"Approximately 1 in 5 adults in the US will experience mental health issues, yet psychoanalysis is rarely covered by insurance — or considered a viable treatment option.
“There’s much more emphasis on medication,” said Lisa Deutscher, vice president of the 106-year-old New York Psychoanalytic Society & Institute. “Even in a rather privileged stratum of society, there are shifts away from the idea that it would be useful to spend your time doing therapy. There are greater pressures, like the fact people are on call for their jobs 24/7. It makes other commitments in life that much harder.”
It can even be hard for would-be analysts to find the time to train. They can’t start until they’ve earned an MD, a PhD, or a license to practice clinical social work. After that, they must complete four years of coursework in psychoanalysis and 200 hours of clinical training.
On top of all that, they have to undergo analysis for at least two years — for at least four sessions per week.
“They’re requirements that fit the 1950s, when every psychologist wanted to be an analyst,” said Jamieson Webster, a psychoanalyst with a private practice in downtown Manhattan. “If you’re doing a MD or a PhD or an LCSW, the conditions of starting a private practice and having a job don’t fit with analytic training anymore. Candidates find their analytic voice at 50. That’s nuts.”
It may also help explain why 52 percent of members in the American Psychoanalytic Association are between 60 and 80 years old.
“We are an aging organization,” said Smaller, who runs the school program in Illinois. “When I became president-elect at age 62, it was scary that I might have been considered a Young Turk.”
To bring in a new generation of analysts, training centers have embraced a mode of treatment called “psychoanalytic psychotherapy.” It incorporates Freudian ideas about motivation and the unconscious, yet requires only two years to learn, making it an easier and cheaper route for new candidates to join the profession."