PSYCHOANALYTIC TRAINING IN DYNAMIC PSYCHI ATRY

The author emphasizes that the change of family structures since Freud 's times led to a shift from neurotic disorders to archaic identity di sorders. It is therefore evident that the analyst has to present himse lf as a real person if he wants to help patients with severe identity problems. The psychoanalytic training takes this situation into accoun t on the basis of an explicitly formulated view of man in which man is seen holistically in his possibilities and needs, shaped by his uncon scious determined and as a social being striving for identity and self -realization. In Ammon's thinking, man is understood as a being in con stant development: ''Identity is that which endures in a person and at the same time something which does not endure. Identity is a process, a permanent search, a permanent development'' (Ammon 1986). Related t o psychoanalytic training this means that the candidate must be encour aged in his possibilities of identity by a complex training milieu in which he can make important steps of demarcation and identification. T he whole net of transference and countertranference of the training si tuation has to be integrated into training analysis. Thus the candidat e learns to differentiate between his own personal past and the presen t group-dynamic situations. This inner work of separation is necessary to help patients who act out their unconscious group-dynamic problems into all groups of their life situation. As the whole training instit ute is structured as a system which organizes itself and takes over al l tasks, the future analyst gets the chance not only to act as a thera pist, but also as researcher, organiser, politician, advertising speci alist etc., thus showing his talents and possibilities. Strenghtening and growth of the candidate's identity is the basis for the developmen t of an inner and outer demarcation of personality structure. Part of this process is also the working through of the candidate's own suffer ing in training analysis in order that he should not conceal his own p ersonality behind a facade of defense, thus seeming ''healthier than h ealthy''. An analyst whose identity problems could not be worked throu gh will more or less reject archaic desires of transference of severel y disturbed patients. Identity therapy takes place in borderline situa tions. One task of the future therapist is to establish such situation s for his patients. Therefore it is necessary to be experienced as a r eal person in an actual interpersonal relation with a patient, resp. w ith a group of patients. Being real means to openly show his own feeli ngs and attitudes. Healing is the result of direct interpersonal conta ct. This demands a high capacity to establish contact in human relatio nships and the ability to be in groups, as well as frustration toleran ce of the analyst towards deficient and destructive reactions of the p atient. An important condition is the analyst's own experience in the different methods of the treatment spectrum of Dynamic Psychiatry, as for example group psychotherapy, milieu therapy, nonverbal methods suc h as human-structural dance therapy, music therapy, theatre therapy an d others. As a basis for any therapeutical work, the candidate gets a training in group dynamics and Balint group work, not only in the trai ning institute, but also in the Dynamic Psychiatric Hospital, in thera peutic living communities, in the psychoanalytic kindergarten, in pare nts' groups, in self-experience weekends and group-dynamically structu red seminars and congresses. A continuous supervision is given by an i ndividual control analysis as well as by weekly group control analysis . As the author stresses, identity therapy has to begin at the roots o f early unconscious group-dynamic disturbances and has to be therapy i n human relations. Therefore, the analyst has to develop a kind relati onship to his own unconscious. He has to gain insight in his own intro jected unconscious group-dynamics for being able to get a sympathetic understanding of the patient's structure and needs in a flexible manne r. Due to strong symbiotic desires, ambivalence and hostile transferen ce relations of the patients, the therapist has to be flexible in his inner and outer demarcation to his own unconscious and to the patient' s wishes and needs. He has to learn the art of opening empathically to the patient's unconscious, while at the same time establishing inner bounderies and distance. The analyst is expected to take up the challe nge of new identity and developmental steps beyond his training period . This makes clear that a central criterium for the admission of a can didate is the ability to develop. This is necessary not only for the i ndividual but also for the whole training institute, which must be an open system in order to counteract the danger of institutionalization and paralysis of training culture. The institute group applies the ins trument of group-dynamics on it self and analyzes its own conscious an d unconscious group-dynamic processes. The author designates Ammon's D ynamic Psychiatry as a change of paradigm in psychiatry and psychoanal ysis, integrating not only group dynamics but also psychosomatics in a new scientific school. In the USA the connection between psychoanalys is and psychiatry unfortunately led to a ''medicinalization'', a proce ss which Freud himself strongly rejected. Being too much a field of me dicine implies the danger that psychoanalysis should lose its spiritua l and ethical as well as its social and cultural impact in favour of a merely therapeutic application Professionalism of psychiatherapy and psychoanalysis entails the danger of conformism and, thereby, the loss of the will to reform and the intellectual and psychic impetus which was inherent in psychoanalysis in its early days. As the author emphas izes, conformism endangers humanity by limiting individual psychic and spiritual existence.