If you can look into the seeds of time, and say which grain will grow and which will not,
speak then to me, who neither beg nor fear your favours nor your hate.
(Shakespeare, Macbeth, I. iii)
Shakespeare, in his famous quote, clearly speaks to our universal quest to be able to predict our future. The author proposes an approach to the assessment of analytic applicants that hopefully will help us look into the “seeds” of our analytic applicants, and know “which will grow and which will not”. The protocol relies on the central notion that knowing what com- petencies we would be expecting of well-functioning analysts guides us in knowing what capacities, and potential capacities, we would be looking for in our aspiring applicants. It is hoped that the described protocol will be shown to have distinct advantages as an assessment tool over the traditional one, in that that it has clear, consistent, and comprehensive criteria, as well as a workable methodology.
The author is aware that we, as yet, have very little research evidence that proves that a protocol, such as the one described, is any more effective in its predictive capacity than the more intuitive assessments traditionally done by senior experienced analysts. The author’s aim is in this paper is to describe a comprehensive, clear and repeatable assessment method. The next logical step would be to research its effectiveness in comparison to other assessment methods. The author hopes that, if this protocol is found to be useful, that it could provide a consistent basis for such research.
Although the author fully endorses the strivings and quest for further understanding and research into how we could improve our predictable capacities, he is also mindful of how the complexities of our human nature and interactions might always reveal our fallibility in being able to make predictions. Freud understood this, and cautions our quest in relying too much on our predictive capacities, and calls for ongoing assessment: “We cannot judge . . . the candidate who comes for training till we have studied him analytically for a few weeks or months”. He cautioned that we could land up as “the sufferers” (Freud, 1933, p. 155).
Kernberg (2000), years later, expresses similar concerns regarding the lim- itations of our predictive capacities. He warns of our committing “institu- tional suicide”, by rejecting the more “unusual and eccentric candidate”. Here he echoes Freud’s concern regarding our being the “sufferers” in the end, when he talks of “institutional masochism”. He is equally concerned that we may select someone whose severe psychopathology may only be unmasked later on. He argues rather for: “ongoing selection by means of appropriate feedback” (Kernberg, 2000, p. 110).
The author does not believe that the ideas of initial evaluation and ongo- ing assessment need be mutually exclusive. The model proposed, because it is based on the criteria for candidate competence, allows for an easy transi- tion from initial assessment of analytic potential to ongoing evaluation of developing competence. This means that, where there is doubt, the progress and development of specific competences of a candidate that are of concern can be tracked and worked on, in an ongoing way “in the field”. The author proposes that the initial year of infant observation makes for an ideal context in which to make further ongoing direct observations of the new candidate’s potential/capacity for further development, as many impor- tant analytic abilities (to be described below) become manifest in this situa- tion.1
In other words, what was initially an assessment tool for candidate selec- tion is transformed into a framework for an ongoing assessment and devel- opment of the candidate. It is hoped that the training committee, by picking up concerns, during the infant observation, that may not have been apparent at the point of assessment, will be better placed to support the new candidate in their growth and development. The author proposes that an ongoing focus on these difficulties might go some way in reducing the need to terminate the candidate’s training, once they have started.
1The capacities that the infant observation process highlights are: free-floating symbolic function, percep- tual-awareness through introjective and projective mechanisms, emotional regulation, boundary function, capacity to collaborate, conceptual ability and capacity to learn in a group context (Israelstam, 2011, p. 1307).
Although there have for years been calls for clearer, comprehensive and more consistent criteria for the assessment of prospective applicants for analytic training (e.g. Greenacre, 1961; Halpern, 2003; Kapelle, 1996; Pol- lock, 1961; Wallerstein, 2012), very little work on this has emerged. Most of the papers in the literature consist of descriptions by many of our well- respected senior analysts, describing what they believe to be important crite- ria for candidate selection. What stands out immediately, however, is that, in spite of having spoken wisely, their criteria are often very personal, too all- encompassing, and are lacking in comprehensiveness and consistency. For example, Sharpe (1947) stresses the capacity for self-observation, insa- tiable curiosity, and a general aptitude. Kohut (1968) stresses a personality that he declares should be characterized by a central firmness and a periph- eral looseness. Greenson (1961) stresses the need for a well-developed capac- ity for empathy. Heimann (1954) stresses the importance of intuition, innate psychological flair and an interest in human beings. As we see, their responses, although relevant, lack comprehensiveness and are idiosyncratic in that they are based on what they personally deemed to be relevant. The author is struck by the parallel in concerns regarding the lack of clearly defined and repeatable criteria for candidate selection, and Tuckett’s con- cern regarding the lack of transparency and comprehensiveness in the pro- tocols for the assessment of candidate competence, where it seemed that “anything goes” (Tuckett, 2005).
Although the attempts at formalizing more productive and consistent assessment protocols are few and far between, there are a few notable exceptions. Fleming (1961) defined criteria for selection, based on what was required of the ‘job’ of analysis. Klein’s research group at Colombia studied a variety of assessment methods in an attempt to validate their effectiveness by correlating these with training outcome (Klein, 1964). The Chicago selec- tion research group did impressive work in exploring what capacities to look for in applicants, as well as how to conduct the interview process so as to extract the maximum information (Benedek, 1976; Fleming, 1976; Pol- lock, 1976). Kapelle (1996) surveyed selectors from the Dutch Psychoana- lytic Society, only to find that most of them relied on informal intuitive methods. In more recent years Halpern (2003) presented a coherent and well-thought-out framework for assessment, based on attachment theory. That it is based on a unitary conceptual model may well limit its wider applicability.
The assessment protocol that the author proposes involves the dynamic interplay between our everyday analytic skills and a schema relating to can- didate competence. Understanding what competencies we would be expect- ing of well-functioning analysts leaves us well placed to know what capacities, and more importantly, what potential capacities, we would look for in our aspiring applicants.
The author’s first task was to decide on what criteria relating to analytic competence would be best used as a basis for the assessment model. A liter- ature search revealed that only a few comprehensive studies stood out.
Weiss and Fleming (1979) of the Chicago Research Group defined a com- prehensive and well-thought-out list of desired analytic competences. Filet and Szonyi (2009), as part of the Working Party on Education of the Euro- pean Psychoanalytic Federation (EPF), through the use of questionnaire surveys, defined 27 candidate competencies. Cabaniss (2008) of the Colum- bia Research Group described a list of competences that related to the can- didates’ stage of training. Tuckett (2005) conducted a qualitative research project involving a diverse membership of the EPF, which resulted in three all-encompassing frames. Israelstam (2011) conducted a qualitative research project involving the members and candidates of the Australian Psychoana- lytic Society, which resulted in a comprehensive schema relating to candi- date competence.
In comparing the Australian Interactive Category Schema of Candidate Competence with those mentioned above, it was not a surprise to find that there was a high degree of concordance amongst them.2 The author has chosen to use the Australian outline over the others as he believes that it satisfies important prerequisites (see below), and also to follow through with the Australian researchers’ recommendation and wish that we as a society make use of our own criteria for candidate competence, as a basis for the assessment of analytic applicants (Israelstam, 2011, p. 1309).
The author believes that the Australian Interactive Category Schema of Candidate Competence satisfies prerequisites that are important in render- ing it a useful and relevant outline of analytic competences, in that it:
-is based on a well-designed and thought out qualitative research method (Kitto et al., 2008; Strauss and Corbin, 1998)
-is ‘home grown’ and therefore reflective of our particular analytic way of functioning
-has clearly defined and comprehensive functional categories that are well balanced, there being not too many and not too few.
Outline of category schema
The members and candidates of the Australian Psychoanalytic Society were asked to provide the researchers with a list of what analytic capacities they believed qualifying candidates should have acquired. Using a qualitative research method, over 200 individual responses were sorted into ever- increasingly refined coherent categories, until the researchers arrived at a clear and transparent protocol based simply on how it is that analysts per- ceive, think, feel and, act (Israelstam, 2011).3
The categories that were arrived at are: analytic stance, boundary func- tion, emotional regulation and tolerance, perceptual awareness, conceptual capacity, and interventive capacity. There were also very important personal characteristics that emerged out of our study i.e. empathic attunement, curi- osity, motivation, frustration tolerance, honesty, authenticity, integrity, humility, courage, quest for truth, firmness, patience and enthusiasm.4 Instead of having a defined category for personality characteristics, it was decided rather to highlight how they feature as an integral part of the weave of the larger more all-encompassing categories (see below).
2In those situations in which institutes find that the more ‘universal’ criteria for analytic competence are too removed from theirs, it would be a distinct advantage for them to establish their own ‘home-grown’ criteria upon which to base their selection criteria.
3The effectiveness of the research was enhanced, by conducting a number of dedicated seminars, where the candidate competences were trialled, reworked and elaborated on.
It is important to emphasize that, although the elements of the Category Schema are described independently, in reality they are extremely interde- pendent and interactive.
The adaptation of the candidate category schema
Although the interviews of the prospective candidate are a crucial part of the total evaluation, there is little written, systematically and in detail, as to how this interview process is actually conducted.5 The author hopes to illus- trate with examples of assessment interviews how our analytic competencies and skills, to be described below, equip us well in this endeavour.
As analysts, we are potentially well equipped to conduct assessments. It is intrinsic to our method to be able to extract a large amount of information, from relatively little behaviour and language, and to formulate deductions from this in a relatively short time frame. This is done directly through our accumulated understanding of human dynamics, and indirectly via an understanding of our own emotional responses, and our capacity to extrap- olate from the symbolic.
When evaluating an applicant for analytic training, we are faced with the challenge of attempting to ascertain their level of skill as well as their poten- tial to acquire these skills, without the use of clinical material. In place of clinical work, we need to rely on evaluating the applicants’ potential to train by focusing on their past biographical and present interpersonal dynamics, their work relationships, their personal thoughts, and their aspi- rations and interests. As mentioned above, much of the information is also derived from the ‘here and now’ interpersonal interactions of the interview.
The next step and challenge in the development of this protocol is in being able to reconcile and bring together two apparently opposing yet interdependent entities, i.e. the somewhat formal and structured analytic competence schema versus our relatively unstructured subjective analytic skills. The ‘art’ lies here in the fine-tuned oscillating of ritual versus sponta- neity (Hoffman, 1998; Israelstam, 2007, 2009). In one moment the analyst’s subjective self is foregrounded, whilst the schema functions as a background ‘scaffolding’. In another moment, the schema is foregrounded whilst the more spontaneous self is backgrounded.
4It is important to note that personal characteristics represented are close to a third of the total of our society’s responses. This emphasis has been well documented in the literature, both for candidate evalua- tion (Hovarth, 2005; Kite, 2008; Szecsody, 2003), as well as for the assessment of new applicants for training (Rosenfeld, 1987; Stone, 1974; Szecsody, 2003).
5One notable exception is the work done by Fleming (1976), Benedek (1976) and Weiss and Fleming (1979), of the Chicago Selection Research team who, over 30 years ago, explored in depth the use of the analyst’s skills in the assessment process.
I will first briefly describe the candidate capacities as per the Australian Interactive Category Schema of Candidate Competence (Israelstam, 2011), and then follow this with a description of how the capacities are adapted for use in assessments.6
Description and adaptation of category schema
Description as it relates to candidate function: Here the candidate needs to demonstrate the capacity to have a mind that floats freely, while attending responsively to the symbolic elements of the unconscious, that arise out of their and their patients’ free associations, dreams, moment to moment behaviours, communications, emotional reflections and responses. The personal characteristics relevant to this stance would include such character- istics as curiosity, empathic attunement, enthusiasm, creativity, and frustra- tion tolerance.
Adapted description as it relates to assessment: To evaluate this category, we would be particularly focused on the applicants’ flow, process and style of thinking as they speak of their lives, relationships, aspirations and inter- ests. Is their thinking stilted and focused more on the overt and concrete, as opposed to being imaginative and appreciative of the symbolic? Can they flow and associate from one idea to another? Are they able to think and reflect about things from multiple perspectives? For relevant personal char- acteristics and interactive flow see candidate description above.
Description as it relates to candidate function: The candidate needs to dem- onstrate a capacity to develop a working and collaborative alliance with the patient that promotes conditions of safety and trust. The important per- sonal characteristics relating to this capacity include empathic attunement, humility, respect, integrity, frustration tolerance, and patience.
Adapted description as it relates to assessment: Our focus here is on the applicants’ relational capacity and style as it emerges in their interpersonal family, social and work interactions. Much of their collaborative capacity can also be gleaned from the direct and indirect (countertransference) expe- rience that the interviewer has of the applicant’s personality and relation- ship style. Is the applicant able to convey and engender in the interviewer a sense of trust, respect, empathy, integrity and tolerance etc?
Boundary and ethical functions
Description as it relates to candidate function: This refers to the capacity to have an awareness of, and maintain and establish clear and appropriate boundaries that involve three main areas; the establishment of an analytic frame and setting; the maintenance of self–other boundaries, which embraces the important capacity to be comfortable with both closeness and separateness; and an awareness of the potential for sexual and non-sexual boundary violations. The relevant personal relational qualities relevant to boundary functions are authenticity, integrity, and frustration tolerance.
6As I will only focus on the highlights of the schema, I would strongly recommend that the reader read the original article (Israelstam, 2011), in order to get a fuller appreciation of those analytic competences that inform us as to what capacities and potentials we look for in aspiring analysts.
Adapted description as it relates to assessment: Through the exploration of the applicants’ personal and work relationships, as well as our own experi- ence of them, we would attempt to deduce their capacity/potential in: main- taining firm and flexible boundaries in their interpersonal relationships and role functions; having clear self and self- other definition; having a capacity for both close and sustained intimacy, as well for the separateness of the other. The relevant personal relational qualities that we would be alerted to are as described above.
Description as it relates to candidate function: Perceptual capacity refers to the candidates’ capacity to take in information by attuning to and reflecting on their own and patients’ internal emotional–mental states, through the use and understanding of transference, countertransference and projective identification. This is in three main areas: (1) Self: an awareness of own mental-emotional state; (2) Other: an awareness of others internal world; (3) Self–other: an awareness of complex dynamics between self and other. Desired personal characteristics involve empathic attunement, curiosity and integrity.
Adapted description as it relates to assessment: In our discussion with the applicant we would be looking for their potential/capacity to take in information by attuning to and reflecting on their own and others’ internal emotional–mental states, i.e. to have some awareness of their own short- comings; to have some sense of how they might affect the other; to have an awareness of how the other affects them. Finally, we look for their potential to have an understanding of the complex dynamics that arise between them- selves and other. (A reflection of their potential to use and understand transference, countertransference and projective identification.) For relevant personal relational qualities and interactive links, see candidate description above.
Description as it relates to candidate function: A capacity for symbolic think- ing is essential in our capacity to conceptualize, and is integral to other ana- lytic capacities such as symbolic–reflective stance, perceptual awareness and emotional regulation.
The candidate’s conceptual capacity is expressed in three main areas i.e. (1) a capacity to construct hypotheses and theories relating to symptom for- mation and maintenance, as well as change and transformation; (2) a capac- ity to develop a formal analytic knowledge base that is in dynamic relationship to the information that relates to the here and now of the ana- lytic encounter; (3) a capacity to learn from peers, teachers, patients and from experience. The relevant personal qualities involved are; curiosity, humility, creativity, enthusiasm, courage, integrity, and frustration toler- ance.
Adapted description as it relates to assessment: We are interested here in the applicants’ thinking capacity and style. Is their thinking enhanced by the capacity to draw on the symbolic and latent elements of language and behaviour? Are they able to think from multiple perspectives? What capacity do they have in being able to understand the interpersonal dynamics of everyday life? Are their ideas and ‘formulations’ relating to their everyday work and personal lives, open and responsive to revision? Are we able to pick up from the nature of their activities, i.e. reading, hobbies and interests, a curiosity, openness and enthusiasm to learn and understand? Do these activities have breadth and depth? Do the applicants convey through their narratives and interaction with the interviewer, a level of humility and willingness to learn from others? For relevant per- sonal relational qualities and interactive links, see candidate description above.
Capacity for emotional regulation and tolerance
Description as it relates to candidate function: Here we look for the capacity to regulate the self and others’ intense emotional–mental states generated within the patient–therapist encounter. It is emotional regulation that facili- tates the candidates’ and their patients’ capacity to think rather than act, to tolerate ‘doubt’ and to avoid ‘premature closure’ in favour of emotional relief (Israelstam, 2009). Relevant personal characteristics involved, include frustration tolerance, patience and firmness.
Adapted description as it relates to assessment: Our focus here is on the applicants’ ability to manage the emotional intensity that is generated in their everyday work and personal lives and relationships. An understanding of this capacity can also be discerned in the interview itself. Are they able to tolerate the frustration of not knowing and not resolving? What capacity do they have to favour thought over action? Do they seek closure instead of learning from their emotional experience? Do they understand their emo- tional ‘triggers’ and vulnerable areas, and how these may be activated by the other?
For relevant personal relational qualities and interactive links, see candi- date description above.
Description as it relates to candidate function: In this process, conceptualiza- tion and hypothesizing are translated into transformation. These can be classified as interpretive and non-interpretive. The candidate should be able to identify and describe these contexts and events, be able to track them and evaluate their transformational effects.
The desired and relevant personal qualities involved in this category are curiosity, creativity, enthusiasm, courage, empathy, quest for truth, frustra- tion tolerance, and patience.
Adapted description as it relates to assessment: As the applicants relate details involving their work, social and family life, we look for evidence of their capacity and potential to identify problems, develop ways of being able to reflect on these, formulate ways of intervening, and then to be able to evaluate the effectiveness of these strategies and solutions. This, I believe, would give us indirect evidence of their future potential to formulate ana- lytic interventions. We also seek the presence of the desired personal charac- teristics as described for this category above.
When the author talks of the assessment of an analytic applicant, it is with the full awareness that the interview process, although very important, is only a part of the assessment process. The selection committee makes their decision based on usually two independent interviews, the applicant’s CV, reports from referees, as well as the applicant’s written application. How the interviewers’ assessment report is shared with the selection committee varies from society to society. In the author’s own experience of his own society, there has not been an emphasis on the interviewers being invited to join the selection committee discussion. On reflection, the author sees many advantages in having the interviewers present at the selection meeting, such as occurs with the British Society, and, as I understand, in many other soci- eties as well (Schachter, 2014). In this model, the admissions committee members are not only more able to explore more fully the assessor’s experi- ence of their interview with the prospective candidates, but their similarities and differences in their findings as well. These findings are then compared and collated with the other information.
There are two important ideas that the author believes are important to be kept in mind in the task of assessing the suitability of an applicant for analytic training:
-We need to recognize that many of the desired analytic competencies described in the Australian schema are yet to be developed and improved through the individual’s analysis and training. The emphasis then should be in assessing the prospective candidate’s potential, aptitude and motivation in developing the candidate capacities as outlined above.
-The assessor should have reasonable and realistic expectations of the aspir- ing analyst’s mental health. As far back as 1945, it was understood that a degree of emotional dysfunction does not preclude good analytic work and indeed may be an advantage (Sharpe, 1947; Sachs, 1947; van der Leeuw, 1961). What is important is that the difficulties are not too severe, that the individuals have an awareness of these, and are receptive to change through their analysis and training.
It is important to try and establish an interview context that would be con- ducive to facilitating the presence of those elements of function that we would be seeking to evaluate. The interview needs to be unstructured and non-directive enough to allow for the applicant’s thinking style and content to emerge. It is also important to see if they are able to reveal sensitive issues relating to family of origin and personal difficulties without prompt- ing. There also needs to be enough silence and ambiguity to allow for the evaluation of the applicant’s capacity to tolerate these emotional tensions. There is a place, however, for some direct questioning and structure, pro- vided that the interviewer allows space for the applicant to flow with his responses, thus allowing for the opening up of important uncovered areas relating to candidate competence that may not otherwise be revealed.
The author would encourage the interviewers to allow their own thoughts, feelings and imaginings to flow as freely as possible, whilst allow- ing the described protocol to act as a guide and structure in the organizing of these thoughts. A mix of free floating intuition, and meaningful struc- ture.
After providing two descriptions of typical interviews, the author will illustrate, with examples, how these findings can be translated into full and meaningful reports, for use by the selection committee.7
Interview with Jack
Jack is a qualified social worker aged 42 married with three children, and is in part-time public service and part-time private psychotherapy practice. I started off our discussion with a brief introduction indicating to him that I wanted to use this interview to get to know him and also understand his motivation and interest in psychoanalysis. I added that he might also want to use this opportunity to ask me questions regarding the training pro- gramme.
I will not reproduce the complete interview, but rather focus on those ele- ments that best highlight my attempt to illustrate the use of the adapted schema. In my response to my question as to what it was that motivated him to pursue psychoanalysis, Jack revealed that since his teens he had found himself searching for meaning and understanding, and how in his university years he discovered Jung and Freud, and began to keep a dream diary. He stated that, although he found his reading and explorations stim- ulating and helpful, he realized that he was unable to help himself, and he entered into once-weekly psychotherapy to deal with his anxiety and bouts of depression. He said that he felt very fortunate that his university case supervisor was an analyst, and that he was inspired by her analytic way of working and thinking. He enjoyed its depth and its attention to detail.
Early on in our interview while talking about his interests and hobbies, Jack commented on how much pleasure he derived from restoring old cottage furniture. Without prompting, he spontaneously remarked how he believed that this passion was fuelled by his experience of having struggled, as a child, with painful and impotent feelings of not being able to “fix up” his parents’ destructive relationship. He volunteered that he had been a rather anxious oldest child, and how he fitted the description of what he has come to understand from his work with families, as being an anxious “parentified child”. He also understood that these family dynamics had influenced his choice to become an analyst.
7The author notes that the identity of the applicants has been heavily concealed by changing gender, life circumstances, biographical details etc. of the described applicants.
Later in our conversation, when asked what he believed could be an impediment to his work as an analyst, Jack revealed that his difficulty in saying no had often caused him to “give too much” and be too accommo- dating of his patients’ needs. He went on to describe how their emails and phone calls would at times intrude into his home life, and that he found it difficult to set limits. He said that he was not clear as to what this was about. He thought that this had something to do with wanting to please and avoid unpleasantness.
It was interesting to note, yet not surprising, that this dynamic revealed itself in our interview. I did note that he was rather over-anxious to please and to “make a good impression”, and that he had some difficulty staying with silence, and at times spoke in order to reduce his discomfort.
While talking of his home life and family, Jack associated to a theme relating to his concern for his wife, whom he described as being in the “grip” of her mother’s guilt tripping. He spoke of how he felt for his wife’s anguish, and how he understood that his wife had always been a parent to her mother. This was complicated by her mother’s deteriorating condition following a stroke. He spoke of how he could not stand his mother-in-law, and how he found her manipulative and controlling. He explained how he had to try hard to resist reacting to her and, when he did, how this would only serve her wish, to drive a wedge between him and his wife. He often resorted to placating his mother-in-law not only “for the sake of peace”, but also because he wanted to minimize the stress for his wife.
Jack spoke of his initial zeal in trying to persuade his wife to enter therapy, as he himself had done and found so helpful. He commented on how this pressure had proven to be counter-productive. He had realized that it was important for her to have the freedom to make this decision independently and, although frustrated, decided to back down from that position.
In response to my asking him to tell me something of his work life, Jack spoke of how he enjoyed his psychotherapy work in his private practice, but that he was tiring of his work in the public general hospital system. He spoke of how he had noticed how much more irritable, unconfident and “low” he felt on the days he worked in his hospital job. He described how he worked long hours without extra payment, and how he felt concerned that this may be causing him to be resentful and somewhat demotivated. In continuing his description of his work situation, Jack spoke of how he and his colleagues worked well as a team, and how he as team leader, together with his colleagues, devised a strategy to try and remedy the untenable situation. He told me that given his difficulties with confrontations, he decided rather to take a diplomatic route in initiating a series of meetings with his department and administrators. This ultimately culminated in the hospital administration agreeing to employ a consultant to assist them in their problem solving.
By the end of our interview, Jack appeared more relaxed to the point where he was able to ask fairly direct and searching questions regarding various elements of the training.
An attempt will now be made, to illustrate how the above information can be translated into a report for the selection committee.
Jack’s assessment report for selection committee
My report is based on what analytic capacities or, more importantly, what potential capacities, Jack possesses that would facilitate his ability (through the training) to develop as a competent psychoanalyst.
Jack appeared at home with my relatively unstructured interviewing style, and was able to associate freely and loosely and demonstrated a definite capacity to understand and extract the symbolic and unconscious meaning of personal interactions and activities, i.e. he demonstrated a free-floating symbolic-reflective potential/capacity. For example, he was able to under- stand the symbolic nature of his hobby, restoring furniture, and its link to his wish to repair broken elements of his childhood, and how this had influ- enced his turning to psychoanalysis.
I was impressed with how Jack, in a brief space of time, was able to disclose relatively sensitive and personal information regarding his inner and inter- personal life, revealing to me his capacity/potential for trust and to establish a collaborative relationship. Further evidence of Jack’s capacity to develop this capacity was also demonstrated to me in hearing the description of his personal and work relationships.
His personal qualities of trust, empathic attunement, humility, respect, tolerance and patience, I believe, would set a firm foundation upon which a positive alliance could be formed with his future patients.
There were many instances in the interview where Jack demonstrated the potential/capacity to understand himself and others through introjective and projective perception (analytic perception). One example of his capac- ity/potential for self- awareness was revealed when he spoke of the resent- ment and demotivation that he was experiencing as a result of feeling exploited at work. Another example of this capacity was his awareness of some of the unconscious factors that motivated him to train as an analyst.
He also revealed a capacity to have some sense of how his mental state might affect that of the other; how the mental state of the other might affect his; and of the complex dynamics that potentially arise between the self and other. This capacity was particularly evidenced by Jack’s ability to understand and manage the emotional dynamics relating to the complex tri- angle between himself, his wife and mother-in-law.
Boundary and ethical functions
I was struck in my interview with Jack by his thoughtful, honest and ethical qualities. I gleaned from the content of the interview, and what was intuitively felt, that his boundaries were essentially clear and flexible; he had a capacity for close and sustained intimacy as well as a respect for the separateness of the other, i.e. clear self and self– other definition. The latter became evident to me when Jack spoke of his recognition of the fact that his wife’s need for therapy might well be different from his own.
Jack did acknowledge that he had difficulty in asserting his own needs and limits in the face of interpersonal confrontation and conflict. This was well illustrated in his above description of the difficulty that he experienced in being able to set limits, in relation to his patient’s intrusion into his per- sonal life. This difficulty, if not addressed, might have the potential, I believe, to limit the capacity/potential he would have in maintaining firm and flexible boundaries (frame) in his future work as an analyst.
Capacity for emotional regulation and tolerance
Jack acknowledged that he had some difficulty in managing the strong emotional tensions that were generated in provocative and confronting interpersonal situations, both at work and with family. I do not believe this to be an overly pervasive problem, and am encouraged by his awareness of this difficulty. In spite of Jack being noticeably uncomfort- able and tense in the interview at times, I was struck by his ability to withstand silences and moments of not knowing in our interview, without him having to create a premature closure of our thinking space. In lis- tening to how Jack managed interpersonal tensions, it was apparent that he had a capacity to think and problem solve, in favour of impulsive action. His ability to manage his resentment at work through positive action, and towards his mother-law through thought and diplomacy, are good examples, I believe, of his capacity to regulate his emotions under duress.
I found Jack to be at home with the metaphorical and symbolic elements of thought and life. He understood, for example, the relationship between his creative hobby, restoring furniture, and how his motivation to be an analyst was fuelled by these reparative needs. Jack’s conceptual and hypothesizing ability/potential also became further evident in our discussion, when he was able to articulate and understand the complex and layered political dynam- ics that were present in his organization. He appeared to understand how he and his social work group were scapegoated and were made to carry the administration’s unrecognized shortcomings.
He conveyed an inherent curiosity and drive, to learn and understand both himself and human nature. His humility, curiosity and self-honesty, I believe, open him up to learning from others.
Jack spoke of and identified specific problems and difficulties that related to his home life and work situation. He had clearly given each of these mat- ters a great deal of consideration both emotionally and conceptually. He described a situation of conflict with the bureaucracy at his work. After having developed what I felt to be a good understanding of the underlying systemic dynamics, Jack proceeded to set up meetings and discussion groups with his department and the administration that led to some resolution of these difficulties. I saw this ability as an indicator of his future potential to develop a capacity to hypothesize, conceptualize and then act in a thought- ful way. This, I believe, could be translated into Jack having a capacity/ potential for analytic intervention in his future clinical work.
Recommendations to selection committee
I found Jack to have very positive potential and capacities in most of the desired analytic competences. I noted in my report, however, that Jack does have some difficulties in dealing with his anxieties and tensions in provoca- tive and tense interpersonal situations, i.e. in the area of emotional regula- tion. I feel confident that, given Jack’s self-awareness and motivation to develop emotionally, this problem will be dealt with in his analysis and training. I would have no hesitation in recommending that Jack be accepted for training.
I would like now to present another example to illustrate the use of this protocol with an applicant whose suitability for training was not as straight- forward as Jack’s.
Interview with Kate
Kate aged 39 years is a psychiatrist in private practice, and is married with two children. As with Jack, I started off our discussion by letting her know that I would like to use the meeting to get to know her and to explore her wish to train as an analyst.
I asked her to feel free to tell me whatever she felt was important for me to know, and that the interview would not be too structured. She responded, appearing rather anxious, saying that she would prefer it if I asked her questions. As we sat in silence, I noticed that she was becoming uneasy, was looking down and made little eye contact. Sensing her discomfort, I waited a while longer and then asked her to tell me what it was that drew her to psychoanalysis. Kate told me that she had become disillusioned with the results that she was getting in her general psychiatry practice and that she was looking for something more effective. She expressed concern that her more disturbed patients were not responding well to medication and that she wanted to acquire skills in psychotherapy. Kate did not elaborate and fell into an uncomfortable silence again. I waited a while, and then asked her to tell me more of her wish to train. She told me that, for that past two years, she had been attending evening seminars and lectures in psychoanalysis set up by our local analytic society, and that she had found them very stimulating. She said that she preferred to attend live seminars rather than read, that she took things in better that way.
Kate went on to say that she has been having twice-weekly analytic ther- apy with an analyst for the past three years, and that she was finding this very helpful. When she did not elaborate further, I asked her if she would mind telling me what it was that took her into therapy. Kate answered that she had been depressed since the birth of her daughter four years ago, that the antidepressants that she had put herself on were not helping that much, and was advised by a friend to have psychotherapy. She stated that she thought that this would also be a good way to experience analytic therapy first-hand.
When I asked Kate to tell me something of her family life, she rather unexpectantly welled up with tears. She immediately reached for a tissue in her bag (although I had a box of tissues near her on my table). She apologized for “letting go like that,” and revealed that she was still grieving the loss of her mother, who had passed away a year ago. She spontaneously volunteered that she had had a very conflictual and stormy relationship with her. She explained that, since starting her therapy, she had begun to form a better understanding of her relationship with her mother: “I have quite a rebellious nature, and tend to speak my mind without thinking first. I’m beginning to realize that I gave my mother a hard time. I am saddened that I did not have enough time to fix things up between us. She meant well, but was so overprotective, intrusive and controlling. She much preferred my younger sister, who was more compliant and easygoing than I was.”
When Kate did not elaborate any further, I asked her to tell me more of what she thought of her “rebelliousness”. “I’m understanding in my therapy that I’ve had a longstanding problem with authority. I left the hospital sys- tem to go into private practice because of conflict with my boss who was incredibly controlling and critical. I’ve been much happier working on my own. I’m very sensitive to being controlled. I’m fortunate that my husband and close friends are so easygoing.”
She went on to tell me that she had become aware that she has been repeating her mother’s controlling behaviour with her daughter. “When she pushes my buttons, I lose it, I find it very hard to be consistent. When my husband’s around, I just hand over to him. He knows how to handle her. I have to learn to manage myself though, I feel so bad about hurting her, and she’s so innocent really. I have been working hard in therapy trying to change this pattern.”
When we got close to the end of our time, I asked Kate if she had any questions to ask me. Kate wondered if she would have to change therapists for the training. When I replied that she may not need to, given that her therapist is a member of our Institute, Kate was clearly relieved, saying that it had taken her all this time to build trust and confidence in her analyst, and that she was currently negotiating increasing her analysis to four times per week.
Just prior to ending our discussion, Kate acknowledged that she had been very anxious in the interview: “I’ve been plagued by performance anxiety throughout my schooling and medical school. My parents migrated here from Eastern Europe, with nothing. They made huge sacrifices to enable us to study. I guess I carry all their unmet needs and expectations. I hope that this anxiety did not put me in too bad a light.”
Kate’s assessment report for selection committee
My report is based on what analytic capacities or, more importantly, what potential capacities Kate possesses that would facilitate her ability (through the training) to develop as a competent psychoanalyst.
I was concerned about Kate’s difficulty in allowing her mind to associate freely. I found her thoughts to be rather stilted, and at time rather concrete and lacking in symbolic flow. This view of her first became apparent early on in the interview when I suggested that I would like to leave things fairly open, and she responded by saying that she would prefer it if I asked her questions. Kate also found it difficult to have much flow of thought, after periods of silence.
There were a few things that left me with some concern about Kate’s capac-
ity to inspire and form a collaborative relationship in her future work. Kate
disclosed that she tended to have conflicts with authority figures at work,
and that she preferred to work on her own. I also found her to be relatively
guarded and somewhat withholding in our interview, although she did open
up a little more towards the end of our meeting. To counter this concern,
there seemed to be some evidence that Kate had, in more recent times, been
building up a positive alliance with her analyst. She appeared eager to
remain with her analyst, should she be accepted to train. I also recognized
that I found her a bit more contactable towards the end of the interview.
I had no real concerns about Kate’s ethics and integrity, but did have some
concerns about her tendency to overvalue self-reliance, and wondered about
her capacity to sustain and manage deep dependence and closeness of the
other. I thought that there was some evidence for this in her expression of
her preference to work on her own, and the fact that she chose to rely on
herself for “treatment”, by prescribing her own antidepressants.
I was also concerned about her capacity to have the firmness and flexibil-
ity to manage an analytic frame in her future work, given some difficulty
that she has in regulating her emotions, as described below.
Emotional regulation and tolerance
Kate, in speaking openly of her difficulties with authority figures and her
lack of control in relation to her daughter, was revealing, I believe, her difficulties with emotional tolerance and regulation as well as her tendency
to act rather than reflect. In our interview I noted that Kate also had diffi-
culty tolerating the emotional tensions of silence and ambiguity.
Kate revealed some difficulty in self-awareness in that she appeared unable
to fully recognize the centrality of her own emotional needs in her decision
to train, for example, the one reason she gave for her wish to become an
analyst was that she wanted a treatment modality that was more effective
than the medical model. On the other hand, she did reveal some capacity
for self-awareness in her recognition of how her performance anxiety might
have affected her interview. She also showed some insight into the difficul-
ties she has with authority. Kate was able to demonstrate some capacity for
self–other awareness in her understanding of how her behaviour might have
hurt her mother and, in the next generation, her daughter.
Although Kate is certainly an intelligent person, her thinking appeared
somewhat stilted and concrete, and I wondered about the potential diffi-
culty she had with symbolic and abstract thinking. Her statement that she
preferred to attend live seminars rather than read, and that she took things
in better that way, did concern me. Also as mentioned above, her reasons
for wanting to train as a psychoanalyst had a rather concrete flavour.
Kate was able to demonstrate some capacity to be able to conceptualizes,
for example, when she recognized how her impatient attitude towards her
daughter was linked to the difficulties that she had with her own mother. I
had the impression that this capacity was improving as a result of her ther-
apy, but was in need of further development.
I was concerned that Kate had some difficulty in being able to identify
problems and formulate action-plans in her everyday life. This difficulty
might, I believe, point to her having difficulties in formulating and evaluat-
ing analytic interventions in her later analytic work. An instance that might
be emblematic of this difficulty was when Kate handed the “problem-solv-
ing” of her daughter’s challenging behaviour to her husband. Although
Kate was able to demonstrate some capacity to conceptualize, she as yet, I
believe, has problems translating these understandings into positive prob-
Recommendations to selection committee
As can be gleaned from my report, I clearly have concerns about Kate’s
capacity to train as an analyst at this point; the question here, though, is
whether Kate has the potential to develop further through her analysis and
training. There are some indications that reveal that Kate is beginning to
benefit from her analytic therapy. As noted above, I am also very aware that her anxiety might have prevented her from coming across in a more
Before I make a decision as to whether or not Kate should be accepted, I
would like the opportunity to hear more about her from the other inter-
viewer and her referees, at the selection meeting. If after careful evaluation,
which might include her having a third interview, our overall feeling is that
Kate indeed has the potential to develop and improve, then it could be rec-
ommended that she proceed. If this decision is made, I would recommend
that her progress and development be followed up during the infant obser-
vation year, allowing for a greater focus and work on the difficulties high-
lighted above, thereby hopefully reducing the need to have Kate leave the
8The author would like to stress again that the ongoing evaluation of a candidate’s competencies should
not be used as a way of being able to be less diligent in trying to be as certain as we can in the initial
assessment, with the idea that we can always decide later. The idea of the ongoing evaluation is to
enable the training committee to be able to provide more focused support to the candidate who may be
In the early years, when psychoanalysis commanded a considerable ‘mar-
ket share’ of the available therapies, it was not uncommon to have a
rejection rate as high as 50% (Kapelle, 1996). Today, the reality of our
fall in ‘market share’ plus a less idealized view of our work has, I
believe, resulted in a more open-door policy for applicants. The challenge
for us now is to find the balance between openness and quality. It is my
hope that this protocol will go some way in helping us to maintain our
standards, by guiding us in making more informed and comprehensive
The idea that “what is most predictable about us humans is that we are
unpredictable” should, I firmly believe, not deter us from trying to improve
our capacity to make more accurate judgements about future analytic
capacity. Looking at the weather, where predictability is vital, we note that
in the last 50 years, in spite of our advanced technology, weather forecasts
have moved from an accuracy of one day to an accuracy of only up to
10 days. This may not look impressive but these extra 10 days, by allowing
time for fortification and evacuation, can make a difference between life
I am sure that, with further exploration and research, we too can improve
our assessment skills. Even modest gains made in our capacity to select can-
didates with analytic potential, I believe, will save our candidates and insti-
tutes, time, money and heartache.
With the increasing retirement rate of senior analysts (Hooke, 2012;
Klockars and Hooke, 2010), and as new analytic training centers open up
in Eastern Europe and Asia (Fonda, 2011; Gerlach 2013;Wallerstein 2012),
the burden of responsibility in assessing new candidates, and the running of
training programmes, is now falling more and more onto the less
experienced members. These growing trends, I believe, make it all the more imperative that we have clearer, documented, teachable and transmissible
Finally, the author hopes that he has emphasized enough that this assess-
ment schema is not there simply to provide a definitive checklist to be fol-
lowed mechanically, but rather to act as a stimulus and guide to facilitate
open thought and understanding. It is wished then, that once having ‘inter-
nalized’ a consistent and comprehensive structure (secure base), relating to
expected analytic capacities, we might indeed feel freer to be able to ‘play’
and give fuller expression to our subjectivity and intuition (Hoffman, 1998;