Feminizing Psychoanalysis

Feminizing Psychoanalysis: the Process and Experience of Integrating Feminist Thinking and Practice in a New Psychoanalytic Institute

By Teresa Bernardez
Originally published in Doing Feminism: Teaching and Research in the Academy  eds, Anderson, Mary, Lisa Fine, Kathleen Geissler, and Joyce R. Ladenson. East Lansing: MSU Press.  Reproduced by permission of the author.
A core women studies group, formed in an association of mental health professionals interested in psychoanalysis, became the main protagonists in the formation and design of a feminist inspired psychoanalytic training institute, the Michigan Psychoanalytic Council.  The experience is important since to our knowledge this is the first psychoanalytic institute in the U.S. or the western world that has introduced an integrated feminist curriculum in the required course work.  In addition it successfully introduced changes in the structure and process of the new organization that would promote a democratic sharing of privileges, women’s participation in equality of partnership and innovations in psychoanalytic thinking and conduct consonant with feminist theory and praxis.
Most institutes in this country who train professionals to become psychoanalysts are comprised under the aegis of the American Psychoanalytic Association (APsaA). This association, the only bona fide member of the larger International Psychoanalytic Association (IPA) has been controlled by MD psychiatrists. Although they have among their members a few psychologists, the requirements for full membership have included an MD degree. With the exception of a number of institutes in New York that are not associated with the APsaA, MDs have ruled and maintained hegemony over psychoanalytic practice and training, defending vigorously the need to preserve Psychoanalysis as a medical specialty. This has not proven helpful to psychoanalysis nor to women, who, until very recently, have been admitted in small numbers in medicine and in psychiatry. Despite the presence of outstanding women in the early years of psychoanalysis (Melanie Klein and Anna Freud, for instance, considered “mothers” of psychoanalysis) and the salience of feminist “deviant” psychoanalysts in its early history (Clara Thompson and Karen Horney), women became more and more invisible in American psychoanalysis after the 1950s.
Over the years, the field became oppressively sexist, and the ecumenism of early psychoanalysis gave way to an increasing orthodoxy. Gradually its patriarchal characteristics began to dominate: an ideology of male supremacy was thinly disguised by attempts to appear liberal, hierarchical structures of dominance were erected in the training institutes, with training analysts as members of the dominant caste. Training analysts are the few selected full members of the participating institutes under the APsaA who can analyze candidates in training and have a very considerable amount of power in decisions that include the termination of the candidate’s career and the determination of her/his readiness for the next step in the training. The candidates in training are professionals in their mature years. In order to be admitted for training they have had to finish their professional requirements, which in psychiatry includes 3-4 years of residency training after the MD degree. Because of this and the economic solvency necessary to pay for the costly psychoanalytic training, these professionals are usually in their 30s and 40s with considerable experience as clinicians and psychotherapists. Despite their age and experience, most candidates in American institutes have had neither participation nor choice in the decisions concerning their training. Most institutes over the years dictated what these candidates should do from course work, when to begin a case, when to terminate analysis and if another analysis was needed, in secret evaluations of their performance. Candidates had no recourse to put into question the judgment of training analysts and education committees, while being in situations of great vulnerability: their most intimate thoughts, feelings and desires were known by their analysts while they had no similar access to their analysts’ difficulties. Similarly, they were not privy to the discussions that determined their fate. This infantilization of professionals in training and the increasing idolatry of Freud, the “father” of psychoanalysis, were features that conformed to a more and more pervasive pattern of patriarchal domination.
Fewer and fewer women became psychoanalytic trainees in the 1950s and 1960s because fewer women graduated from American medical schools. The proportion of women also diminished considerably because psychologists and social workers, professions in which women were found in greater numbers, were not allowed to enter psychoanalytic training institutes. Very few exceptions were accepted for admission, and that only under a “waiver” and the promise of restricting their practice to research. In addition, women were discouraged by the blatant male bias found in theories of female development and psychoanalytic practice which seemed to go hand in hand with other signs of the oppressive paternalism that began to govern every procedure and congress. Little attention was paid to the movements of liberation of the 1960s, the student movement, the civil rights movement and the women’s movement. The insularity that characterized psychoanalysis was further increased by the denial purported by most analysts about the importance and relevance to psychoanalysis of these social movements. A defensive indifference and a devaluing attitude characterized their view of the women’s movement’s quest for equality.
Feminists, in turn, were rabidly critical of psychoanalytic practice and theories and they deserted their ranks. The few who were sympathetic were co-opted in the male dominated institutes. Those women lost their voices and touch with their sisters since they had to maintain fidelity to their psychoanalytic groups which ostracized them unless they toed the line.
In this climate, a group from the American Psychological Association (GAP, Group for the Advancement of Psychoanalysis) sued the American Psychoanalytic Association in 1985 for restraint of trade and in 1989 won (APA Monitor 1988). Psychologists who qualified had to be admitted to these institutes associated with the IPA. Psychoanalysts of the APsaA could not be forbidden to teach and train psychologists. During these years, new psychoanalytic societies formed by psychologists began to appear in every state. One of them in Michigan, the Michigan Society for Psychoanalytic Psychology (MSPP), founded in 1980 and officially incorporated in January 1981, is the one wherein the women’s studies’ group that was instrumental in founding the new institute originated. Some of the most active members of MSPP, who had been instrumental in teaching, presenting papers and holding office, became interested in forming a training institute and certifying the members after a course of work and specialization, but others opposed them. After several surveys of the membership, which indicated the majority’s desire for this course of action, and considerable discussion to resolve the disagreement between the two groups, there was a split that culminated in the creation of the Michigan Psychoanalytic Council (MPC), a new psychoanalytic training institute. The group interested in creating a new institute tended to be more flexible, less dogmatic and with aims sympathetic to feminist strivings for equality. I had been impressed by their willingness to discuss openly with all members controversial matters appearing in the Executive Committee, to examine the historical record of the organization and to attempt an analysis of their own behavior, conduct that had been taboo in the history of organized psychoanalysis. The secrecy that has surrounded psychoanalytic practice, the inner workings of its organizations, and the conduct of its major leaders is often explained by the confidential nature of the practice. It really has more to do with the difficulty of their members to accept and correct error and imperfection in the theory or its leaders.
It was refreshing to find openness and flexibility in a psychoanalytic organization and it seemed quite natural that the women’s studies group would join in the endeavor (Tenbusch,1990).
The Patriarchal Family and Its Legitimate Successors
I will attempt an interpretation of the unconscious dynamic forces that may be at play in the psychologists’ psychoanalytic society (MSPP) and similarity of conflicts that later re-emerged in the feminist camp.
In a manner characteristic of groups without power, the few psychologists admitted to traditional institutes tended to feel grateful and special and to disassociate from their original group.  Those psychologists who had been waiting for acceptance in the traditional institutes, some of whom had attended courses or received supervision in the traditional institutes, were eager to be accepted in those institutes as “legitimate sons” in the “patriarchal nuclear family.”  I insinuate here that the struggle of the psychologists for entrance to the traditional institutes governed by MD psychoanalysts resembled  acceptance in the “legitimate” family of psychoanalysis. These professionals did not challenge the myth that MDs legitimately represented psychoanalysis; the psychologists, acting similarly to other subordinate groups, internalized the “inferiority” assigned to them by the ruling class.  With conscious or unconscious resentment, they tried to enter the sacred realm where the powerful reign.  They did not question systematically the reasons for their exclusion: they just wanted “a piece of the pie.”  Most of them did not conceive of organizing institutes of their own.
In Michigan, a different play was being enacted:  some of the psychologists who had received instruction and supervision by MDs, but were neither admitted to these Institutes nor certified (certification being the culmination of a formal course of training in those institutions), formed informal groups and remained outsiders.  They could not call themselves “psychoanalysts,” and presumably could not treat patients utilizing psychoanalysis.  They formed an “illegitimate family” outside the border.  They represented the “illegitimate children” who, as long as they do not question their shadowy status and the status quo’s tenets, continue to be convinced of their illegitimacy and inferiority. I would label this group “the illegitimates.” Some of these people had executive roles in the MSPP and had assumed responsibilities for teaching and disseminating knowledge in psychoanalysis. A similar group, also composed of psychologists as well as other professionals, differed from the former by its desire to create its own institute and introduce necessary changes in psychoanalytic training more in keeping with the radical assumptions of psychoanalysis (Karon 1989). This group began to be seen as defiant of the status quo and uninterested in accepting “illegitimate” status. I would label this group the “wayward sons and daughters” in consonance with the family metaphor I am utilizing for the psychodynamic understanding of the group conflict. Meisels (1989) has explicated the role of envy in this struggle between the two groups: “the illegitimates,” who are approved by the patriarchy as long as they remain unnamed and at the border, and the “waywards,” who have the gumption to reject the patriarchal order and their assigned second class status and form their own group. The major difference between these two groups is similar, I propose, to what separates feminists from male-identified women: a rejection of patriarchal values and power and a move toward a vision and a voice of their own. It was thus not difficult to conceive that the few feminists in MSPP would form an alliance with the defiant members.
The Feminist Position
Only feminists have questioned and analyzed the reasons for the dominance by men and the systematic exclusion of women from positions of power and knowledge. Despite feminist criticism of psychoanalysis, its tools of inquiry and conceptualization have been used by feminists precisely to understand and transcend their situation of inequality. (Witness these examples: Firestone believes that the original class distinction is between men and women and that the inequality is linked to men’s and women’s differing reproductive roles. Similarly, O’Brien sees patriarchy, the oldest system of domination as man’s compensation for and attempt to counteract the alienation of his reproductive consciousness. Rich believes that men are jealous and fearful of women’s reproductive powers and thereby attempt to control women’s sexuality and mother’s power by enforcing a system of mothering that is essentially in men’s control. In all these hypotheses, unconscious determinants are assumed to be of significance in the dominant behavior of men toward women.)
Just as the psychologists who were accepted in small numbers in the traditional institutes became supporters of the patriarchal order, women were similarly co-opted and silenced. When very few women are accepted to masculine inner circles and have special status conferred upon them, they often become ardent defenders of the status quo, of the control of men over women’s activity and they lose their identification and solidarity with women as a group. Thus, change is prevented although a minimal kind of integration is achieved.
In the particular male precinct of psychoanalysis in the US, a similar token integration occurred.  The need to preserve male and MD privilege led, however, to increasing deterioration: psychoanalysis began to lose prestige and stature because of the necessity to preserve territoriality, the inability to be deeply critical of its origins and practices and its practitioners’ unwillingness to examine their poor record in treatment outcomes. Women and psychologists as disenfranchised members became at this time the ones who could bring renewal by claiming psychoanalysis for themselves and rejecting dogmatic hegemony.
This is precisely what happened in Michigan. The psychologists challenged the leadership of MDs in the lawsuit they won, but they did not examine or change its patriarchal structures and its origins and therefore they were fated to repeat its discriminatory history. It would be unavoidable that another patriarchy would be set up, and this time psychologists would discriminate against the next in line, social workers who happen to be mostly women. The feminist women at MSPP who had been meeting regularly to study issues of women in psychoanalysis were able to contribute the needed feminist analysis. They were interested in the challenge of a new vision of psychoanalytic education which would include women and their ideas. They saw the opportunity to involved more women in psychoanalytic education and practice, but they also sought a deconstruction of the patriarchal order. The more radical psychologists and the feminists needed one another to support the new vision and to recruit new and disenfranchised members. The feminists demanded their share of leadership and required the institutionalization of a number of changes consonant with a more egalitarian and just order. Thus the alliance between feminists and defiant psychologists became potentially a very fruitful one, and in December 1989 the Michigan Psychoanalytic Council was officially born.
Instituting Change
The creation of a new educational institution was achieved in the first few months of the life of MPC in a collaborative spirit spearheaded by the feminist group. The differences with traditional institutes were meant to be dramatic and involve the evolution of principles of conduct, regulation and distribution of authority and power and a feminist integrated curriculum.
Some of the changes introduced increased critically the number of women active in the organization. Others were intended to live up to the radical nature of psychoanalysis (Karon 1989), to democratize the process and organization and to have it conform to more collaborative, egalitarian views of training and education.
Interdisciplinary Openness
It was accepted from the outset that all of the main mental health professionals would be eligible for membership and for analyst/faculty status. This would include social workers and psychiatric nurses in addition to psychologists and psychiatrists. The former had been denied access to traditional psychoanalytic institutes and they are still kept from training. Since the great majority of nurses and social workers are women, this prominently insures the presence of women in large numbers as faculty and trainees.
Sharing Power and Decision Making
Our next concern was to insure a critical percentage of women in power in the organization. Our bylaws mandate that women occupy half of the executive and board positions in the organization and that this ratio be maintained throughout in the composition of committees.
In addition, we institutionalized the participation of candidates in the board and the training committee so that they would have influence in the decisions concerning admission policies, curriculum and training issues. This attempt to involve candidates from the very beginning in crucial aspects of the training is intended to restore the responsiveness and mutuality of the training relationship (Cunningham 1990). In traditional institutes, candidates, though most are seasoned professionals, were subject to a very passive and conformist role, infantilizing them and denying them input in their own education.
Curriculum and Training Issues
The curriculum was to take precedence over other aspects of training. We wanted to innovate psychoanalytic education as had been envisioned (Meisels & Shapiro 1990) and to introduce and integrate feminist theories of development and of clinical practice. Feminist theories of women’s development are required courses. Teaching the views of male development from a feminist perspective have been included. Feminist critiques of Freud’s cases are incorporated in the curriculum. A clinical perspective conscious of the issue sof gender is to be taught, as well as contributions from other schools of psychoanalysis that have been considered deviant primarily because they have emphasized the male biases in traditional theories. Thus there are clinical seminars emphasizing feminist views of transference and countertransference as modified by the gender of the analyst and conscious of the most common gender biases encountered in analysts of both sexes (Bernardez 1978). The feminist curriculum would be required for certification since it meant to critique and transform the sexist aspects of the more classical curriculum.
Women’s Voices in Psychoanalysis
In addition to the required curriculum, a program of seminars, workshops and presentations by women who have contributed to psychoanalysis and who reflect in their theory and practice the missing aspects of theorizing from a woman-centered perspective, was instituted to disseminate and discuss feminist perspectives and the work of ignored women psychoanalytic pioneers.
But it did not seem sufficient to institute these changes if the organization would function like similar institutes, ruled in a hierarchical manner by small groups in power.
Abolishing the Training Analyst Position
In our institute any faculty analyst can analyze candidates. Our candidates can also be analyzed by analysts from other institutes with the approval of the training committee. This is distinctly difference from institutes belonging to the American Psychoanalytic Association where a “caste system” of training analysts, separated from the rest, have the power to analyze candidates and decide matters in the educational committees. In our opinion this situation has resulted in these analysts (with no demonstrable superiority over others) accumulating an unusual amount of power, having no checks and balances and dictating the fate of the careers of the candidates. This situation leads to self-serving aims and the development of “followers” with consequent negative influences in the analysis of candidates, who are not as free to disregard their own analyst’s positions, to criticize them and to differentiate from them. In our institute, the candidates choose their own analysts (rather than being assigned one); analysts do not participate in any way in decisions concerning the educational status or certification of their analysands.
Structuring participation of candidates in the decision making process was also felt to be fundamental, since their feedback and participation was deemed essential (most candidates are mature professionals with years of clinical practice). This is an unheard of practice in analytic institutes.
A Permanent Affirmative Action Committee
The Permanent Affirmative Action Committee originated by the feminist group which instituted and negotiated the changes in the structure of the organization, was institutionalized as a permanent committee shortly after the birth of the institute (Tenbusch 1990). Practically, the same members that constituted the Women’s Studies Group formed the first affirmative action group. Its functions were (1) maintaining awareness of the goals of affirmative action for women and minorities, (2) creating regulations and bylaws that would promote equality, and (3) preventing prejudicial behavior in the organization and its process. One of the first actions of the committee was to regulate the way in which potential candidates were to be discussed in the process of admission, emphasizing confidentiality, an attitude of respect in the presentation of personal data about the candidate, and strict guidelines about the information permitted to be shared in the discussion. Members had felt that rumors, unexamined evidence of difficulty and critical remarks that were vague or unsubstantiated were potentially harmful to the candidate and should not be allowed. This step was felt to be a part of a different way to conduct meetings, more in consonance with feminist concern with protecting groups with less power and encouraging an atmosphere of cooperation and respect for one another. Decisions regulating conduct were incorporated as position statements together with the bylaws, defining in this way the aims and the value system of the institution. The second position statement was on homosexuality. The committee felt that psychoanalytic institutes had discriminated against gay and lesbian professionals, not admitting them for training and holding to the traditional notion that homosexuality was a perversion and a disorder that required treatment, despite the lack of research evidence for this assumption. The committee wished to make public the acceptance of gay and lesbians to the MPC for training since the discrimination these members experienced in traditional institutes had been silent and not explicit.
These changes in curriculum, structure, hierarchy and process of operation defined, in our opinion, our institute as a “feminist” institute.
Reactions to Change: Repetition and Working Through
This institute is composed of women and men most of whom are not feminists. For most of the men the challenge is to allow women to share power, to discover other perspectives, to examine their own conduct and possible biases, to learn from women, and to give up attempts to do business in the old way.
For the women the task would be to introduce desired changes and teachings in the new place, to share work and power with men and challenge their old belief system with appropriate data and yet to tolerate differences of opinion even when it appears prejudicial. This would require women to stop perceiving the other as the enemy, to stop projecting their disabilities on men and to struggle to examine their own conduct when sharing power. It also puts to the test the capacity to remain creative and to continue to envision a feminist perspective, warding off the dangers of assimilation.
What happens to the women when integrated in a new organization in which they share power and responsibility with men? Which struggles are over and which ones are new? The problems that surfaced in the feminist camp after the “victory” of integration have important lessons for feminists in other institutions.
Women are not free of conflict themselves about their status as inferior or devalued practitioners.  Remnants of internalizations of inferiority persist despite success and external confirmation of their value, and they have to be systematically and persistently dealt with.  In our group, envy and strife occurred because some members of the groups felt less successful and with less credentials than others.  This led to an attempt by those members to “erase” those differences rather than value members for their particular contributions, and to silence people who had skills and knowledge they did not possess.
In an integrated society, women can no longer project their own difficulties on men, non-feminist women or other less than “ideal” members of our group.  In  our own situation, we saw the reproduction in our women’s group of the very conflicts that were found before among the two groups of MSPP, with the suspicion of lack of integrity, compassion and/or prejudice being assigned mainly to men.
In groups that have been segregated or kept peripheral to the mainstream, it is not unusual for their members to project some of their most negative traits onto the outsiders, maintaining coherence and purity in their own group.  The projected traits are very often a disliked and real characteristic of some of the dominant groups’ members, which makes the projections difficult to detect. In women, the aversion to aggressive and competitive behavior with which they are socialized, in addition to a wise dislike of arrogance, domination and hostility, make it doubly dangerous to admit to a trace of these traits in themselves.  Competition, arrogance and hostility were found in our group surrounding the issue of opening the group to a more democratic sharing of power.
These problems presented themselves in a different fashion in women’s groups because for the most part women are socialized with conflicts about the direct expression of anger (Bernardez, 1988), and competition and rivalries are neither syntonic with their self identity or with their feminist ideology.  In women’s groups (Bernardez, 1987) these conflicts come about in a more obscure manner but just as certainly as in the mixed groups.  In our own group, conflict over “who had ownership of the group” was hidden from view at first and led to  great discomfort in the members when it appeared explicit.  There was a definite split between what Bion calls the “basic assumption group” and “the work group,” the individuals defending an emotional position that was not in keeping with their presumed rational ideology.  What Gilligan found as the persistent myth in the idea of the perfect girl in her adolescent studies and what Chodorow and Contratto called the “phantasy of the perfect mother” surfaced as well in our feminist midst.  Women tried to hide their rivalries and desires for power because they were inconsistent with their fantasies of themselves as good and ideal feminists.  These prohibitions prevented women from addressing and understanding unpalatable aspects of ourselves that had been previously projected onto the men.  These difficulties were harder to deal with because a sizeable number of the members neither knew much about groups nor anticipated these conflicts as part of the process of “integration.”  
A feminist analysis is a great tool for those who want to expand and change psychoanalytic practice, but its very use requires us to be open and vulnerable.  To debunk patriarchal assumptions it is necessary to do it not only with men but with ourselves.  To continue examining ourselves and what we are doing, with the tools of psychoanalysis, with the guidance of feminist understanding and ethics is the challenge of the “post-integration” era.  To allow and nurture differences among feminist women in the more complex and more threatened context of integration is a difficult step, but the desire to transform the nature of educational institutions may fuel the effort.
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________. 1988. Women and Anger: Cultural Prohibitions and the Feminine Ideal. The Stone Center Papers #31.  Wellesley College.
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