1961Historical Perspectives in the Selection of Candidates for Psychoanalytic

Training. Psychoanalytic Quarterly, 30:481-496

Historical Perspectives in the Selection of Candidates for Psychoanalytic
Training
George H. Pollock, M.D.
I
This review presents the genetic developments that have occurred in the
selection of candidates for psychoanalytic training and surveys the various
papers that have dealt with the criteria for selection of applicants.
Prior to World War II, psychoanalytic training to a large extent was self-selected
by the future trainees, following the voluntary tradition present since the start of
the psychoanalytic movement. It was available to any qualified person.
Immediately following World War II, the number of individuals applying for
psychoanalytic training increased greatly, a trend that has continued to the
present time. The overwhelming training needs of American psychoanalytic
students just following the war were more easily met because of the migration
of European analysts to the United States.
With the expansion of psychoanalytic training and better organization in
teaching institutions, various problems arose which necessitated alterations in
policy and procedure. Some of these changes have been instituted and some
are still in various stages of resolution or discussion. Knight called attention to
this situation in a paper in 1952 (31). Furthermore, present currents in
psychoanalytic training and in other educational fields have brought
reconsiderations and investigations of goals, teaching techniques, and of the
problem of talent identification. All of these involve the question of selection.

In 1954 Gitelson wrote that 'our candidates, as we find them, are the future of
psychoanalysis. We cannot side-step our responsibility for trying to insure that
future' (22). Knight noted that in the twenties and thirties there was 'less
emphasis on selection procedures and many analysts were trained who might
today be rejected' (31). This statement directs us to another critical issue,
namely, the possible elimination of talented individuals who might otherwise
have made significant contributions had they been selected. However, errors in
judgment are unavoidable, and the systematic study of such mistakes can lead
to worthwhile insights and, hopefully, rectification in the future. In 1936, Jones
said: 'In London, where I interview every applicant for training, … the selection
of candidates could well be stricter, since a smaller number of suitable analysts
would be more effective as a body than a large number of less satisfactory
ones' (29). However, Jones did not indicate what he considered 'suitable' or
'less satisfactory'. In 1954, Lampl-de Groot, commenting on the postwar influx
of requests for training at the Dutch Institute, stated: 'For the sake of
psychoanalysis as a science and as a therapy, as well as for that of the student
himself, we prefer to reject an applicant rather than educate an inefficient
person. A small group of efficient workers is more valuable than a large group
of mediocre members' (32).
Some would disagree with these two psychoanalytic pioneers, and the issue of
higher academic learning in principle available to everyone versus elite training
is now actively debated in all educational circles. The main trend is in the
direction of the more rigorous selection of trainees. As our educational
programs become more intensive and complex, even greater emphasis will be
placed on finding suitable applicants as advanced training is too costly in terms
of time and money to be wasted on unqualified individuals. However, careful
study of rejectees and training failures will be essential lest we too dogmatically
follow a rigid philosophy. But before this investigation can be carried out, a
program of selection must be initiated and selection research developed and
implemented.
II
The first reference to psychoanalytic training per se was made by Freud in
1914. He stated: 'From the year 1902 onwards, a number of young doctors
gathered round me with the express intention of learning, practicing, and
spreading the knowledge of psychoanalysis. The stimulus came from a
colleague who had himself experienced the beneficial effects of analytic
therapy. Regular meetings took place on certain evenings at my house,
discussions were held according to certain rules, and the participants
endeavored to find their bearings in this new and strange field of research and
to interest others in it. One day a young man who had passed through a
technical training college introduced himself with a manuscript which showed
very unusual comprehension. We persuaded him to go through the
Gymnasium [secondary school] and the University and to devote himself to the
nonmedical side of psychoanalysis. The little society acquired in him a zealous
and dependable secretary, and I gained in Otto Rank a most loyal helper and
coworker' (19). We see here not only the earliest precursor of the later
psychoanalytic training institute, but the first recruitment activity. Unfortunately,
we do not know what initial qualities in Rank evoked the encouragement to
complete his education; however, a selection process was at work here.
The first training analysis was conducted by Freud in 1907 and 1909. Max
Eitingon was the analysand. This analysis was conducted over a period of
several weeks, and occurred when the analyst and analysand took long walks
in Vienna (30, Vol. II). Freud wrote Ferenczi on October 22, 1909: 'Eitingon is
here. Twice weekly, after dinner, he comes with me for a walk and has his
analysis during it.' On November 10, 1909, Freud wrote again: 'Eitingon, who
has fetched me twice weekly for an evening walk during which he has had his
analysis, is coming for the last time next Friday; he intends to settle for a year in
Berlin'. Perhaps this work with Eitingon, as well as his own self-analysis, led to
Freud's statements in 1910 that unresolved difficulties in the analyst could lead
to deterrents in analytic work with patients (20). In 1912, Freud recommended
that 'everyone who wishes to carry out analyses on other people shall first
himself undergo an analysis by someone with expert knowledge' (21). In 1914
and in 1916, Ferenczi spent several weeks in Vienna being analyzed by Freud.

Balint writes that 'the foundations of our present training system were laid at the
Budapest Congress, 1918, where three important events took place. The most
important one was Freud's warning that the time had come when analysis must
prepare for the coming demand of psychotherapy for the masses both in its
technique and in its training. The second event was that Anton von Freund,
perhaps the most lovable man in the early history of psychoanalysis,
immediately offered to put at the service of Freud's idea a considerable sum
(thirty to forty thousand pounds) and to organize an institute for: (a) mass
psychotherapy; (b) psychoanalytic training; and (c) analytic research. The third
event was Nunberg's remark in a private discussion, often quoted by Eitingon in
his reports, that no one should henceforth be allowed to analyze who himself
had not been analyzed previously' (8). Because of von Freund's financial
adversities, a change in plans was necessitated and Eitingon's generosity then
made it possible to establish the first training institute, the Berlin Policlinic and
Institute, in 1920. In 1922, the Vienna Ambulatorium was opened (30, Vol. III).
Hanns Sachs became the first training analyst at the Berlin Institute, and Franz
Alexander the first student (1).
Psychoanalytic training in the United States was started in the fall of 1922 in
New York. The educational activities consisted of lectures and courses
'modeled after the series initiated in Vienna in 1921-1922 for the New Yorkers
studying there' (36). In 1923, the first small Education Committee to direct
training was appointed. The New York Psychoanalytic Society and the
American Psychoanalytic Association had been organized in 1911. In 1919, the
first American, Dr. Adolph Stern, visited Vienna for a didactic analysis. In 1922,
the first didactic analysis for physicians wishing to become analysts was begun
in New York. The first 'comprehensive' Education Committee was appointed by
the New York Psychoanalytic Society in 1927, and in 1929, 'didactic analysis,
over a regulated period by an officially recognized senior' became a prerequisite
for admission to the New York Society. Even prior to that time, however,
personal analysis was almost obligatory for professional recognition. Oberndorf
stated that 'the student [prospective analyst] made arrangements for such an
analysis with an analyst of his choice, and before long certain men who had
acquired a reputation for leniency and speed of their analyses were apt to be
sought by candidates looking for an easy way of meeting a still unofficial
requirement' (36). The New York Psychoanalytic Institute was established in
1931, and a year later the Chicago Institute was founded.

Minimal Standards for the Training of Physicians in Psychoanalysis appeared in

the first volume of the Bulletin of the American Psychoanalytic Association (3).
The minimal requirements for the admission of students into training included
previous medical and psychiatric training and personality qualifications: 'an
applicant must satisfy the local training authority of the organization to which he
has applied as to the maturity of his personality, the integrity of his character,
and his aptitude for psychological work'.
In 1939, the Council on Professional Training discussed the basic methods
used by the various institutes of the American Psychoanalytic Association for
the selection of candidates for training. David Levy made specific
recommendations for selection procedures which included direct contact
(personal conversations) between the Admissions Committee and the sources
of personal recommendation, psychological tests including the Rorschach, and
the use of a special psychiatric anamnesis to elicit further data on potential
neurotic difficulties in the candidate. Levy felt that too many emotionally
unstable, neurotically driven, intellectually or scientifically limited candidates
were finding their way into psychoanalytic institutes and were managing to
complete their training, graduate, and become members of the societies. 'He
felt that, either in the process of selection of students or in the subsequent
processes by which they are weeded out in the course of training, more rigid
and objective methods were urgently required in order to overcome the
optimism and leniency of our teaching staffs. He felt that sympathy with the
candidate seemed too often to dominate the ultimate decision of those
entrusted with this responsibility' (4).

Helene Deutsch supported Levy's general thesis and suggested that training be
divided into two parts, with the introduction of some system of examination
which might safeguard 'against the filtering through of inadequately trained or
inadequately gifted students'. French suggested that this 'weeding out' of the
'unfit' occur ahead of time in order to spare the student additional trauma.
Kaufman felt that the selection of proper instructors (training analysts) was
essential, as 'no changes in method would work if the instructors themselves
were not more exacting in their demands upon themselves and upon their
students'. Rado stated that the problem of selection would become an ever-
increasingly important one as each institute grew; he noted that in New York
there were thirty-five candidates in training and fifteen applicants. Kubie
indicated that the selection of students was a problem 'not peculiar to
psychoanalysis'. In order to save time, expensive training, and for 'the sake of
analysis itself', he urged that more clearly and sharply defined methods of
selection be evolved; he suggested that institutes adopt a definite academic
year with application deadlines and an annual selection. Blitzsten felt that 'a
long preliminary psychiatric interview was of greater assistance than anything
else in weeding out unfit applicants'. Alexander suggested that a round table
symposium be held to discuss the entire problem (4).
A Round Table on Problems of Training took place in 1940. Levy described the
selection method utilized at the New York Psychoanalytic Institute, which
included academic evaluation, personal recommendations, personal interviews
with members of the Education Committee, and preparatory analysis. He
discussed the limitations of the personal interview and advocated the use of the
Rorschach test; he 'defended the type of personality that is healthy but not
stereotyped as making the most promising student' (7, pp. 25-26).

These two meetings are the earliest published reports of the deliberations
involving selection problems. The emphasis was on detecting negative,
disqualifying characteristics, as well as on procedures to be used in this task.
The issues of twenty years ago resemble in many ways those with which we still
wrestle today.
In 1946, a Conference on Postwar Problems of Psychoanalytic Training took
place (26). The discussion centered around the 'extraordinary and
unprecedented problem of psychoanalytic training' due to the very large number
of physicians who desired such training and the paucity of available and well-
qualified training analysts and instructors. The wish to maintain and strengthen
prewar standards was paramount, and with this aim in mind about thirty
conference members and guests worked for two days. The question of
selection of candidates figured prominently in the deliberations. Knight's study
of techniques of selection and Lewin's suggestion that the 'actual past
experience of training analysts' be used in a postdictive fashion in evaluating
candidates were among the reports. Warburg presented a statistical study of
applicants of the New York Institute, including a discussion of rejected
applicants. The Knight survey was used in the subsequent study conducted by
Holt and Luborsky at the Menninger School of Psychiatry.
In 1948, a panel on Problems of Psychoanalytic Training discussed the question
of student selection again. It was stated that 'we do not know how well or how
badly our present methods of selection function', and that there 'is no way' of
checking fully the results of the selection procedures. Discussing the goals of
selection, the conference members emphasized that the aim was not merely to
reject the unfit but to select those with special aptitudes. This involved
questions regarding the task and role of the selectors, as well as studies on the
applicants. The very high cost of selection per applicant was highlighted. The
panel proposed that a study of selection procedures be undertaken including
comparative evaluations of different procedures, institutes, and validation
investigations. For later checking, they suggested that the interview
impressions be 'rated' and recorded (35).

In 1950, Ekstein discussed trial analysis as an aid in the selection of candidates

for psychoanalytic training. He suggested that this experimental period allowed
both analysand and analyst to come to a decision about analyzability and
suitability for training, and permitted the applicant to explore his motivations for
wishing to become an analyst (12). Frank raised a question about the
usefulness of the trial period as an evaluative procedure in candidate selection;
he implied that the analysis should not be burdened by this potentially
resistance-provoking encumbrance (17). The role of the training analyst in the
training decision is still much debated today. Everyone would agree, however,
that the results from the training analysis can substantiate or refute the decision
arrived at when the initial selection was made.
In 1953, a symposium on Problems of Psychoanalytic Training was held at the
International Psychoanalytic Congress, Papers by the participants were
published in 1954 (9), (10), (22), (25), (32). Also in 1953, the American
Psychoanalytic Association presented a panel on Selection of Psychoanalysts.
In their paper, Holt and Luborsky emphasized comparative instruments of
selection, focusing on the interview, reports of past performance in clinical work,
and psychological tests. They discussed the questions of criteria used by the
'selector' concerning 'the position applied for', and the conscious awareness
during an interview with an applicant of whether or not the necessary essentials
were present or could be developed in the future (27). An unpublished paper
presented at the 1953 panel was Henriette Klein's report of the initial systematic
research on psychoanalytic selection then getting underway at the Columbia
University Clinic (11). Ekstein discussed the history of psychoanalytic training
as well as the selection of students, and referred to the 'capacity for training'
(13).

In 1956, the American Psychoanalytic Association published the current Minimal

Standards for the Training of Physicians in Psychoanalysis (6). In a section
dealing with suitability for training, it is stated: 'The applicant must establish
evidence of integrity of character, maturity of personality, and suitability for
training. Adequate capacity for training will be determined through interviews
with members of the faculty, supplemented by such additional studies and
examinations as are deemed necessary.' Except that it includes the interview
as a specific assessment instrument, the statement is similar to the 1938
statement quoted above.
In 1956, the Report of the Survey Steering Committee to the Board on
Professional Standards appeared (5). The Preliminary Commission on Faculty
reported on Special Problems in the Selection of Students and discussed the
'normal' applicant and his difficulties in training as well as the use of the physical
examination as part of the application procedure. The Commission on Students
raised questions about the 'goals of selection', the qualities which tend to make
a good analyst, and the techniques that could best be utilized to get the
information that was needed for selection. In Psychoanalytic Education in the
United States, Lewin and Ross summarily discuss the goals, principles,
procedures, and instruments utilized in the various psychoanalytic training
centers, and the research projects on selection of candidates at the Chicago,
Columbia, New York, and San Francisco institutes (33). In a recent paper,
Eisendorfer briefly discusses his observations over a ten-year period of
continuous membership in the Committee for Admissions at the New York
Psychoanalytic Institute, and presents his picture of the acceptable candidate
together with the personality traits and characteristics he has found important
(14).
In this historical review of the selection problem, it is appropriate to present the
findings of the first information sheet of the American Psychoanalytic
Association Consultation Service on Psychoanalytic Education (2), which
concerns itself with the number and disposition of applications for training for
the year September 1, 1958 through August 31, 1959. In this period 378
individuals applied to the eighteen institutes and training centers. Of this group
151 (40 per cent) were accepted; 167 (44 per cent) were rejected; 46 (12 per
cent) were held over; and 14 (4 per cent) withdrew. It is obvious that selection
was an essential process in operation here.

III
In Personality Patterns of Psychiatrists, Holt and Luborsky have described and
discussed qualities attributed to psychoanalysts and desired in applicants for
psychoanalytic training. They have also presented a summary of expert opinion
on the making of a psychotherapist or psychoanalyst, grouping the latter into
five categories: 1, the issue of trainability and innate capacities that cannot be
learned; 2, abilities and capacities; 3, attitudes, interests, and values; 4, motives
for training, desirable and undesirable; and 5, life experiences and
achievements (28).
The question of criteria for successful performance is an old one. Plato was
aware of it when he stated in The Republic that 'the most skilful physicians are
those who, from their youth upwards, have combined with the knowledge of
their art the greatest experience of disease; they had better not be robust in
health and should themselves have suffered from all kinds of illnesses'. The
problems in the analysis of the 'normal' candidate have been discussed by
various authors (22), (25), as have the more overtly serious psychiatric
disorders in candidates. Heimann feels that the depressive reaction type is
more suitable than the manic or schizoid reaction type (25). Bibring, on the
other hand, states that the 'selection of candidates is bound to lead to the
prevalence of character analysis' (10). Fliess notes that 'our educational recipe
directs us to select a physician with mental health, psychiatric training, and
psychological aptitude'; however he feels the psychological aptitude should be a
prerequisite for training instead of expecting it to result from training (16).
Thus one can see that various factors have been emphasized in the 'what to
look for' category. Some authorities focus on pathology or normality, others on
innate traits, still others on various ego activities and defenses. Some are
concerned with the contradictory components to candidacy in psychoanalytic
training, others with positive criteria for selection. One must ask why to each of
the listings. How does this relate to the job for which this person is seeking
training? Fleming discussed this aspect of the selection process more fully in a
recent presentation (15).
Freud remarked on characteristics and attributes of psychoanalysis in several
papers. In some he discussed criteria of analyzability for any patient.
Obviously a potential candidate would have to be analyzable, so that this would
be of prime consideration. In Analysis Terminable and Interminable, Freud
further indicates that the analyst—not the potential student—must have a
'comparatively high degree of psychical normality and correct adjustment… He
must be in a superior position in some sense if he is to serve as a model for his
patient in certain analytic situations and, in others, to act as his teacher. Finally,
we must not forget that the relationship between analyst and patient is based on
a love of truth, that is, on the acknowledgment of reality, and that it precludes
any kind of sham or deception' (18). As noted above, these characteristics are
necessary ingredients for the analyst. At selection one must ask whether they
are present and identifiable or whether behavioral clues are present which
indicate their potential appearance or development.
In 1930, Ella Sharpe discussed essential qualifications for the acquisition of
psychoanalytic technique, and listed academic, cultural, and personal criteria
(38). In 1947, in a paper entitled The Psychoanalyst, she discussed what the
analyst does and how this is related to the necessary qualifications (39). Also in
1947 appeared the posthumous report of Hanns Sachs in which he discussed
requirements to be fulfilled by any therapist or professional person, specific and
unique qualifications for psychoanalytic work, and the consideration of negative
as well as positive traits. He emphasized that pathology of itself is not a
disqualification, and that the main question is how adaptation occurred in the
face of the existing pathology (37).

In 1948, Balint wrote that 'candidates are picked material; severe neurotics and
unstable characters, i.e., bad risks, are rejected at the beginning; good
intelligence and some success in life, and a measure of good social adjustment
are conditions of acceptance' (8). Gitelson, in the same year, followed Sachs
and wrote that 'what the person had made of himself despite his neurosis' would
be important. Gitelson looked for evidence of creativity, effective energy,
emotional flexibility and resonance, interpersonal interest and empathy, native
shrewdness, wisdom, and intellectual powers as having prognostic implications
(23). Grotjahn, in 1949, described the ability to identify as one prerequisite for
psychoanalytic work. He wrote that in the preliminary interviews information is
sought which will allow evaluation of the strength, degree, quality, and level of
integration of the applicant's identification with idealized figures of the past. He
felt that 'a favorable qualification in a candidate is his capability of temporary,
flexible, so-to-speak token identification with his patients. The analyst should
be capable of withdrawing this identification when its purpose of understanding
is accomplished' (24). In his paper Grotjahn tried to illustrate what he looks for
in order to assess the particular ability he feels so essential in the work of an
analyst.
The vocational choice of psychoanalysis may have various unconscious
determinants and they may be the most significant motives for this career
decision. Marmor has attempted to delineate a few of the motivational and
characterological components in his paper dealing with the feeling of superiority
as an occupational hazard in the psychotherapist. He feels that potential
therapists are initially attracted to this type of work because: 1, it is an attempt
to solve inner personal psychic conflicts; 2, it is a way of gaining prestige
professionally; 3, it provides an opportunity to 'mother' or 'father' other people;
4, it allows the sublimated gratification of strong curiosity about the private
affairs of other people; or 5, it can permit the constant exercise of authority
which may stem from unrealistic feelings of superiority (34). Wheelis has
specifically addressed himself to the problem of the vocational hazards of
psychoanalysts. He too discusses motivation for doing psychoanalytic work
and notes that vocational choice 'proves successful when the vocation makes
possible a partial sublimated discharge of the impulses and a corresponding
reduction in the warding-off activities of the ego'. He feels that the inner conflict
which propels the prospective applicant toward psychoanalysis must be
assessed by those in charge of training. Wheelis comments on the central
significance the problem of intimacy may have for some as a principal
determinant of the vocational choice of psychoanalysis. The conflict, as he
sees it, is between the tendencies that lead to closeness and the defenses that
may be evoked by closeness—aloofness, detachment, isolation. If this difficulty
is not resolved, the problem of intimacy may be aggravated by the lifework that
was meant to solve it. The analyst can then withdraw into his isolated position
and so insulate himself (40). Our selection techniques in the future may have to
focus more on this crucial area of motivation for vocation. External and reality
factors can be easily ascertained; more latent aspects require skilful selection
procedures.

IV
This survey has attempted to trace the history of selection as an issue and as a
procedure-process from the early days of psychoanalysis until the present time.
There were four periods in this development. In the first, preselection era,
training was the personal decision of the student. Impressionistic statements
about what was required in the future analyst were scattered in the literature. In
the second stage, selection was more specifically considered and various
problems were more clearly delineated. Although analyzability was the major
requirement of selection at this time, as it still is, the criteria were vague and
indefinite. The formulations presented were gross and broad, and were in the
nature of general yardsticks rather than specific measures. In the third, recent
postwar period selection became a pressing issue because of the large influx of
people desiring training as compared with the smaller number of qualified
analytic teachers. The necessity to develop standards and criteria was evident
and stimulated our present development. Before that time much empirical and
experiential information had been collected but was not available, refined, or
operational. The Survey (33), one hopes, will initiate an era of the scientific
study of selection. Many investigations are either already in progress or will be
undertaken shortly. The future will decide their validity.
Having considered what we already know or intuitively feel, we must attempt to
make conscious and to systematize our current knowledge. Once this has been
done, certain questions will arise. To answer them we may need more detailed
investigations of the unconscious as well as the conscious motivations for
psychoanalytic training and practice; of the differences between training
analyses and therapeutic analyses; of the varying local and national standards,
procedures, philosophies of selection, training and professional affiliations and
responsibilities, and of the requirements other than analyzability that we require
of our students. As we consciously address ourselves to these issues,
methodological matters—the collecting of information, means of checking
reliability and validity of data, and the consequent elucidation of the initial
criteria utilized—will require clarification.
The papers mentioned in the last section of this report, dealing with
qualifications, criteria, attributes, negative and positive traits and characteristics,
and motivational factors, may serve as starting points for the definition and
formulation of future studies. Selection problems have existed since the time of
individual and group choices and preferences. Further investigation of this very
essential process of selection will uncover new, still unrecognized dimensions,
and will add to our already existing knowledge.
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