Legal, Ethical, and Professional Issues in Psychoanalysis and Psychotherapy
president's column ON MCE
Etta G. Saxe, Ph.D.
President of the Michigan Society for Psychoanalytic Psychology
For the last few months my mind has been much occupied with the subject of education, continuing education and mandatory continuing education. I have found myself reflecting on my years of ongoing education, how this education has been influenced by the contexts in which I pursued it, on what has been meaningful and “most educational” and on my evolving philosophy of education. I have also been occupied with imagining how things might have been for me, had the context been one in which I had to follow another’s preset path, formats and measurements, rather than the curiosities of my mind and my self directed desire for education.
In the course of this thinking I have frequently visited my disbelief that any professional psychologist and practitioner of whatever persuasion (especially a psychoanalytic thinker) would not be interested in ongoing study driven by a fascination with the thinking of people, themselves and others.
I have also been engaged in frequent conversations with others, one to one and in groups, on these subjects which have become front and center as the possibility of Mandatory Continuing Education looms large on the Michigan horizon. In this column I will try to write about some of my thoughts/conclusions, especially those centering on specific details arising from the conversations I have had and questions posed to me about these details. I will do so as I have come to believe that aspects of MCE’s nature and perspective can become clarified through such a focus.
I am doing this in part with the hope that I might stimulate some of my readers, especially those who are MSPP members, to spend some of their time engaging themselves in similar thinking and conversation and perhaps in communicating with me (and the MSPP Board) about these matters. We would be very interested in how each of you views your past education and in how you are currently continuing your own education. As a society FOR psychoanalytic psychology and with our purposes, according to our by-laws, so heavily weighted toward psychoanalytic education, our responsibility to consider the future of psychoanalytic education and the future of psychoanalytic psychology/psychoanalysis, is to me a given.
One conversant queried me about my concerns about the format of “advertising” if MCE credit is involved. The standard format requires listing goals and objectives of the presentations for which credit is offered. “How can that make a difference?” I was asked. I believe that the “advertising” is itself part of the education and reflects an educational philosophy. It very subtly (and often crassly) conveys information about what learning is and how it best takes place, and has considerable influence on all participants in how they think about educating themselves and education. Goals of the speaker/educational organization, especially with words like the student will learn about, speak the language of “ought/should,” the language of the superego and of a hierarchical and categorically absolute situation of informed vs. uninformed and of right vs. wrong knowledge/thinking.
Such a perspective does not encourage the development/use of thinking capacities or of inquiry motivated by self-direction. It has not been my experience that what I “learn” in any presentation is necessarily what the speaker intends and for me, being focused by superego injunction keeps me from learning what I at that moment in time might “need” to learn. I have found that in a freer educational context I have often come to understand an issue of immediate importance and relevance to my work with someone or to my understanding of a “theoretical” issue associated in some way with the matter being presented with which I have been playing. A steady diet of “shoulds and oughts” lessens the likelihood that people will come to appreciate and cultivate the kind of learning that I have experienced and makes the pursuit of such experiences more conflictual. Since it is my view that psychoanalysis teaches us the value of associative, non-linear thinking, then psychoanalysis, like many other subjects, is best studied with minimal restrictions. The stage, in my opinion, is then best set with announcements that tell not of goals but of what the speaker(s) think they will be speaking about and who they are. That is why MSPP writes its brochures the way it does - - as an invitation to come and listen to the speaker’s thoughts/ideas if these seem interesting to you. Do I think people will learn something this way? I do, because there have been very few times that I have not and because many others have spoken with me about the same experience. I cannot but assume that many other people are like us. Do I think that such learning will afford as good a “protection of the public” as other formats (the reason given for MCE)? You bet I do, as professionally responsible self-direction is built right into the education and that protects the public. Such self-directed, self-responsible experiences are likely to encourage seeking further collegial consultation, in a timely way, at one’s own initiative when questions arise in one’s work. In my view, such consultation offers one of the finest protections of the public!
In another conversation I was told that MCE would not interfere with getting credit for collegial study groups, although someone would have to be responsible for “taking attendance.” My response to this is that such a group would no longer be collegial although it might still be called such. The subtle shifts in power and function growing from having a “monitor” (I am reminded of elementary school) can not be ignored and the shifts in group process that are likely to occur will make the group not quite so collegial and the discussion different and perhaps less fun. This matter of power and authority is one that has received much press in psychoanalytic thinking/writing recently, especially within the relational and intersubjective discourses and in the writings about psychoanalytic education and about Institutes. I believe we should apply that part of our education to our education and the reporting/monitoring functions of MCE make that highly unlikely and impractical. The effect might well be to kill this most important kind of education as time would in all likelihood limit people to more “reportable” and acceptable formats.
Collegial educational interchange has many other forms which have provided me and I imagine most of you with a great deal of education, e.g., time spent with colleagues in cars on the way to formal classes or going home from a presentation or over the coffeepot. At times these conversations are follow-ups from more formal presentations and at other times the results of a shared reading experience or case conference in a work setting. While I cannot measure how much I have learned in such collegial conversation I do know the great value to me of a mindset that values such exchanges as continuing education. I fear that not having such exchanges “count” may contribute to a mindset as to what education is, that will narrow perceived opportunities for learning and lessen the joy of learning for those who live in less free times than I did and for no overriding gain to anyone except perhaps those whose advertisements of programs that offer CE credit keep my recycle bin full.
The question was put to me about why I saw the necessity under MCE for a prearranged curriculum to be problematic as the group would just have to decide what it would study and justify its educational value ahead of time to those who police. But, there are so many times that study groups pick readings because they seem interesting. I am hard pressed to imagine how one can know ahead of time whether anything will be learned. One must read the book to know what that learning might be. The limitations imposed on exploring ideas/books/articles /interests /possibilities by this seemingly simple requirement undermines the whole concept of collegial study and curiosity driven education.
If people must first prove a book is educational in order to get “credit,” their choices might be dictated by the decisions of other readers/reviewers as to what the book teaches and if it is creditable. In those few programs where reading is accepted as a legitimate source of credit a test is part of the package. The hands of time and the power of money will make the free exploration of books very impractical. The first lines of a poem from childhood, “ I always think the cover of a book is like a door, that opens into someone’s house where I’ve never been before,” speaks to my difficulty in imagining a professional life where books are thus regulated.
Many proponents of MCE are surprised/shocked by the idea that teaching should count as MCE for the teacher. The view from their perspective is that teaching is a one way process between knower and not -knower and a process where the teacher does not ever have to learn anything new to teach. This does not match my experience of formal teaching at all and certainly it does not match my experience in “continuing education.” I do not think my experience is unique to a small group of those who have participated in formal teaching. No two classes are ever the same and the questions and direction of discussion are always different. I always rethought my “lectures” as I presented them and constantly changed reading suggestions. The refusal of those who administer MCE to give credit for teaching speaks very clearly of the educational perspective inherent in the push for this regulation. I can only shudder and predict an arid future for psychoanalytic psychology/psychoanalysis and all psychology in such an educational climate.
I have just returned from the Division 39 Spring Meetings and am therefore thinking about how these and other national meetings do not count for MCE in most states. While at APA one still is given a form to keep a record of what sessions are attended, it is no longer worth anything as evidence of continuing education. One must sign up for extra money for special sessions that are called CE at most meetings/conventions. Collegial interchange has no CE value. Only authorized authority has value. The difficulty in policing attendance is one reason given for this. Yet I have used these meetings for considerable continuing education over the last ten plus years as I have attended regularly. I often have given myself the task of attending multiple sessions over a series of meetings about perspectives and clinical work that are not part of my usual diet. I have updated myself by immersion in such sessions and especially in those of the sessions where work within these perspectives was demonstrated.
So these are some of my thoughts about MCE and some of the sources of my passion to prevent its imposition. I would be very interested in your thoughts on this vital subject, including any thoughts you might have about MSPP’s role in the current debate in addition to that which we have undertaken of keeping people informed.
Please write to email@example.com or to my home address, 1514 Ottawa, Ann Arbor, MI 48105. Please also consider contributing your thoughts/ideas to the MSPP News for sharing with your MSPP colleagues.
This President's Column was originally published in the June 2002 newsletter of the Michigan Society for Psychoanalytic Psychology. It is reprinted here by permission of the author. She may be contacted at firstname.lastname@example.org
Etta Gluckstein Saxe, Ph.D., is a psychoanalytic thinker, practitioner, and educator whose participation in psychoanalysis as discipline, practice, and scholarship spans almost 40 years. She has taught and done supervisory consultation in the Departments of Psychology of the University of Michigan and the University of Detroit Mercy and in the Department of Psychiatry and Behavioral Neuroscience (previously Department of Psychiatry) of the School of Medicine of Wayne State University, Detroit, Michigan, with a specialty in work with children and adolescents. Dr. Saxe is a long-time member of the Michigan Society for Psychoanalytic Psychology, which she served as the vice-president and program chair (1989-1991) and as president (1991-1995 and 2001-2003).
Dr. Saxe is a long time member of the Division of Psychoanalysis (39) of the American Psychological Association and was the year 2000 president and year 2001 past-president of Section IV (Local Chapters) of Division 39. She is a member of the International Federation for Psychoanalytic Education and has served two terms as a member-at-large, with her area of responsibility the development of a Mentorship Program. She is an active member of the Academy for the Study of the Psychoanalytic Arts and one of the "founding members" of this group. Dr. Saxe practices in Ann Arbor and Royal Oak, Michigan, offering personal and educational consultation, seminars and study groups.
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