John S. Kafka, MD

In five minutes, I can only mention that there exist significant differences in the psychoanalytic climate and practice in different countries in which different psychoanalytic schools may be dominant. I cannot develop theme of the prominent place of infantile sexuality in the theory and clinical work of some French analysts, for instance, or of the unhesitating and speedy transference interpretations of some British Kleinian analysts. But later, in this presentation, I will consider the task facing analysts from different backgrounds when they work together in developing psychoanalytic institutes where there had never been psychoanalytic education, or where none had existed for a long time.

Some of the challenges that psychoanalysis encounters in the U.S. are global. These include the necessity to face the competition of quick, simplistic, narrowly symptom oriented behavioral and biologic treatments. But the greatest challenges psychoanalysis faces are different in countries where it was politically suppressed. In these traumatized societies struggling to come to terms with new freedoms - and with the hidden remaining power of the old autocratic institutions - the great demand for and the great expectations from psychoanalysis constitute other challenges.

Where and when did and does psychoanalysis prosper?

Psychoanalysis never developed in an “average” expectable environment.” (Hartmann’s phrase.) Vienna, during Freud’s time, was an extraordinary center of social, political, and cultural change.

Different but at least equally radical social change provided fertile ground for the development of psychoanalysis when dictatorships collapsed in Latin America and especially in Germany, where, after the end of the Nazi regime, we saw the development of the second largest psychoanalytic community in the world. A spectacular growth of psychoanalysis in Eastern Europe that began after the end of the cold war is another example, one with which I am familiar, of a situation favorable to the development of psychoanalysis. East Europeans flocking to psychoanalysis were eager to be in a situation in which one could talk freely and escape from the basic insanity of idealogically distorted language.

During the last twenty years, I have worked with analysts engaged in the development of psychoanalysis in Eastern Europe. Since traditional training facilities were not available, we had to develop new ways of organizing psychoanalytic education. In our evaluations, we emphasized competence and analytic sensitivity rather than formal educational criteria. We also developed, for instance, “shuttle” analysis, a system of various models of periods of training analysis in the West when and where no local training analysts were available.

The growth of psychoanalysis in Eastern Europe continues at a rapid pace. Fully recognized psychoanalytic societies and institutes, or provisional societies, or study groups, function in Budapest, Prague, Warsaw, Belgrade, Romania, and Croatia. A special psychoanalytic development program exists for Turkey. PIEE, a virtual psychoanalytic institute (it does not physically exist in any one location), organizes training and outreach activities in locations not yet ready for study group status.

There are two large study groups in Moscow. I currently chair the sponsoring committee developing these two study groups that will eventually become provisional and then full psychoanalytic institutes. Each of the members of this Moscow Sponsoring Committee comes from a different country. The committee members represent diverse psychoanalytic orientations. But they all face a task that differs from the psychoanalytic work and teaching that they do at home.

Eastern Europe has known recent massive social trauma. Our challenge consists of treating traumatized individuals in traumatized societies. Sometimes the interplay between social and individual trauma becomes especially vivid in Eastern Europe. A memorable example for me occurred in one psychoanalytic summer school when a French psychoanalyst presented a case and beautifully described subtle transference and counter transference fluctuations in the course of treatment. The discussant was an Ukranian psychiatrist who had started psychoanalytic training. He complimented the French analyst on this elegant and subtle presentation. He said, however, that most of his own patients had more simple transference feelings toward him. Few had grown up in an intact family. Many had grown up in institutions and considered Stalin their father. In transference, he said he was either Stalin-devil or Stalin-god.

Psychoanalysis always involves the search for uncensored knowledge and self knowledge. There is an underlying expectation in psychoanalytic thinking that such knowledge has a therapeutic function. Different psychoanalytic cultures, however, range from an almost exclusive focus on self-knowledge to a less exclusive one that gives more room to the therapeutic function of psychoanalysis. When teachers from such different cultures come together, they learn from each other and they have a joint learning experience when they meet the candidates who themselves had suffered severe personal and social trauma and who are treating patients whose personal and social traumas may have been even more severe. The issue of the differentially weighted emphases on self-knowledge-enhancing or therapeutic functions in different psychoanalytic cultures, appears in a new light.

Autocratic regimes had attempted to entirely stifle the search for uncensored knowledge and self-knowledge. It is in working with traumatized individuals in traumatized societies that the consequences of the imposition of powerful strictures on thinking and self exploration is particularly clear. The stifling of unhampered search for personal meaning and the forced immersion in ideologically crazy making speech, does not just create interpersonal social difficulties, but also creates symptomatic pathological structures. Violence directed against others and/or oneself is just one of the symptomatic consequences of frozen thought. Here we can make a bridge to the challenge that psychoanalytic treatment faces in the West. As psychoanalysts, we see more clearly than other therapists the limits of only symptomatic treatment when it is divorced from the search for self-knowledge that is central to psychoanalysis.

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