Cristina Calarasanu: Mr. Luc Moyson, you are the president of EFPP, an institution that joins together the applications of the psychoanalytical theory in four fields: individual adult, children and teenagers, groups, families and couples. Can you, please, tell us what principles rule and coordinate EFPP?

Luc Moyson: The founding of the European federation for Psychoanalytic Psychotherapy (EFPP) in 1991 must be understood in the context of the political, economic and social developments that occurred in and between the European nations and the growth of Europe.

Two main reasons can be pointed leading to the founding of the EFPP:

the European Integration process and the crisis in the field of psychodynamic psychotherapy

a) The European Integration Process - The founding of the EFPP has to be considered from the perspective of the creation of the Single European Market and the suppression of the national borders of the so called Schengen countries. This meant that any professional was allowed to migrate in any other European country and was free to live and work there..

b) The crisis in the field of psychoanalytic psychotherapy - The initiators of the EFPP were aware that in all parts of Europe psychoanalytic theory and treatment were being attacked by alternative short term therapies, regardless of the patients intra psychic needs and this only for economic  reasons and not for therapeutic ones. Psychoanalytic psychotherapists were replaced by cognitive therapists in hospitals and universities because of “evidence based” practice.

Unfortunately the field of psychoanalytic psychotherapy in Europe, at that time, was fragmented mostly into local or regional and seldom into national bodies. This situation was not the best way to defend psychoanalytic psychotherapy.

Furthermore, there was no cohesion in the field: the training models looked very different and even the training standards were incredibly different from country to country. No consensus could be found of what psychoanalytic psychotherapy really was.

The lack of cohesion in the world of psychoanalytic psychotherapy had a lot to do with  tension fields and differences: differences between clinical psychologists and psychiatrists, academic trained and non-academic trained, psychoanalysts and psychoanalytic psychotherapists and differences between members and non members of the IPA. And then I haven’t even mentioned all the different analytic frameworks people adhere to: Post Freudians, Winnicott, Klein, Meltzer, Bion, Lacan, and more recently Kernberg and Fonagay etc.

The EFPP initiated a still ongoing discussion about training models and standards. The EFPP training standards are agreed upon as the benchmark for national networks and we consider it as an important task to give support in the training of member countries who ask for assistance. We may say that the EFPP has brought some cohesion in the fragmented national organisations by helping the existing national bodies to discuss together and so to come closer. This wasn’t felt as a loosening of the specificity of each society but as a mutual enrichment, full of developmental capacities.

In other countries EFPP initiated the founding of regional societies in regions where no psychoanalytic psychotherapy organisation existed so far. In several countries EFPP stimulated the establishment of a national umbrella organisation.

c)The aims of the EFPP - In short, the overall principle is to keep in contact with the development of psychoanalytic work in our member countries, with special regard to the conditions of work with our patients. Permanent attention to training conditions and research are also of great importance. Europe is growing and with the recently new EU member countries, the balance seems to have shifted towards the eastern part of Europe. Right from the beginning, one main area of the work has been to discuss and exchange experiences from the various types of training in psychoanalytic psychotherapy that are offered in different countries in Europe. Our aim was to reach an agreement on the level of minimum standards of training that is desirable and realistic. This discussion is an open ended one while continuous changes in society demands constant adaptations. Huge differences in history and traditions lead to different perceptions and interpretations of what psychoanalytic psychotherapy really represents.

We offer a forum in which further explorations can take place and in which we can learn from our differences.

The EFPP promotes a European Community network of psychoanalytic psychotherapists through activities such as annual EFPP conferences, the publication of the EFPP Book Series, through support of training programmes, through setting up different special interest groups and through the EFPP Website.

Cristina Calarasanu: You told me about the project “Past, present, and future”, which you created in order to get to the south-eastern European countries and make the specific of EFPP known. How do you see now the integration of these countries and their attempt to make up their own psychoanalytical identity?

Luc Moyson:  From 2004  many countries in Central and Eastern Europe became members of the European Union. This development had been foreseen by the EFPP and contacts with many of these countries have been developed since the start of the EFPP. In 2005 Ludek Vrba (Czech Republic) became a member of the Executive Committee and through him and others many of these contacts have developed in a very positive way. From 2005 till now, members of the Executive Committee have been invited to give presentations, seminars and workshops or to work as Supervisors in Ukraine, Bulgaria, Russia and Poland.

More of the Central and Eastern European Countries have developed their training standards and are joining the EFPP either as full members or associate members in the same way as other European countries do.  A suggestion that was supported by many was that the next step could be different forms of continued supervision in order to enable those who have now finished their training to develop their work further and eventually be able to work as teachers and supervisors themselves.

We know only a little about the situation of psychoanalytic psychotherapy in Romania. The coordinator of the special interest group on research was not informed about psychoanalytic research done in Romania. We presume that indeed the development of psychoanalytic thinking was most probably restricted by the former political system. But we hope that we will be informed via contacts about the current situation and we are willing to think together about what is needed at the moment and how this goals can be achieved.

Cristina Calarasanu: I know that the main purposes of EFPP are the ones related to formation and research. Can you tell us what the most important directions in these areas are today, when the clinical and theoretical labour is experiencing transformations and reconsiderations?

Luc Moyson:  Critics of psychoanalysis are as old as psychoanalysis itself. The spreading of caricatural ideas on psychoanalysis is enormous, not only in the popular media (films and novels) but also in the academic world.

It is remarkable that the empirical substructure of these accusations is hardly scrutinised!

Another remarkable finding is the complete lack of knowledge about the extensive empirical research in psychodynamic concepts and theories. The criticism that psychoanalysis is completely unscientific or that its assumptions cannot be tested empirically can, on the basis of a lot of empirical studies be rejected.

Psychoanalysis is too often, even in mental health itself, identified with the typical cure: several times a week, on the sofa, for many years. Obviously, psychoanalysis is much more than that. Different important writers such as Klein, Winnicot, Lacan, Bion, Kohut, Kernberg and Fonagy contributed not only to further theoretical developments but also to a broader clinical practice where practically the whole spectrum of possible psychopathology, by the way of adjusted methods and techniques can be approached.  Nowadays, many psychoanalytic therapists work on wards for new born or elderly patients. They try to help in the first contacts between the baby and his parents, do play therapy with toddlers, help adolescents to find their way in their individuation and sexualisation processes, and you even can find them on wards for addiction problems and forensic psychiatry with more severe psychopathology.

Unless the theoretical diversity ,we observe on the technical level a lot of converging tendencies in which psychoanalytic psychotherapy develops as the common ground and as the therapy of choice for most kinds of psychopathology, inclusive neurosis.

We need to show the society and the politicians that our work is effective and with enduring results and that psychoanalytic psychotherapy is for a lot a patients the therapy of choice. And  this assumption can even be scientifically be supported.

Research and psychoanalysis

It is remarkable that in the recent publications of psychoanalytic journals, traditional case studies and theoretical contributions gave their space to a growing number of empirical studies in which psychodynamic hypotheses or concepts are tested in a systematic way.

This is a conscious strategy concerned to give a concrete answer to the multiple critics about the empirical-scientifical status of psychoanalysis. But it is also an attempt to assure the future of psychoanalysis as a theory but essentially as a psychotherapeutic instrument in this time of evidence-based medicine Existing research shows that a systematic testing of psychodynamic concepts by means of questionnaires and experimental research are in fact possible and can be theoretically and therapeutically relevant.

On the other hand it is of course true that research has to connect much more, not only to the complex daily clinical experience, but also has to recognise the complexity of psychodynamic concepts. In too much research, psychoanalytic terms are used in a caricaturist way.

We cannot underline enough the crucial importance of reliable conceptual research, which forms one of the strongest points in psychoanalysis. Expanding conceptual research by using insights from other scientifically disciplines like philosophy, linguistics, cultural anthropology, biology, neurosciences, attachment theories, mentalization theories and history is even necessary as the systematic testing of these concepts.

Psychoanalysis is neither medicine nor philosophy. It is a most important breeding ground for clinical practice and is in a constant and critical dialogue with a lot of other sciences, it explains unconscious mechanisms that influence our mental lives and psychopathological phenomenon’s. Its ethics are not focused on normality or morality but on the affective working through of the human tragicomedy. As far as it wants to preserve its value in the field of psychotherapy, it needs to find enough connections with the present scientific framework of psychiatry. Otherwise it runs the danger of being perceived as an alternative mental health service.