This rule is not superfluous at all. There are several reasons for it.
In the first place, it is hard to combine organic and psychical
treatment. In the second place, the particular condition of transference
frequently prevailing in analyses may make it inadvisable for the
analyst to subject his patient to physical examination. In the third
place, there are all the reasons in the world for the analyst to doubt
his own opinion, inasmuch as he is so intensely interested in the
psychical aspects of the case.
“I now understand your position towards lay-analyses. You insist that
there must be lay-analysts. However, as you have to admit their
insufficiency for the task, you compile everything that could serve to
excuse them, and make things in general easier for them. To be frank
with you, I cannot understand why we should have lay-analysts at all,
inasmuch as they would never be more than second-class therapeutists.
This need not include those few laymen who have already received their
training, but institutes for psychological training should not accept
laymen any more.”
I would assent to all this, if I could be shown that such restrictions
would benefit all parties interested. You will admit that these
interests are tri-fold:—There is the interest of the patient, the
interest of the physicians, and last but not least, the interest of
science which, in turn, includes the interest of all patients of the
future. Let us investigate these three points.
It does not matter whether the patient be analysed by a physician or a
layman, as long as any danger of mistaking his condition is excluded by
being properly examined by a physician before the beginning of the
treatment, or re-examined as soon as developments, in the course of the
analysis, make this advisable. It is much more important for the patient
that the analyst possesses those personal qualities which invite full
confidence, and that he has that knowledge and experience which alone
qualify him to apply psychoanalysis. To some people, it may seem that it
might undermine the authority of the analyst to have his patient know
that he is no physician and must obtain the advice of a medically
trained expert in certain matters. However, although we have never kept
a patient in the dark, as to the qualifications of an analyst, we have
come to the conclusion that the patients have no prejudice against a
non-medically trained analyst; they are only too glad to accept the
benefits of treatment, wherever they offer themselves—a fact resented by
the medical profession for the longest time.
It also must be considered that analysts, practising today, are men and
women with academic training and degrees, pedagogues, of great
experience and impressive personality. The analysis, to which all
candidates of psychoanalytical institutes are required to submit, is the
best means of testing their personal suitability for the performance of
so exerting an activity as an analysis presents.
Public-domain text, read in full here on John Shaqi.
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