Skype's the limit

The CAPA program has about 50 Chinese students and more than 200 international psychoanalysts and analytic psychotherapists, but what sets it apart is that much of the training takes place through Skype, software that allows users to make online voice and video calls.

Instructors in other countries simply speak into Web cameras, with the images broadcast to students' computers across China.

"It's a miracle," said Jerome Blackman, a professor of clinical psychiatry at Eastern Virginia Medical School and a training analyst with the New York Freudian Society. "It enables me to discuss psychology with students who are thousands of kilometers away."

Although, the method is far from perfect (several consultants in China said they are regularly frustrated by poor Internet connections and technical difficulties), the majority of people involved in the program who talked to China Daily praised the convenience of the Skype-based training.

One aspect that has proved controversial, however, is the course requirement that students themselves undergo different types of psychoanalysis, which is also carried out over the Internet.

This has overturned the traditional Freudian method in which the analyst and the person being analyzed - referred to as the analysand - are in the same room.

"We must respect the limitations of technology," said professor Jose Saporta, a clinical instructor at Harvard Medical School's psychiatry department, who stressed that doing psychotherapy and psychoanalysis over Skype is unlikely to have the same effect as if they are done in person.

"There is no simultaneous eye-to-eye contact over Skype," he said.

His colleague, Wynn Shwartz, an expert on the supervision of psychotherapy, also pointed out that when technical problems interfere during an online training session and people are forced to repeat things, there is a risk they will change or exaggerate their statement.

"This naturally reduces spontaneity, which is what analysts base their judgments on," he added.

During the International Psychoanalytical Association conference in Beijing last month, psychologist Xiong Wei from the Wuhan Mental Health Center, one of few Chinese psychodynamic psychotherapy supervisors, released a case study based on 600 hours of online supervision of more than 20 students.

"Tiny but important information such as sighs and facial expressions are easily missed during Internet- based therapies," she said before warning that information safety is also a big concern in regards to hacker attacks.

For many consultants, however, online training is the only choice.

"Do you know how difficult it is to find a supervisor in China?" said Chen Yuying, a psychological consultant at East China Normal University and a second-year student with the CAPA. "Although imperfect, Skype training is better than nothing."

There are 108 psychodynamic psychotherapy supervisors in China but no analysts, according to statistics from the Chinese Psychological Society. In the US alone, there are some 3,500 analysts.

However, as the central government has just granted the permission for universities to recruit postgraduates in applied psychology, Yang at Capital Medical University said he is optimistic.

"Things will certainly get better if we have a strong training platform of our own," he said. "The history of psychoanalysis in China is yet to be written."

More international organizations are also looking to get on board, including Lingyu International Psychology Center in Toronto, Canada, which is preparing to launch its own online training program in Chinese.

Currently, most international teachers give lessons in English, which some people fear is hampering those mental health professionals who do not have the necessary language skills. Lingyu has promised to provide a translator for all of its training sessions.

As for the question of using Skype as a training platform, Elise Snyder, president of the CAPA, answered by referring to Freud's own words.

"When Freud wrote to the Chinese scholar Zhang Shizhao in 1921, he said, 'In whatever way you wish to carry out your intention by paving the way for the development of psychoanalysis I will be extremely pleased'," Snyder wrote in a paper presented at the IPA conference in Beijing.

"Many of us are following Freud's advice," she added.

(China Daily November 22, 2010)