Academic journal article International Journal of Psychoanalysis

Psykoanalys I Välfärdsstaten-Profession, Kris Och Framtid [Psychoanalysis in the Welfare State-Profession, Crisis and Future]

Academic journal article International Journal of Psychoanalysis

Psykoanalys I Välfärdsstaten-Profession, Kris Och Framtid [Psychoanalysis in the Welfare State-Profession, Crisis and Future]

Article excerpt

Psykoanalys i Välfärdsstaten-Profession, kris och framtid [Psychoanalysis in the welfare state-Profession, crisis and future] by Jürgen Reeder Stockholm/Stehag: Brutus Östlings Bokförlag Symposion. 2006. 344 p. Reviewed by Henning Paikin, Kildevæ nget 37, DK-2100 København Ø, Denmark - henning@paikin.dk

This is a book which is in many ways unusual, interesting and informative, containing among many other things an analysis of the present crisis of psychoanalysis. And Reeder suggests a bold solution! The book may be seen as a continuation of and elaboration on themes from Reeder's (2004) examination of the profession's dilemma.

Reeder initially enumerates the reasons for the crisis: psychoanalysis has become financially inaccessible to people who pay for their treatment by taxed income; psychiatry-which has always felt estranged from psychoanalysis-has turned biological; psychoanalysis is increasingly in competition with newer psychotherapeutic methods; at the same time, psychoanalysis has been subject to massive, predominantly unfounded attacks; and, finally, psychoanalysis has disappointed the exaggerated expectation that it alone would be able to solve all of the difficult tasks facing psychiatry.

Reeder sees psychoanalysis and psychoanalytical psychotherapy as a continuum with shared theory and clinical objectives. He believes it to be more pertinent to emphasize likenesses and shared interests than the differences. 'As long as the clinical activity is guided by psychoanalytic knowledge, theory and objectives I would characterize it as "psychoanalytic." ' He further states that he includes the large group of authorized psychotherapists in his discussion as they have common interests concerning the conditions for private practice (p. 13). He points out that the social authorities in Sweden, who authorize psychotherapists, use only the term 'psychodynamic'-'psychoanalytical' is completely absent!

Chapter 1 consists of two parts: an ultra-short description of the history of psychiatry from c. 1800 to the present day, and an impressive, almost 40 pages long, survey of all Swedish and international psychoanalytical and psychotherapeutic institutions and societies. It contains information such as their history, training requirements, and open consultations, but no information on 'individuals and their deeds'.

The history section describes how psychiatrists of a biomedical persuasion opposed the authorization of psychologists for fear that they would engage in independent psychotherapeutic work. However, psychologists were authorized in 1978 and psychotherapists in 1985. Sweden has a national psychotherapeutic training programme consisting of two levels. The first level is a basic training, while the second level, the psychotherapeutic training per se, is called a postgraduate programme. I shall not go through the training rules here, but I find it noteworthy that the requirements for 'therapy' are modest, just 50 hours of individual or 120 hours of group therapy in the basic training, the corresponding periods in the postgraduate programme being 75 and 160 hours, respectively.

Under the heading 'Profession, ethos and society', Reeder lists a number of aspects that he sees as characteristic for a profession, i.e. monopolization, financial control, regulated training and authorization, professional ethics, autonomy and respectability. Ethos, a difficult and ambiguous concept, is described as a way of being and relating that is bound to the personality, while a professional code of ethics functions rather as a law or a moral injunction (p. 83). The two are not necessarily in opposition, but the difference between them is like the difference between virtue-ethics and duty-ethics.

In this section, Reeder argues in favour of the importance of what he calls a 'professional milieu'. To my knowledge, the concept and its description are an original contribution. A professional milieu comprises psychoanalytical and psychotherapeutic training activities and a forum for academic exchange and research. …

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