Psychoanalytic Psychotherapy Networks from Central and Eastern European Countries

Serge Frisch

The founding of the European Federation For Psychoanalytic Psychotherapy in the Public Sector can only be understood in the context of the political, economical and in the last years also social developments that occurred in and between the European nations since world war II.
EFPP with its structures, internal functioning and its policy can only be understood in relation with the development and the growth of Europe.

Allow me to recall some important dates in the construction of the European Union? *

1950
On a suggestion made by Robert Schuman, the French Foreign minister, six countries namely Belgium, France, Luxembourg, Italy, the Netherlands and Germany pool together their Coal and Steel resources leading to the European Coal and Steel Community (ECSC).
1957
The treaty establishing the European Economic Community (EEC) is signed
1958!!!
German, French, Italian and Dutch are set up as official languages of the Communities. Very important: the wish that not one language took priority upon the other languages, all languages were equal. I am convinced that this was a reason why Europe managed to develop during all these years.
European Court of justice is set up. This Court will take an increasing importance in the European integration process and will abolish all differences in rights and discrimination between the inhabitants of Europe.
1960
A further important step is done in 1960 by the signature of the EFTA convention regrouping Austria, Denmark, Norway, Portugal, Sweden, Switzerland and the United Kingdom. This was a first step of linking these countries closer to Europe. For some it took more than 30 years to join Europe i.e. Sweden joined in 1995 and Switzerland still didn’t.
Creation of the European Social Fund aiming to promote employment and geographical and professional mobility of workers within the Community.
1973
Denmark, Ireland and the UK join the European Communities
1974
The European Court of Justice rules that whenever a national of a Member State wishes to set up in business in another Member State, the other Member State is obliged to refrain from applying any law, regulation or administrative provision or practice which might discriminate against him as opposed to its own nationals.
10 years later (1985) the European Court applies the non discrimination based on nationality principle.
This non discrimination is really the major integration engine of the Brussels Commission.
1975
Negotiations are started with Spain, Israel, Algeria, Maroco and Tunesia as well as with Malta
1975
The Community and 46 African, Caribbean and Pacific countries (ACP) sign a convention the so called Lomé I convention. In 1989 69 ACP countries will sign this convention.
1981
Greece becomes the 10^th member of the EC
1985
The first European passport are issued in most of the Members States.
Spain and Portugal join the Community.
1986
The Single European Act is signed
1989
9 November: The Berlin wall collapses.
1990
The Schengen Agreement on the elimination of border checks is signed by benelux countries, France, Germany and Italy
1991
Europe agreements are signed with Poland, Hungary and Czechoslovakia
1993
The Single European Market to revitalise the process of European integration and the Treaty on the European Union enter into force.
Associated countries of Central and Eastern Europe are assured that they will become full members as soon as they satisfy the requisite political and economic conditions.
1995
Austria, Finland and Sweden become members of the European Union
The Schengen Agreement comes into force between Austria, the Benelux states, France, Germany, Portugal and Spain
Romania, Latvia, Estonia, Lithuania and Slovakia apply to join the European Union

All these dates may be a bit boring but it is important to have a feeling of this European integration process to understand EFPP because we all in Europe who had since centuries wars one against the others have been profoundly influenced by this process lasting over years and changing our lives and perspective of freedom.

EFPP was founded in 1991 and was initially restricted to the countries member of the European Union and EFTA countries. We were thought to exert political pressure on the European authorities in Brussels.

After a few years of existence the executive committee of the EFPP and the delegates meeting had a first important decision to take namely the decision to accept or not Israel as a member of EFPP. Immediately after that we had to take the decision to accept or not those countries you are representing here today. The pro argument was that your countries will become member of the EU in some years and that it is important to associate you now at the decisions that have to be taken in EFPP and not to wait until your countries have joined EU as full members. It is was also clear for the EFPP that you would not get a special status but that you would be considered on the same level as any other EU country. The consequence is that the full EFPP constitution is being applied to you as to any other country. We shall have enough time to discuss this in detail during this WE.

Lets come back to the reasons of founding the EFPP

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

• the mentioned European integration process
• the crisis in the field of psychodynamic psychotherapy

a) the European integration process

The founding of the EFPP has to be considered in 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. Of course he had to prove his professional qualification in that new country but the hosting country could not forbid him to work in the profession he had in his country of origin. The hosting authorities could only ask him to complete his professional qualification.

b) the crisis in the field of psychodynamic psychotherapy

But the initiators of the EFPP Brian Martindale, Lydia Tischler, Miranda Feuchtwang and many others were aware that in all parts of Europe the psychoanalytic theory and treatment methods were attacked by alternative short term therapies regardless of the patients intra psychic needs and this only for economical reasons and not for therapeutic ones. Psychoanalytically trained psychotherapists were replaced by cognitive therapists in hospitals, clinics and universities.

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

More, there was no cohesion in that field: the training models very different and even the training standards were incredibly different from country to country. Some training models were very structured lasting for 3 mostly for 4 years others for only 2 years. The most structured models had a well defined programme: that’s what I call the menu model of Northern Europe. In Latin Europe the a la carte training models existed where each individual professional tried to define his/her own training model and content. As you know, in restaurants some people take always a la carte whereas others take always the menu. It’s an affaire de gout. My purpose is not to tell you my preference nor that one model is better than the other one but to show how much energy it took to initiate discussions between all these models. EFPP initiated a still ongoing discussion about training models and standards we believe basic to be trained as psychoanalytic psychotherapist.

But far more EFPP has also brought some cohesion in the fragmented national organisations by helping the existing national bodies to discuss together and so to come closer. That 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 founding of a national umbrella organisation of societies for psychoanalytic psychotherapy.

What did the EFPP achieve so far?

In the last 10 years the Federation has made a significant impact on the provision of psychodynamic psychotherapy in the public sector:

1. All European Union countries except Austria have active memberships, testifying to the need of such an organisation. The membership now represents about 13,000 psychoanalytic psychotherapists.
2. Some of our member countries have formed national networks or organisations as a direct consequence of the EFPP. Prior to the EFPP, without national networks psychoanalytic psychotherapists would have had no chance of recognition by national Boards of Health or similar organisations responsible for mental health policy.
   Some networks were in existence before, but the impact of the EFPP has led to national networks being created in such countries as Belgium, Denmark, Finland, Italy, Spain, Norway, and Switzerland.
3. In the last four years many organisations in former Eastern and Central European countries have understood that the EFPP offers a good quality umbrella within which to develop and we are happy to see that you wish to join the EFPP.
4. We have held a series of conferences on important clinical topics in a number of our member countries and the national networks have held their own conferences. We had also regional conferences as for instance the biannual Francophone conferences. These conferences lead to increased knowledge and exposure to clinical expertise that benefits those suffering from mental illness.
5. We have produced 7 books in a series of publications that will lead to improved clinical knowledge to benefit those suffering from mental illness. We will continue to publish at the rate of one or two books a year.
6. Recently EFPP started a research work group because the research theme is becoming more and more a very hot issue for reasons I don’t need to tell you.
7. On a political level we inform our networks of what is happening in the EU in Brussels and we also try to circulate important political information happening in one country to all the networks. This is important for those networks who are involved in discussions with national politicians and governments for in

What are the major EFPP guidelines?

• People suffering from psychic pain or psychiatric pathologies should be able to choose qualified psychoanalytic psychotherapy or psychoanalysis.
• Only qualified core professionals with an adequate training in psychopathology can be trained in psychoanalytic psychotherapy.
• Proper training for psychotherapy requires theoretical seminars, supervision, individually and in groups, as well as a personal psychoanalysis. Continuous training after graduation is imperative to safeguard the high standards of the profession.
• Such high level training standards are necessary to avoid that people not adequately trained endanger the fragile mental health of (psychiatric) patients through creating undue pathological dependency through emotional exploitation hence secondary traumatisation. The danger of sects searching influence in the field of psychotherapy also should be taken into consideration.
• As qualified psychoanalytic psychotherapists should only be accepted professionals with a documented training that fulfil the above mentioned criteria e.g. posses a complete and coherent theory of the development of psychic functioning and psychiatric pathologies. Psychoanalytic psychotherapy requires a framework build on appropriate theory concerning personality.
• Long term and high frequency psychoanalytic psychotherapy treatment have to be available for those who need this therapeutic approach.

What are the internal structures of the EFPP

Only national networks can be member of the EFPP and not individuals.

EFPP is divided into 3 sections

• Child and adolescent section
• Adult section
• Group section

Each country can delegate 2 members in each section i.e. a maximum of 6 delegates represent each country at the General Assembly of the EFPP.

The sections elect 3 members i.e. a total of 9 members. These 9 members are the executive committee of the Federation. The executive is electing the chairperson, vice chair, honorary secretary, treasurer etc. You certainly wish to know that amongst the 3 persons elected in each section one is elected as section co-ordinator or if you prefer the chairperson of the section, a very important function indeed.

So far this general introduction to EFPP its historical context off founding and some of its leading principles. I am expecting that this WE will allow us all to exchange a lot of information to allow us a better mutual understanding and collaboration.

Prague 19- 21 October 2001