Prologue: Overcoming Distance: The China American Psychoanalytic Alliance

Prefaces and introductions usually end with a list of thanks, but I would like to begin with thanks: First to the editors of Psychoanalytic Inquiry, Joseph D. Lichtenberg, M.D., and Melvin Bornstein, M.D., and to Associate Editor Daniel Goldin, M.F.T., for inviting the China American Psychoanalytic Alliance (CAPA) to do an issue. This is both an honor and a unique opportunity to introduce our organization and our work to a large part of the world. Then my thanks to the members of the CAPA Board of Directors, Committee chairpersons and members, many of whom have written articles for this issue as the directors of CAPA’s various programs. Then, thanks to the more than 400 members of CAPA for their incredible generosity teaching, treating and supervising—pro bono—the CAPA students. And finally, thanks to the 400 CAPA students and graduates without whose desire to learn about psychoanalytic psychotherapy, CAPA would not have come into existence.

This issue begins with the history of psychoanalysis in China – a topic filled with surprises for most Westerners who know little about this topic. It is followed by an article (by me) on the history of CAPA and a brief introduction to the many things that CAPA does. Many of the articles in this issue are filled with personal anecdotes. One reason is the obvious one. Most of those writing the articles played important roles in the development of CAPA and as directors of CAPA’s various functions. The other reason is—when CAPA began, many people thought it was a crazy idea; some thought it (distance training and treatment in China of all places) was a bad idea, and some thought it was doomed to failure (Osnos, 2011, p. 63). One thing all were curious about was “What is it like to teach or treat or supervise on the internet with someone you have never met ‘in the flesh’ so to speak and who lives in China.” The anecdotal style helps to answer these questions as the authors write about what it is like – in some ways very different from their usual work and in some ways surprisingly similar. As regards the other responses to the announcement that CAPA was beginning: “It is a crazy idea.” Actually, I thought so too. And actually, it was not my idea. Rather, it was my response to the many Chinese mental health professionals who wanted training and treatment.¹ “It is a bad idea.” Obviously, I and all the CAPA members and students do not think so. It is, I and my colleagues think, a very good idea. It makes training in and treatment with analytic psychotherapy and psychoanalysis possible for people who live in areas where there are no analysts or analytic psychotherapists, people in China, Africa, parts of Southeast Asia, parts of South America,² and in the five American states where there are no APsaA Members;³ candidates in training whose cities (and institutes) have been decimated by a hurricane, patients who have to move. I do not think that CAPA can claim all the credit for the expansion of distance training and treatment around the world in the past ten years (roughly the length of CAPA’s existence as a training institution) but it does deserve some of the credit. A nonprofit organization of reputable therapists and analysts certainly goes a long way convincing people that it might be a good idea. The comment of some, “It is doomed to failure,” has not been borne out.

How are we to measure success. The number of applicants for CAPA training grows every year. It is often difficult to find a graduate of the advanced program who can take on new patients in his or her private practice. While the first CAPA members were old friends and colleagues of the founding members, now analysts and therapists write from the USA and other countries to join CAPA and teach and supervise pro bono. And speaking about success, I received an e-mail from the Chair of the Education Committee of an APsaA institute that had agreed to do distance analytic training with Advanced CAPA graduates. “What are we going to do with this candidate. She knows more than our third year candidates.” I consider it a sign of success that none of the CAPA teachers, supervisors or officers have gotten rich or, indeed, have made any money for their work with CAPA. Those doing treatment negotiate minimal fees with the CAPA students. But CAPA has earned enough money from tuitions (among the lowest in China for a foreign training organization) and from the dues members pay (very small, but as one teacher asked “We have to pay for the privilege of working pro bono?”) to pay our five full time staff people.

Psychoanalytic organizations have a long history of internecine warfare. CAPA is fortunate, we have none of that. I find it odd at this stage of my life to be involved – even if only a little – with governments. Thus far the Chinese government has been welcoming and helpful. The U.S. government less so – refusing visas for people who had been accepted by American psychoanalytic institutes for local training. One US diplomat asked a psychologist applying for a visa “Why does analytic training take so long?” I doubt that the articles in this issue will be able to answer that question.

Elise W. Snyder, M.D.

Issue Editor

Notes

¹ “I’m just a girl who can’t say no.” Rogers, R. Oklahoma.

² It should be noted that wars and natural disasters have traumatized many people in these areas.

³ APsaA was the only organization from whom I could get this information.