Psychoanalytic and psychodynamic education in the 21st century

Psychoanalytic and psychodynamic education over the past 50 years is reviewed in the context of the author's personal experience, as well as the changes that have taken place in psychiatry and psychoanalysis over the same time span. Several key issues are identified, including (1) the increasing biological reductionism of psychiatry; (2) the gradual de-emphasis of subjective experience along with the biopsychosocial explanation of human behavior and psychopathology; and (3) the increasing attention paid to neuroscience, psychopharmacology, and brief therapies during residency training. In order to address these issues, it is suggested that education in psychodynamic and psychoanalytic psychiatry be integrated into residency training. This would take the form of subspecialty training in either psychodynamic psychiatry or psycho analysis. Such training would promote an understanding of the connections between neurobiology and psychodynamics, versatility with a variety of dynamic psychotherapeutic techniques, and familiarity with research methodology. Psychiatrists educated in this type of integrated training program will be optimally equipped to advance psychodynamic and psychoanalytic treatment, theory, and research in the 21st century.