and possibly transparent rules that don't take root so nothing can be changed in the future because we constantly come up against another rule. I found it very interesting in our group. We only had representatives of the Eitingon model and then tried to explain the other two models. In relation to the aforementioned history in particular, I found it important that changes often come in questions of power, authoritarianism and paranoia. I believe that it is important that these changes take place on the basis of any kind of trust or even a leap of faith, as always it can be determined.

The main difficulty for those from the IPA coming to see what is practiced in a society is that the best judges are still the members of the society. We have a resistance to look at the drawbacks and faults in our own training. It would be better for the IPA to help societies to recognise when their training is not as good as they would like it to be. If on the other hand they are coming to see what the members are doing, there will be defensive attitudes; that is where I believe it is very important that the IPA help Societies to go through a process of self-criticism of their development and practice.

I will quote Anna Freud. One day I was welcoming her to an IPA meeting where the psychoanalyst's training and identity were being discussed. She said ‘You're still speaking about that – it's totally unnecessary. What is a psychoanalyst? It is someone who continues to practice psychoanalysis’. And I believe this is very significant. Assess candidates when they leave their training at the first monitoring stage and above all at the second monitoring stage, however to look again five or ten years later at what is left of the analysis practitioners is still the best training criterion and that must also be taken into account.

Clara Uriarte, Montevideo, Uruguay
Regrettably I arrived late and so I could not get together with my group so the things I am going to say are rather personal; they don't correspond to what was discussed in the group but they coincide with a lot of what I have heard. In recent years we have seen the IPA go through a very significant opening process which has allowed us to acknowledge the 3 models. I hope that we can continue along this route to openness and flexibility. If there is something that we can take from what Alvaro Nin said it is the importance that each group has a constant reflection process over its own role, its own duty in its corresponding area, whether it is the Institute's analysts, supervisors or training professors. Of course this does not just happen in the Uruguayan Society, I believe that the IPA has to respect the experience these Societies have and, of course, to recognise the diversities, the differences and the idiosyncrasies, what is appropriate, what is the very nature of each region, culture, society and what makes our identity, what gives us our working method and our way of thinking through problems. The Oversight role as I understand it has to consist of an exchange role, consultancy, an exchange of ideas; I don't think it ought to be a delegation but only when it is requested. I understand it as an exchange of ideas, a didactic exchange role, respecting the IPA's framework regulations. If we were to create something similar to an oversight role, I understand this role would be given to the Education Committee but we should not create commissions or a group dedicated to this exchange of ideas; it would just be the Education Committee which would have to take charge, for example, of this type of exchange, petitions that could come from the Societies; it would maintain this within the Education Committee.

Jacqueline Amati Mehler, Rome, Italy
First of all I would like to ask you all not to be contaminated by the fact that my pessimism prevails over my optimism, I have been interested in problems connected to IPA training for more than 20 years. The issue of a database has been brought up, but we have a database in the IPA, which has been gathered, collected, looked into for many, many years. The problem is, and maybe this is an inevitable problem with institutions, that at each administration there is a change on what we should do with it, and how to deal with it. So, this is one of the main problems, because the database is of course adjourned and one adds to it. I was very glad that Claudio mentioned the House of Delegates which was many years ago, as for four years the House of Delegates discussed training models. In those days, discussions were very fruitful although there were of course fewer of us. We had two models. Over the years now we have three models, but we all are aware, as somebody, said that within one of the Eitingon model we probably have twenty or more models. So the question that I want to raise is where do we go from here? By the time we meet again we might have many more recognised models. What I would like us to reflect on is what are we going to do about this? because this is in my mind the deep problem of the whole thing. Where do we draw the line and accept that there is a minimal necessary cohesion of what we think we should do, or be, or teach as analysts? If I look back and I see the development of the issue, it is worrisome. I hope optimism can help us to find ways to avoid the IPA changing its policies and convictions every four years so that we are not aware of data that we already have.

Susana Velasco Korndörffer, Mexico City, Mexico
How do we begin to implement a didactic exchange? - I like the idea proposed by Alvaro Nin. Considering what has been done by the European Federation it occurs to me that, as some of the parameters that have been proposed by the Education Committee are already in place we could perhaps work on it as a mutual project. Each Society could include it on its website and put forward its internal discussion on what the parameters are and the definitions and begin the discussion from there. We will probably find that there is a lot of variety and knowing what these differences are will allow us to work.

Roger Kennedy, London, UK
I wanted to share two meanings of the word oversight in English. An ‘oversight’ means something is lacking. Another meaning of ‘oversight’ is an overview. So there are two aspects; what is lacking and what is present.

In a way we are talking about, what we call in Britain, continuous professional development. As analysts we have a craft, and craftsmanship is about developing a skill over many years. Craftsmen like to have their work looked at, admired, and judged, and that is part of the art of craftsmanship. We have a system of compulsory continuous professional development; people have to be in small groups and present their clinical work in order to perfect their craft, so that there must be some sense of others looking at our work. It is done in small groups in which we hope to trust each other. But that takes a lot of work over a period of time.

We have done this in Britain with the French and had Anglo French dialogues for many years where we, who use the Eitingon model, discuss the French model with the French around individual clinical work. It has taken years for us to develop trust in each other and respect each other’s points of view. I feel that it is absolutely vital that the IPA has oversight in the two senses of the word at some point. It is vital for the future of psychoanalysis. Shmuel came to our group and said “in no other profession is there an oversight function to become a Component Society and then nothing more”. You are an analyst for life and there is no oversight, which in other professions is quite extraordinary. So why are we different from everybody else? I know that we have heard from the other side “don’t come, don’t look at us; we can do our own thing”, which is fine, but I do feel we need to let people in as well. This may mean it will be uncomfortable at times, looking at oversight in the sense of what we lack, but I think it’s necessary if we are going to have oversight in the other sense; of what we have.

Otto Kernberg
It seems to me that if we take a very long look, we can see a clear solution to our present problem. When we reach the point when we can define competence – i.e. what is the analyst we want? There is much more agreement on what we aspire to; the disagreement concerns how we reach that goal. The problem is that we haven’t defined objectively what we want, and many people say you can’t; this is so subjective, we can’t be like other sciences; we can’t be more precise. But in practice we know whether a candidate is good enough or not. We use criteria. What we have to do is transform that which we are doing already into clear criteria. The criteria need to be clear and we have to develop instruments to evaluate whether a candidate lives up to those criteria. We have never done that and we are beginning to do it. The European Federation is beginning to do it, and David Tuckett created a very good model that many of you know about which details criteria to evaluate the value of clinical work. Werner Bohleber in Germany has done the same with different criteria; a relatively simple but very good model and others have also done this too. We therefore already have a basis on which we can proceed. When we have such true standards concerning what an analyst should be and criteria on which we evaluate this, the whole problem of models will disappear. Let us see which of their candidates lives up to our model. In other words competence can then be used to evaluate what is being done. This opens up the possibility of different roads to reach the same goal. Experimenting and using new educational methods with which we may develop or take from other sources, so in the long run we have a clear road to go down. There are reasons why we haven’t done this before, but I won’t go into this now. However the institution is opening up, we are now aware of this, and the flexibility regarding models is just a step on the road to our long range goal. We used to call standards criteria, the true standards we have to begin work upon, but once we do we won’t be worried any more about the identity of the analyst because we will have a definition and can see whether we are able to train and maintain the profession.

Monica Siedmann de Armesto, Secretary General
I very much enjoyed this meeting because of the growing transparency which all of our colleagues' involvement has denoted both in the discussion groups and in this plenary session. This is why I strongly support the idea of having many more of these meetings at international or regional levels for us to be able to continue discussing these topics with the seriousness and respect with which it is being done at the moment. This really is something auspicious for us to accept diversity in training. I believe we are all aware that in reality we have the same basic training tripod which is not altered in any of the models. this is a profound analytical process for those training to become analysts, the supervisions and seminars, whether this is done before, after, 3, 4 or 5 times a week, whether there are variations, the tripod is what really links us as IPA analysts and distinguishes us from other types of training going on around the world. I believe in this tripod and that this is our back bone and so long as this remains the same everything else can change. I liked Alvaro Nin's proposal of speaking about didactic exchange, I like the word exchange, an exchange among colleagues on a topic and perhaps that way we may find the solution to the word Oversight which provokes such bitterness in us. I am extremely pleased by the huge attendance we have had at this meeting – 150 people debating such important topics for all analysts.

Shmuel Erlich, Chair of the IPA’s Education Committee
It has been in many ways an extraordinary day. If I think back on my days as a President at a Congress, to me this has been a very meaningful day of cooperation and reflection. I thought that one thing that troubled us a great deal is the theme of diversity versus uniformity. It is as if these are two polar opposites and I think that perhaps we can be helped by Stefano’s metaphor of the elephants. My first reaction was that perhaps Stefano has made our life at the IPA even more difficult. I used to feel that we are like six blind men trying to feel and say what the elephant is, and now he has actually introduced two elephants and maybe 150 blind men are trying to feel what two elephants are. At any rate it seems to me that what this metaphor can make us think about is, not only that the two elephants have grown up and adapted themselves to their environments, but the interesting question of what makes both elephants. The question is what is generic, what is essential, and here I think this has to do with what Otto was talking about: if we could define the essence of what the psychoanalyst does we would be a great way ahead of where we are now. We have in the past and historically tried to do that by defining essences and not competences and perhaps that shift of emphasis will be an important addition.

As to the word ‘oversight’, I have had the same input at the Board. If you understand English then oversight is a very difficult word, because it really points to neglect as much as to supervision and control. However, we didn’t find a better word and my colleagues adopted this and I live with it. I would like to quote what one of the colleagues said; that we want a strong IPA, we want liberty and we want good standards. That is a very a very interesting and very truthful way of putting it, and I think if you reflect on that you can see that in this triangle there is an enormous inner tension between these three wishes. It is not easy to square the circle. A strong IPA, personal or institutional liberty and the maintenance of good standards - how do you do that? That is really in a way the task that we are facing. In the first instance, this tension produces a great deal of anxiety and the anxiety has focussed on the word ‘oversight’. I would certainly be very happy if somebody could come up with a better word, but I really don’t think it is a matter of the word. It is a matter of putting these three elements together. In a historical sense we are perhaps regressing today, not only concerning the issue of training and education, but in a deeper sense the issue of the discontinuity between the IPA and its Component Societies. I think that is the real issue; that it has evolved in such a way, that in many ways the IPA and its societies have not maintained a vital contact with each other. This is also evident in the questions that came up about the database. In terms of what Jacqueline raised, I know enormous amounts of data have been collected, but I think that to collect enormous data on a one time basis is not the same thing as getting data in on a continuous basis. It simply isn’t the same and the use of the data would not be the same. When the societies and the IPA have a more routine exchange with each other then we will be able to use this data in a much more lively, immediate and current way.

There has been a lot of discussion about the Eitingon model and whether it is one model, twenty or a hundred models. I think that the Eitingon model is one model, many variations have evolved within it, many of them not concerning the model, but with the implementation and the standards. What we heard in some of the groups was that in many places there is a tendency to practice the Eitingon model with three times a week, which is not part of the model. I don’t think the model itself has changed only the way it is implemented. This is also the advantage of using models because what I learned in the course of this work is that the French model is not a singular model; there are quite a number of very interesting variations among the French speaking societies, in the way this model is implemented.

The Uruguayan, which you might think is one single model, because it is in one country, in the course of the work we have done this last two and a half years, has changed in a way. I have received different reports back on the Uruguayan model. One said we do it this way, one said we do it that, so even within one model you get variations. It is important to keep in mind the difference which is an abstraction; it tries to distil an essence of understanding, a psychoanalytic course of training and preparation for qualification, and the implementation of the model. I hope that we have made a step forward today in being able to reach a better dialogue between the IPA and the societies, between the Education Committee and the institutes in searching it, learning it, exploring it, and hopefully also working together.

Cláudio Laks Eizirik, President
Taking into account Stefano’s metaphor of the two elephants, I myself have the idea that the IPA is a strange animal. A strange animal which lives in our minds. However it is not always the same animal, and for each one of us it is a somehow different. Even when the IPA intends to stimulate dialogue and open interchange there is from time to time a certain unconscious request to put this animal in a watchdog position. When we discuss oversight perhaps we must be aware that despite the word perhaps not being perfect, we are trying to stimulate a concrete dialogue and interchange, however we cannot avoid the fact that this strange animal has had, among other functions, a think tank function and regulatory role from the very beginning. This is clearly expressed in Freud’s formulation when he created the IPA and therefore the IPA will be able to live with this, among other functions and perhaps among the many valuable things that you said today here and in the small groups.

Monica and Shmuel pointed out that there are several themes that are permeating our discussions. The plenary discussions have been recorded and we will therefore have a record of what was discussed. We will circulate the text of our discussion to all the Presidents, Directors of Training and Board members so that this dialogue can continue. In my view we have made very important progress in defining the three models. I would suggest that we stay with these three models. Let us try to really understand them and the internal coherence of each of them. I suspect that it will take us some time. The fact that the definitions were approved yesterday does not mean that all of us can completely understand them. I went to several group discussions today and it was interesting to hear the various concerns from colleagues about the models that they are not familiar with. Among the many other things that this strange animal the IPA has to deal with, and perhaps the most important, is to continue analytic listening. Of course as we know this is a very difficult task. We continue to listen to our patients for hours, and one wonders how many of these hours we are really listening to other things. So this was an exercise in mutual listening. This is one of the most important ways of interchange and trying to understand each other in clinical exchange.

Once again I would like to remind all the Presidents here to take advantage of one of our programs, Analytic Practice and Scientific Activities (CAPSA) through which the IPA is offering an interchange of the regions, based on clinical discussions, and I think that this program could be very helpful. Perhaps especially by Societies inviting analysts who work with a different model to see how these colleagues work. My own experience in several of these exchanges is that it is possible to become a good analyst from any of the three models.

Finally I would like to thank you all very much. I think that we are going to begin a very successful Congress tomorrow. In a sense we are beginning the Congress today by having this wonderful opportunity to learn from one another, in both the small discussion groups and in this final plenary. I have been very impressed by the way this meeting has developed, with everyone listening attentively and concentrating on the topics at hand. Many colleagues spoke in their own languages and it is a very moving experience to see that we are slowly and progressively learning to listen to each other. Perhaps this is one of the greatest lessons psychoanalysis has to give to the world, where listening to others sometimes seems an impossible task. We are continuing to develop our ability to listen and not only through training issues, but also through clinical issues, research issues and theoretical issues. Over the next few days we will have a wonderful opportunity to get in touch with the developments in our discipline.

We will continue to work with the models and consider the concept of oversight and how to implement it. We will continue to consult closely with you, as Presidents and Directors of Training of IPA Societies, over the next months and years. The Education committee will continue to be in charge of all education issues including oversight.

Dr. Eizirik closed the meeting.