Het initiatief van Han Groen-Prakken
Ton Stufkens beschreef in 2009 voor de IPA de ontwikkeling van het initiatief van Han Groen-Prakken, prominent lid en zowel oud-voorzitter van de NVPA als van de Europese Psychoanalytische Federatie (EPF), om in Nederland psychiaters en psychologen uit Oost-Europa op te leiden in de psychoanalyse.
Meer dan veertig collega's hebben zich gedurende tien jaar als docent ingezet om dat te realiseren. Dit heeft er mede toe bijgedragen dat er nu in de voormalige Sovjet-satelietstaten, waar de psychoanalyse onder het communisme verboden was, analytici werkzaam zijn en psychoanalytische verenigingen bestaan.
Zie ook: www.hgp-piee.org
A Retrospective of Ten Years (1999-2009) Amsterdam Psychoanalytic Training Programme for Eastern Europe
By Ton Stufkens
In 1999 Han Groen-Prakken began with three students/colleagues from former Mid- and East European countries a theoretical and technical training in her own consulting room. In the years prior to this, she had travelled widely in the satellite states of the former Soviet Union as part of her functions in the EPF and the IPA. There she had noticed not only the interest in psychoanalysis of many psychologists and psychiatrists, but also how much they longed for some form of systematic theoretical and clinical/technical psychoanalytic education. Moreover, she was convinced that the future of psychoanalysis could be in Eastern Europe. Therefore, she decided to do something about it. Soon after she started, she asked me to help her set up a sound curriculum and to implement it. Since then, the Amsterdam Programme was established, and over the years, dozens of Dutch analysts in various capacities contributed to this project and made it successful. Since naming only a few would neglect the importance of others and naming everyone is impossible, I refrain from mentioning names in this short personal report.
Han and I had to take into account all sorts of limitations. Ten years ago, many colleagues in those countries were very poor, and they could not afford the frequent travelling to Amsterdam, not even buying books, so everything had to be offered for free, and very regular seminars, comparable to the normal psychoanalytic training, were out of the question. We also had to reckon with the fact that an educational project of this type would impose a heavy burden on many Dutch analysts, who as teachers also had to travel to Amsterdam and to donate several hours of a free weekend without financial compensation. We concluded that the maximum attainable and most realistic intensity would be a course of a total of four years within each year four weekends, so we would have 16 long weekends. But the question was how to set up a curriculum in which we intended to communicate as much as possible of psychoanalysis in a 'pressure cooker format', addressing more 'classic' as well as 'modern' psychoanalytic views?
We designed a course which consisted of theoretical seminars, seminars on theories of psychoanalytic technique and practice, and clinical seminars. We divided the theoretical seminars in 'headings' and 'sections' and presented them in chronological order over the four years. Contents were history (of the psychoanalytic movement, of theory and practice), development (from infancy to adulthood in six sections), psychopathology (in ten sections), theoretical models (schools, frames of reference, new developments), and a heading called topics such as shame and guilt, on dreams and dreaming, similarities and differences between psychoanalysis and psychotherapy and so on (five sections). In addition to these seminars, in each weekend, there were seminars on technique, such as, Freuds' technique papers, aspects of the analytic relationship, on intervening, on beginning and ending the treatment (in nine sections). Furthermore, in each weekend, we planned two clinical seminars with presentations and discussions of analysands who were treated by the participants.
After their arrival in Amsterdam on Friday, a weekend usually began for many of the students with a visit to a supervisor. Both Saturday and Sunday were used for the classroom seminars, each day from 9:30 till 17:30. Most of them returned home on Sunday evening or Monday. In every weekend, we had a total of 9½ hours of theoretical seminars and 2½ hours of clinical/technical seminars. The students were required to have completed 20 hours of studying the relevant literature before each weekend. This literature was not available to the participants in their own countries, which meant that we had to send them in advance photocopies of the compulsory reading. Initially, the literature was sent from the library of the Dutch Institute, however, due to all sorts of difficulties with the mail on the East European side, we decided to ship it from an East European country. Since then, it was sent from Lithuania. The literature list covers 16 pages and was updated regularly.
Management & administration
It is understandable that a venture of this size required a lot of organising. We had to raise interest in qualified colleagues willing to offer part of some of their weekends to teach, and we found them in the two Dutch (IPA component) societies, the Dutch Psychoanalytic Society (NVPA) and the Dutch Psychoanalytic Association (NPG). A total of about forty Dutch analysts participated over these ten years as teachers in this project. Besides Han and me, there were some five training analysts leading most of the clinical seminars in addition to their teaching activities in the theoretical seminars.
We also had to find funding for all of the extra activities, a location for this project, and facilities like a porter and food and drinks during the day. The Dutch Psychoanalytic Institute made the building and services available to us during these four weekends a year. Some colleagues donated money, the Dutch Psychoanalytic Funds and the Psychoanalytic Symposium Utrecht provided necessary and substantial financial help.
In order not to overburden the participants with expenses for a hotel, we asked colleagues living in Amsterdam to offer lodging during these weekends in their houses on a bed and breakfast basis. Many of the Eastern European candidates have made use of this, and usually, they were welcomed with much more than B&B, many of them having developed very friendly relationships with their hosts. Some jokingly called themselves 'foster parents' for the students, who sometimes felt so far away from home, family and 'normal life' in a relatively wealthy Western city. Gradually, they began to feel at home with us.
Another topic was the question of control cases and supervision, and the arrangement of the so-called shuttle analyses. Committing themselves to a four year course and travelling four times a year to Amsterdam meant that some of the candidates wished to have their shuttle analysis in our country and for a few this could be realised. It was agreed that all participants were allowed to start a control case after the first theoretical/technical year. For these control cases, we offered a sort of 'second opinion' screening panel that advised on the possibility of beginning an analysis with a particular patient, and subsequently, we tried to find a Dutch supervisor when the student wished so. The fee for a supervision hour was equal to the amount the candidate received for one hour with his or her patient, usually a very modest amount. This facility of carefully examining a proposed patient in addition to the opinion of a supervisor and sometimes as a help in the assessment procedure with a patient already in psychotherapy with the candidate, was accepted and appreciated in many cases, and was for most of them a great support in dealing with a prospective analysand. With Dutch supervisors, there were face-to-face meetings at least four times a year, and the weekly or fortnighly contacts in between these sessions usually took place by email, phone or later Skype.
Development of the organisation
Although interest among Eastern European future colleagues in participating in the Amsterdam Psychoanalytic Training Programme was high enough to have been able to start a class every year, this would have been unrealistic and beyond our capacities. We decided to start every other year with a new group. The initial class of three was followed by a class of six in 2001, and in both 2003 and 2005 we had twelve candidates in every year. It is important to realise that with each course running for four years, we had overlapping classes in each weekend. For some years 9, then 18, and between 2005 and 2007 24 people visited Amsterdam in one weekend.
Two events had a significant impact on this project. The first one is the birth of the international Psychoanalytic Institute for Eastern Europe in 2002, namend after Han (HGP-PIEE). As is known, many educational and teaching activities in Eastern Europe were organised by others before 1999. These focused on psychotherapy or psychoanalysis, and were either incidental or on a more continuing base. The Amsterdam project in principle was based on a personal initiative and was, in the wider sense, a Dutch offer to the Mid-and Eastern European colleagues to help them and to promote psychoanalysis in those countries. We selected the candidates for this programme, and we especially screened for people who in their own countries had acquired academic qualifications, showed a sincere interest in psychoanalysis and were determined to become analysts. There also had to be proof of a good-enough knowledge and use of the English language since the whole programme was taught in English.
What has changed for our Amsterdam project with the (IPA-EPF-) creation of the Psychoanalytic Institute for Eastern Europe? We agreed to cooperate and arranged that, from then on, only candidates selected by PIEE could be students on our course. Supervision and the reporting by supervisors would be a PIEE task, and reporting had to be directed to the associate director of the PIEE training section. We still offered the possibility of being supervised by Dutch analysts, but it was clear that the supervisors' reporting had to be to the PIEE. As from 2002, the Amsterdam Programme was still a relatively autonomous but no longer 'private' enterprise, and had its place under the umbrella of the HGP-PIEE, which also resulted in an increased amount of applications and participants.
The other major event was the death of Han Groen-Prakken in 2003, which was a great personal loss to many. The Amsterdam Programme lost its founder and - when she was still healthy - hardworking 'Chair of Training' (Many East Europeans could not cope with the absence of 'titles' and functions in the organisation and on their request we decided that she would be the 'Chair of Training' and I the 'Director of Programme'). Due to the enormous load of work at that moment and also ahead of us, after her death, I asked three colleagues to participate in the management work. One became responsible for contacting teachers and preparing the schedules for each weekend, another communicated with supervisors, and the third arranged lodging in Amsterdam. This group now formed the new 'Training Committee' of this project and from 2004 until recently, we periodically discussed all of the relevant matters, like I had done previously with Han.
Results and other relevant topics
In these ten years, 33 candidates from 9 different countries graduated, almost half of them from the Baltic states: 2 from Estonia, 6 from Latvia, and 8 from Lithuania. From Croatia and Bulgaria participated each 5, from Russia 4, and from Ukraine, Slovenia and Kazakhstan each 1 colleague. Of these 33, 21 were female and 12 male.
In addition to the organisation connected with the curriculum, there were a lot of activities and frequent contacts with the candidates in between the scheduled weekends. This work varied from requests for advise in personal matters to writing letters to Dutch Embassies abroad and the Ministry of Foreign Affairs asking for visas. A huge amount of books and journals, donated by colleagues in the USA and by Dutch analysts, were shipped to Eastern Europe. Handling the complex formalities connected with this and contacting ignorant customs in a changing EU area usually does not belong to an analyst's work. Activities also included writing regular reports for the bulletins of the Dutch societies, and completing paperwork regarding the organisation of special social events. Every two years, we celebrated the arrival of new candidates, and we handed out certificates to each participant who finished the course. These were the eventful and moving 'Welcome and Graduation Parties' with speeches, presents, food and drinks, attended also by some fifty to sixty Dutch analysts. These gatherings had an atmosphere that nobody who took part in it will easily forget. After Han's death, a Memorial meeting was organised, in which not only the East European candidates, but also the Board of PIEE and many Dutch colleagues participated. The end of the Amsterdam Programme was marked by the so-called Goodbye Conference with the title 'Inner Freedom', held in May 2009 in the Beurs van Berlage, a historical building in the center of the city. In the morning and afternoon sessions, ten (former) participants of the Amsterdam Programme presented their papers, in the evening during dinner we had our last 'graduation party' and the weekend closed with an excursion on our last common Sunday.
The Dutch Society has offered to our students a 'corresponding membership' of the society after they had received IPA direct membership. They were asked to deliver a paper at a scientific meeting, as is usual for every new member. Two participants have made use of this opportunity and presented themselves to the members.
It is incredible how much has changed in the socio-economic/political arena in Europe over the past ten years. This is not the place to discuss it, but it is quite understandable that these developments have affected our candidates in one way or another, and we were privileged to witness these changes. We have been fortunate to be able to do something for our East European colleagues, and we expect that they, with the expertise gained from the Amsterdam Programme, will use this experience in developing and shaping educational programmes in their own countries in the future. These candidates made great sacrifices for participating in our project and offered to us their dedication and sincere committment, friendliness and warm personal contact, and also some insight into their personal situation, histories and backgrounds. We look back to a very rewarding project and an unforgettable time that has certainly on many levels enriched everyone who was involved in it.
Dr A. Stufkens is psychoanalyticus en opleider bij de Nederlandse Vereniging voor Psychoanalyse, het Nederlands Psychoanalytische Genootschap en de Nederlandse Vereniging voor Psychoanalytische Psychotherapie.