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Shuttle Analysis, Shuttle Supervision, and Shuttle Life-Some Facts, Experiences, and Questions1 Gábor Szőnyi Tamara Štajner-Popović 2

Tremendous effort supported the spreading of psychoanalysis in what was formerly known as "Eastern Europe." Since 2002, the Han Groen Prakken Psychoanalytic Institute of Eastern Europe has integrated this work. In many cases, training components had to be provided in "shuttle format." Shuttle analysis can be considered as an experimental domain in psychoanalytical education. The discussions on shuttle analysis have brought into the foreground some of the aspects of the process: high variation of setting; handling of unavoidable cultural c1ash; special shaping of defenses; the repetitive separation; shuttle life as a consequence-periodically interrupted practice, combination with shuttle supervision; high investment.

Training with shuttle components is always a project, never a routine, because of the demand on extra organizational investment. We discuss shuttling from the point of the analyst, of the candidate, of the supervisor, and of the developing organization. Questions include special defense mechanisms, observations on transference- countertransference, "shuttle reality" of ten resembling a "dream-like reality," and special problems of supervision. The question of evaluation is an especially difficult one. The evaluation is as traditional as in regular education. At the end, we face the question: What makes shuttle analysis/shuttle training work?

HISTORICAL BACKGROUND

In 1987, a handful of potential candidates from different parts of Eastern Europe (Prague, Belgrade, Warsaw, and Zagreb) under the auspices of the new/old Hungarian Society met with the Executive of the European Psychoanalytical Federation (EPF) in Hungary. For years, there have bee n sporadic contacts, but the analy tic community was, so to say, just more or less aware of Eastern Europe. The fact that there were no institutes su ch those in developed societies of the West were taken as the proof that there was also no expertise whatsoever, no basis for fostering the development of analysis. The Budapest meeting was, at some points, quite a temperamental one. The Easterners argued that, before reaching a decision, it would make sense at least to visit, to investigate, and to see. Obviously, to have su ch a meeting in the first place took courage from both sides. The EPF Executive, especiaIly its president at the time-Han Groen- Prakken, the initiator of the meeting-was in a way chaIlenging the set principles of the establishment. The situation was not too simple for the Eastern Europeans, either. It was, in' a way, a test of narcissistic vulnerability, but there was also the external reality as most were coming from behind the iron curtain, and chose a ri sky adventure, as analysis in their countries only existed underground. For both sides, years of waiting and hoping lay ahead. Yet with the deci sion that was initiated in Budapest, to go East and see, the so-caIled "Project Eastern Europe" was about to begin. The goal was to attempt to integrate the split-off part of the European continent into the European analytical community. Much was to change in a few years. Hungary, Poland, and Czechoslovakia soon were no longer countries behind the Iron Curtain; the most prosperous and liberal communist country, the forrner Yugoslavia-the only one not belonging to the Warsaw Pact and open to the West-was to be, for years, ravaged by a bestial civil war. However, even before the major changes in the external reality happened, it was evident from the very beginning that "Eastern Europe" was a generalization and an abstraction. That is even truer today, as each East European established or nonestablished group has a character of its own. There are vast differences, the same as there would be in the West between, lets say, Greece and Norway. De facto, Eastern Europe encompasses countries with different cultural and historical

1 The final, corrected version was published: Szőnyi, G., Stájner-Popovič, T. (2008): Shuttle analysis, shuttle supervision, and shuttle life – some Facts, Experiences, and Questions. Psychanal. Inq. 28:309-328. 2 Gábor Szönyi, M.D., is a training analyst at the Hungarian Psychoanalytical Society, as weil as being Associate Director for Research, Han Groen-Prakken Psychoanalytic Institute for Eastern Europe. Tamara Štajner-Popović is a Medical Psychologist, a Training Analyst at Belgrade Psychoanalytical Society, and Associate Director for Outreach, Han Groen-Prakken Psychoanalytic Institute for Eastern Europe.

2 backgrounds, and the so-called common denominator of the totalitarian regime tremendously varied among its different parts. Economically, there are those countries still tottering in poverty and those with a much more Western standard ofliving. The so-called 'societies in transition ' denoted states with no demoeratic tradition whatsoever, as weIl as those with developed demoeratic institutions prior to the outbreak of World War 2. Yet, when it carne to development of psychoanalysis, there were common denominators. Hungary was an exception, as it was the only Eastern Europe country in which a society existed before the War. The first Hungarian Society was founded in 1913, and, although it was forced to dissolve in 1949, the special political circumstances allowed the reestablishment of a study group in 1975, of an International Psychoanalytical Association (IPA) provisional society in 1981, and of an IPA component society in 1989. Except for the established Hungarian Society, it seemed as if there were two East Europes in the analytic sen se. On one side, there were group s in Prague, Belgrade, and Warsaw where analysis began to develop before World War 2 and continued afterwards. The training was very much along the lines of the tripartite model including standard training analysis. During the first decade of "Project Eastern Europe," except for Hungary, three more IPA established groups were to be recognized. In other parts of so-called Eastern Europe, spreading from Moldavia to Armenia, psychoanalysis had no tradition whatsoever, or was virtually extinguished by the communist regime. Developing analysis in these groups (spreading over half of the European continent, encompassing some 15 countries and 28 groups) was the challenge. As we write this article, there are two IPA component societies (Hungarian, Czech), two provisional societies (Belgrade, Polish), four study groups (Romanian, Croatian, and two in Moscow) in Eastern Europe, and quite a few groupings are close to apply for study group status.

TRAINING IN SHUTTLE FORMAT

Extending psychoanalytic training to areas where psychoanalytic traditions are poor, where no training analysts can be found, and where financial tools to support people in living in another country for several years are lacking asks for new solutions. The political "Eastern Europe"-countries that until1990 mostly belonged to the Soviet empire-were such a part of Europe during and after the deep social- political-economical changes around 1990. Analytic training, especially personal analysis, requires the candidate to visit the analyst almost day by day. In cities and countries where no training analyst is located, the candidate has to move for several years to aplace where training analysts are settled. This form demands that the candidate give up his or her life and professional embeddedness for the training years, and to set up another life and professional circumstances. One may hope that, after having finished analytic training, the candidate goes back to his or her city/country of origin. Obviously, it often does not happen; instead the new analyst settles down where he or she underwent training. Another option is that the candidate moves regularly for shorter periods to the place of the training analysts, which varies with periods of staying at home. That one we call shuttle analysis (supervision, training). At shorter distances, when it is also financially feasible, so-called condensed analysis might be a solution. It means that more than one session can be held on a day, and the weekly number of sessions remains unchanged. The setting used at the training of many candidates from the Baltic States in Helsinki was something between shuttle and condensed analysis. The candidates went every sec ond week to Helsinki, and had, compressed into one week, all the personal analytic sessions, seminars, and supervisions of a two weeks period in regular training. Although concentrated analysis is an accepted IPA training option, shuttle analysis-which is a form of concentrated analysis-is accepted only at the diseretion of the IPA on an individual basis. From oral tradition, we know that shuttle analysis has always existed, but usually was hidden, denied, and sporadic, and it has never been investigated. The history of German analysts after World War 2 has contacting points with shuttle analysis. The developments in Eastern Europe represented a quantitative difference. In the last fifteen years, we faced a boom in psychoanalytic training. Candidates from over ten countries looked for training simultaneously, yet at most places no training analyst was to be found. Luckily, the high interest of many 3 individuals and analy tic societies to help the development of psychoanalysis in Eastern Europe led to a temporary explosion of special solution s to train Eastern European candidates, often with the help of shuttle settings. We speak about spreading of psychoanalysis in more than 15 countries simultaneously. The Han Groen-Prakken Psychoanalytic Institute for Eastern Europe (PIEE) developed as a joint EPF and IPA venture when it became evident that the teaching organized by the East European Committee of the EPF needed to be enlarged by providing more structured training in the area. In the initial phase of psychoanalytic training by shuttle analysis, shuttle analysands went to Western training analysts. The differences in social, political, and cultural values, as well as in religion and language, are vasto It seems that there is a search for cultural similarities, of the shared emotional heritage of the past of living in totalitarian regimes, and of having an analyst, that know s the mother tongue (for example, Russian). Yet, one needs to bear in mind that the age of the shuttle analysands varies, from those who in their forties to those who were children when the curtain fell. There is a recent tendeney of younger ones wanting to start shuttle training, now that the "seniors," most of ten the group leaders have finished theirs. A second phase has begun: There is a shift to eastern training analysts, a choice that should "ensure" less cultural shock. PIEE has a two-fold primary task:

• to coordinate, foster, monitor, and evaluate the education of East European candidates from countries and areas where no study group exists, to become good enough to be internationally- cornparable analysts; and • to foster the formation of analytic groups, which than may become IPA study groups.

PIEE also organizes summer schools for colleagues interested to join psychoanalytic training. The PIEE, founded by IPA and EPF in 2002, is a special institute. It has a staff of eight analysts from different countries, but it is a "virtual institute." Its registrants-registrants in analysis, candidates, and IPA direct mernbers-i-leave PIEE when a study group is formed in their home. The training and supervising analysts do not belong formally to the institute; they are connected to it through the candidates. The institute provides them with the guidelines of training. The institute cooperates with those societies and institutes that help in one or another way the training of East European candidates (e.g., by organizing special seminars, or by providing lodging during shuttle), and with the IPA sponsoring committees active in the area. The PIEE supports psychoanalytic education of individuals-done mainly by others (training and supervising analysts, seminars); and supports formation of local groups-done later by others (European Subcommittee, sponsoring committees of the International New Groups Committee). This bifocal task influences selection of candidates, and its policy on supporting/limiting shuttle training.3 Shuttle is one of the options of training guarded by PIEE: an exception, with exceptional investment. The evaluation at PIEE is as demanding as in a regular education. At qualification, at least one of the evaluator is an invited training analyst of an IPA component society.

Workshops and Surveys on Shuttle Analysis and Shuttle Supervision4

Over the past 15 years, shuttle analysis has become a major development in spreading psychoanalysis in Eastern Europe. This development raised interest and instigated many new questions. This brought about a strong need to bring together the shuttle analysts in order to exchange their experiences and to explore shuttle analysis as a model of personal analysis.

3 The institute set up guidelines about requirements of shuttle analysis and shuttle supervision: http://www.hgp-piee.org/ index.html 4 We express OUf special gratitude to Paolo Fonda and Ursula Volz for their tremendous work at the EPF conference workshops and retreats.

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The first new style annual EPF conference (Prague, 2002) offered space to organize a three-hour workshop on shuttle analysis and shuttle supervision,5 organized and conveyed by Ursula Volz in consultation with Paolo Fonda. The initiative was followed by workshop s on shuttle training at the conferences in Sorrento (2003), Helsinki (2004), and Vilamoura (2005). In the enthusiastic discussion, many of the participants expressed a need that an ongoing group on shuttle analysis forum should be formed in order to explore the topic. Two retreats were organized between EPF conferences, attended only by a core group (Kamp-Lintfort, 2002; Budapest,2003). The main objectives were to bring together shuttle analysts, to exchange experiences, to explore the question of shuttle analysis as a development in psychoanalytic education, and to explore possibilities and limits of research on shuttle analysis. The first forum on shuttle training focused mainlyon shuttle analysis. How does shuttle analysis relate to shuttle life, to the hidden domain behind it? Is there a support system for lod gin g, for setting up the structure of life during the shuttle phase? Who is involved? How do everyday life conditions in the host town influen ce the base of analysis? Howare the analyst and the candidate chosen? Is conducting shuttle analysis an exception for the analyst or a regular way of working? How does shuttle analysis relate to other components oftraining? How does shuttle analysis relate to later analytical practice? The second workshop on shuttle training6 continued to explore the questions of shuttle analysis. The discussion material included both hard data on shuttle analysis in Eastern Europe and the opinions colleeted from shuttle analysts. Because most of the shuttle analysts have only one candidate in shuttle analysis, and because of reasons of confidentiality we had to give up having case presentations. New questions were discussed, including indications and contraindications of shuttle analysis. How can the analyst be prepared for the task of shuttle analysis? How do cultural differences influence shuttle analysis? What language is chosen? Is evaluation influenced by the fact that the candidate was trained in shuttle format? Is it more difficult to evaluate "shuttle candidates" than those who are in regular training? The shared conclusion was that shuttle analysis is an experiment in psycho analy tic education. It is only one aspect of a massive change in education within the societies. Eighteen colleagues participated in the third forum:7 training analysts, interested members and-for the first time-candidates of PIEE. The candidates were admitted, because no confidential material was exchanged. (One of the initial ideas of the first two workshop s was that training analysts could exchange confidential experiences gained during shuttle analyses. However, it turned out that this required another frame-participants would unavoidably recognize the analysands.) It was more an exchange on general experiences of shuttle life. Questions of caring for the candidates in the host countries, and questions of conducting analysis in a foreign language (which is often neither the mother tongue for the candidate nor for the analyst) were discussed. It was the first time that colleagues from Eastern Europe reported about experiences during their shuttle analyses: Katya Kalmykova gave an impressive overview on experiences of separation. Nina Asanova confided in a frank way her personal experiences in training analysis in an Eastern European country. The conclusion was that shuttle analysis works, It is a creative answer to the challenge of the growing demands for psychoanalytic training in countries without developed psychoanalytic education. Candidates of the first generation are highly motivated and devoted in their training. The fourth event on shuttle analysis8 moved in the direction of experiences with shuttle supervision and the impact of shuttle life on therapy practice. Tamara Štajner-Popović gave a short summary of the workshops at previous conferences. Gábor Szönyi reported on the hard data of shuttle supervision settings. Anna Kazanskaya and Marina Arutunyan spoke about a survey on shuttle experiences among PIEE

5 The workshop on shuttle analysis, EPF Conference, Prague, 2002, was convened by Ursula Volz, with support of Paolo Fonda. Presenters included Gertie Bögels, Gilbert Diatkine, and Paolo Fonda. 6 The Workshop on shuttle analysis at the EPF Conference, Sorrento, 2003, was convened by Ursula Volz. Presenters included Tamara Štajner-Popović and Gábor Szönyi. 7 Workshop on shuttle analysis and shuttie life at the EPF Con ference, Helsinki, 2004, convened by Ursula Volz and Gábor Szönyi. Presenters included Nina Asanova and Katya Kalmikova. 8 Workshop on shuttle supervision and shuttIe life at the EPF Conference, Vilamoura, 2005, convened by Gábor Szönyi. Presenters included Tamara Štajner-Popović, Marina Arutunyan, Anna Kazanskaya, and Gábor Szönyi.

5 candidates. Later, they also compared their findings with a small sample of German and Hungarian analysts/candidates and how they imagine shuttle life. Organization and setting of shuttle supervisions seemed to be the most problematic question of shuttle training. Tamara Štajner-Popović gave a personal account of experiences with shuttle supervisiono She emphasized that supervision must be maintained between personal encounters. The success of supervision depends highly on whether the training analyst and the candidate can use the chosen method-phone or e- mail. One conclusion was that a minimum number of face-to-face sessions would have to be set. In her survey, Arutunyan (2004) compared those who got training in a condensed-like format (condensed training in every sec ond week), and "real shuttlers," who go 3-5 times a year for longer periods to attai n training. She differentiated three profiles: the "stoic," who takes burdens and pains of shuttle life with dignity and pride; the "wanderer," who is in permanent transition in space and time, having a shuttle life "out of time"; and the "player" or wonder-seeker, who is moved by curiosity, for surprise, and for adventure. "Wanderers" were higher represented among real shuttlers, than among those who were trained in condensed-like setting, where she found more stoics. She expected but did not find difference in perceiving separations between the two groups. Candidates in high travel frequency, condensed-like frame were more occupied with the setting, while real shuttlers were more sensitive to cultural differences. Kazanskaya (2004) used a projective questionnaire that contained 14 unfinished sentences to make a pilot review of moods about and around personal shuttle experience, The unfinished sentences include "Analysis is a shuttle between…." When answering the question about the most pleasurable experience connected with shuttle, people mentioned freedom, rest, self- and mutual understanding, dignity, enthusiasm, learning a new language, and making new friends. However, if separations are experienced as something negative, the change of ambience is rarely regarded as something very unpleasant. Although some people mentioned problems that they had with their adaptation to a new surrounding, 15 (vs. 3), respondents evaluated their new cultural experience as something positive in the end. Following this line of thinking, some questions were aimed to investigate moods about group relations at home. Most of the respondents thought that group relations improved during, or due to, shuttle analysis of the members. Maybe the absence of supervisors during group discussions make s the feeling of rivalry less acute inside the same group, and makes relations better. Most of the people reported that clinical group discussions at home without training analysts were "good." Another aspect is that the supervisors do not belong to the same group, nor are they even members of PIEE. Therefore, candidates move between two settings: regular supervision and peer. Most of the respondents considered the work of a shuttle analyst as more difficult than the work of a normal training analyst, although they could also think of some advantages, mostly connected to the interest in another culture and new work setting. These two parameters are clearly linked to one another as they represent an overall interest to the new and unknown that the candidates ascribe to (or sense from) their analysts. Shuttle analysis seemed to be felt by most Eastern candidates as a lucky enterprise.

PERSONAL ACCOUNT ON EXPERIENCES WITH SHUTTLE SUPERVISION

The situation with shuttle supervision today very much resembles Bernfeld's statement (1952, quoted by Ekstein 1960), who recalls Freud's words encouraging him to start analyzing a patient: "You go right ahead. You will get into trouble. Then we'll figure out what to do about it" (p. 167). The descriptions of personal experiences are very scarce and stem from three sources: • Shuttle supervisory cases that cannot be presented for reasons of confidentiality . • The final evaluations within PIEE (rigorous as within various institutes). • These are of ten quite illustrative on how much the supervisee learned from his supervision, tells us something about the variation of shuttle supervision settings and supervisory techniques. The supervisory reports tell the story of their own: expectations, goals achieved, the overinvestment with their exceptionally high demands, and the underinvestment-"anything goes." • Communications with other shuttle supervisors 6

The shuttle supervision setting, the dream-like reality in combination with virtual reality, the rivalry with peer supervisees and other supervisors (schools) promote regressions and facilitate learning, colored by projective identification. The omnipotent fantasies that the supervisee has access to the other person's skills and traits, that he "possesses" all of the supervisor's knowledge, are a constant threat. The result may be one of deformed identification with the candidate's behavior colored by imitation of the supervisor's therapeutic attitudes. The issues dealing with problems revolving around narcissistic issues of being the chosen ones often are characteristic (more or less pronounced) both in shuttle analysis and shuttle supervisions from both dyadic partners. They can be present at various levels with all of the participants of the triad. In such cases, the learning may be based on the projective identification of the idealized internal object, which, as is well known, results in the candidate's behavior being characterized by arrogance and omniscience. One of the often-mentioned countertransference reactions seemingly more pronouneed in shuttle supervision is one of low tolerance towards the patient. The supervisee complains that he does not know what to do with the patient, usually due to lack of experience and knowledge. This sort of low tolerance and difficulties of facing the unknown are usually defenses from anxieties, feelings of worthlessness, and fe ars of loosing the patient or the supervisor's love. Does the setting, the discontinuity of the shuttle supervisory process, promote them? The question that arises in shuttle supervision is: What are the basic psychic realities of the shuttle supervisee/analysands, and the shuttle supervisor? The parallel process-where the two share unconscious conflicts and anxieties and the se identification s are then enacted in supervision-is an indicator of "matching" ("attunement") of all the three members of the triad: client-analyst-supervisor, or of the existence of "transitional space" among them-the generated new reality with its own unique emotional climate. How to monitor the attunement? Perhaps we could say that the identification with the supervisor stems on one side from gratifying emotional experience of being accepted, understood, safe and the other from the frustrating experience of separation that is part of the reality. We could describe the identification with the supervisor as that of successful mourning. Shuttle supervision may carry by the nature of the process itself risks of pathological mourning as well. In shuttle supervision, there might be greater needs and dependency than in standard supervisions. The triad shuttle analysis/shuttle life/shuttle supervision, in a way, resembles the parallel process, in the wider sense-the one that take s into account the possibilities of enactment originating from the supervisor-of the colluding analyst. Risks of a bond of commitment, of issues of ethical neutrality coming to the foreground, of mutual idealization and seduction, difficulties in handling aggression with negative feelings being repressed and denied are hazards present both in shuttle supervision and in shuttle analysis. It seems that the risks are lower when the rhythm of personal encounters as proposed by the PIEE guidelines is observed. These few hypotheses concerning shuttle supervision point to the importance of the parallel process phenomena that seem to have a special role in the triad of shuttle supervision, shuttle analysis, and shuttle life itself.

THE COMPLEXITY OF SHUTTLE COMPONENTS IN TRAINING: SHUTTLE ANALYSIS, SHUTTLE SUPERVISION, AND SHUTTLE LIFE

Having a shuttle analysis in another country is a huge deci sion that demands careful consideration regarding reali tie s and conscious-unconscious expectations on different levels on both sides. It is not just about a special setting of personal analysis. It also forms other components of training, of professional, and of private life. In most cases, theoretical education is provided in different ways: participation In seminars of the host institute, seminars in the home city, weekend workshops, and summer schools with international teachers. The rhythm and setting of supervision is also influenced by shuttle analysis. In the case of so- called condensed training analysis, the practice of the candidate is impaired only to some extent, and he or she can provide regul ar analysis to the patients. In case of condensed-like training analysis (when the 7 candidate goes regularly every sec ond week for training), the rhythm of therapy weeks and breaks is still stable for the patients. Shuttle analysands create "shuttle patients," During shuttle training, the therapeutic work of the candidate undergoes irregular breaks, parallel to the of ten visit-to-visit changing agreement due to environmental circumstances. Supervision becames shuttle supervision. During the visits for shuttle analysis, often another analyst also provides supervision. Consequently, face-to-face supervision happens during therapy breaks, in blocks. The supervisory process parallel to the therapeutic work of the candidate has to use other tools, phone, fax, or e-mail. Shuttle analysis has a direct, major consequence on the life of the candidate: Shuttle visits mean an interruption in ordinary flow of life and professional work. The candidates take on enormous burdens by leaving their families and their patien ts, and staying in a foreign environment. The other side of the coin is the adventure. Some speak of shuttle analysis as an adventure similar to the early pioneer days of psychoanalysis. However, this is wrong, because psychoanalysis has changed its theories and we have developed different tool s of training than in the first decades. Still, we agree that shuttle analysis is an experimental domain in the development of psychoanalytic education. Shuttle analysis is a regular part of a training with goals that go beyond traditional educational ones of the institutes: It produces first generation analysts, who form group s to found analytical organizations in their home country/city. Shuttle analysis is always a project, not a routine, because of the demand on extra organizational investment

SHUTILE ANALYSIS AT PIEE

Looking at some specificities of shuttle analysis, we focus on the following:

• high variation of setting, • handling of unavoidable cultural clash and the special role of language, • special defenses and other characteristics of the process, and especially • the "melody of separation."

On Setting Variations

We have an overview about candidates, who registered at PIEE (see Table 1). Up to now, we have not found a way to collect data about the prevalence of shuttle analysis at other training institutes in Europe. What we know from "professional gossips" is that one can meet shuttle analysis in many countries be side the forrner Eastern Europe. In 2003, of 50 PIEE candidates, 18 (36%) were in shuttle analysis. Fifteen attended a concentrated training (traveling every second week to another country), and 17 had the opportunity for regular analysis in their home city (the numbers do not add up). The picture is changing year by year, because, aceording to PIEE regulations, no new shuttle trainings can be started, when there are training analysts available. Shuttle analysis, which produces "shuttle life," is always an individual project. The strongest finding is that the setting varies from case to case. The contract on setting may change year by year, or, sometimes, from visit to visit (e.g., the length and session number of the next visit). It is because ofhigh variation of environmental factors, both in home life of the candidate and in the host country. What is the financial construction of the training? For how long can the candidate leave hislher work? Hislher patients? Hislher family? How many days with analytic sessions can the training analyst offer? On what support can the candidate rely at home? Is there a support system for accommodation in the host city? Is there any possibility

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TABLE 1 Formai Data on Shultle Analyses Details Asked For Variations Number of sessions per day One/day (6 cases) One or two/day (11 cases) Two/day (15 cases) Two or three/day (2 cases) Number of sessions per visit 4 to 5 (13 cases) 8 to 12 (11 cases) 30 (I case) No data (9 cases) Length of visit 2 to 3 days (6) 1 week (14) 2 weeks (2) No data (12) Time between visits 7-10 days (11) 3 weeks (2) 2-3 months (2) No data (19) Session duration in minutes 45 (5 cases) 50 (7 cases) 60 (10 cases) 45-60 (4 cases) No data (8 cases) Number of sessions per years Below 60 (I case) 60 to 80 (6 cases) 80 to 100 (3 cases) 100 (7 cases) 100 to 120 Note. Data collection from the Han Groen-Prakken Psychoanaly tic Institute for Eastern Europe (PlEE) candidates registration form (data at the foundation of PlEE in 2002). There were 34 people included; 14 were considered as condensed analysis 14; 20 were considered as shuttle analysis 20. This study was exceptional in that all questions were answered by respondents. to work during shuttle? Is it possible to participate in professionallife (e.g., attending seminars), or is it a time of solitude? Two conclusions have been drawn: (a) It seems fruitful to clarify working dates for the whole year in advance, instead of fixing them from shuttle phase to shuttle phase; b) some factors contribute to the temptation to modify the setting-the guilty feelings about leaving the family and living in a "paradise," Therefore, a minimum number of sessions/year (l00) must be set in advance. Fifteen training analysts are engaged in shuttle analyses and 10 in condensed-like analyses. Most of the training analysts have one shuttle analysand, but a few have two or three. To our knowledge, most analysts conduct shuttle analysis as an exception. There are a few exceptions, for which shuttle analysis is a substantial part of the training practice. The question of how to prepare the analysts for the task of conducting a shuttle analysis leads to observations that the analysts are not well prepared for such an exceptionally difficult and exhausting work: to handle the separation, the regression, the indications and contraindications, and the transference, as well as to support a process by an adequate number of sessions to provide holding functions. Training analysts learn from their own experience similarities and differences between shuttle analysis and regular analysis. Crossing boundaries and changing context required by a shuttle analysis in a different country, a different language and culture is a most chaIlenging experience. For a containing analytical space could be created and a therapeutic contract to be made, a workable balance of flexibility and firrnness needs to be found.

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Shuttle Analysis: "Cultural Shock" and the Special Role of Language

The analytic pair in shuttle analysis has of ten to face major differences in social, political, and economical systems, as well as in language, religion, and traditions. In the initial phase of East European shuttle analysis analysands went to Western training analysts. Now a sec ond phase has begun: In recent years, there is an increasing trend of approaching training analysts from forrner Eastern Europe-perhaps because of cultural sirnilarities and seemingly less cultural shock. However, in the former Eastern Europe there are many cultural differences. The life of shuttle analysands differs in the host countries. There are very different experiences between societies that arrange a caring structure for the candidates and those where candidates are very isolated in some societies. Strong cultural and political differences contribute to the difficulty of finding a common ground of life experiences. For instance, totalitarian systems enforced the hiding of knowledge and the survival of secrets. Appropriately, we ask: Whose language is used in shuttle analysis? TypicaIly, the analysis is conducted in a mediating language. Sometimes it is done in the mother tongue of the analyst, or, rarely, in the native language of the candidate. The candidate has to learn the language (and culture) of the analyst, but there are a few training analysts who learned, for instance, Russian. The interest of the training analyst can be motivated by personal roots in the country of the shuttle candidate, in which case we rnight speak about a "secret mother tongue." The question of different languages leads to the question of different thinking, which might be illustrated by the differences in thinking due to differences in socialization between Western and Eastern German candidates in regular training. These differences are evident and chalIenging, even if the analyses are done in the same language. The fact that most candidates do not use their mother tongue shapes the form of resistance. Two types of observations should be mentioned from the discussions:

1. Using a foreign language in psychoanalysis is responsible for a higher resistance level. Some analysts had the experience that of ten the "hot" affects come out in the mother tongue, possibly, because affects are bound to early language. The foreign language facilitates the internal expression of horrible things in arather crude way, therefore intensifying defenses/ resistances. 2. Others argue that the fact that one cannot use the mother tongue, and have at one's disposal "sophisticated" verbal maneuvers, facilitates the appearan ce of emotions in a more open way. U sing a foreign language may reduce resistance or facilitate information by body language. Using foreign language hinders the verbalized exchange of emotions, and fosters regression.

Factors that may lessen regression are longer breaks, greater "physical distance" from the analyst through the breaks, and the use of a foreign language.

Shuttle Analysis: Special Defenses and the Question of Analytic Process

In discussions on shuttle analysis, we of ten meet the fear that an analytic process cannot develop in a shuttle setting, or it produces "sec ond class" analytic experience. The reports of shuttle analysts contradict this preassumption. They find that an analytic process does evolve, although it might have some special features, e.g., that the breaks between shutt!e visits serve working through and the development of internal objects. Exaggerated polarities of idealizationldevaluation might belong to the specialries of transference- eountertransference in shuttle analysis. The shutt!e situation might cause extremely painful feelings of 10 being an outsider, being excluded from "family nest." Opposite to this, the exception al status of being in shuttle analysis feeds feelings of grandiosity, of being a chosen one. Discussing regression, some analysts argue that deep levels are a question of duration. When shuttle analysis is conducted over a period of 3-4 years, they are shorter than the average of 6-8 years of regular training. EspecialIy regressions to bodily issues need space and time. However, higher number and long er duration of sessions (e.g., six 60-minute sessions per week) may contribute to the development of deeper regression. Shuttle analysands tell an abundance of dreams, up to four dreams a session. Often this overproduction of dreams is a form of resistance. A second observation is that there is a lack of day residues in the dreams. One explanation relates this to the fact that everyday life of the shuttle analysands is not present in shuttle analysis. The candidate of ten has no structured tasks or programs between sessions (having eventually more than one session in aday). We wonder whether lack of structured/usual everyday life facilitates an access to the inner psychic world and to associations and to dreams. On the other hand, connected with the problem of using a foreign language in analysis, may dreams become a kind of language, which the shuttle analysand shares with the analyst? Shuttle life creates "shuttle realities," quite of ten "dream-like realities," which is a fúrther cause for increased communication of dreams. "Shuttle realities" create a loyalty conflict: where do I belong, which is my real world?

Shuttle Analysis-Shuttle Process: Repetitive Separation

The most specific feature of shuttle analysis is the repetitive altemation between periods of intensive being together and of being separated. We might speak: about "the melody of separation" in shuttle analysis. This is one of the major arguments against shuttle analysis. Before discussing it, we would like to illustrate this point with a short statement from a shuttle analyst from the countertransferential angle.

I never found my self with so many questions and dilernmas while working, literally about everything: Should I be more active or passive, should I follow more the Oedipal or the pre- Oedipal material, what about two sessions per day-in a row or not. .. , should I stick more than is usual for me on separation issues .... all these questions, I was able to realize, were a threat to spontaneity and my analytic role. All of thern could be summed up in one: How will all that we do here reflect on periods when the analysand goes back home? Will anything stay? I was constantly comparing with the other "domestic" analyses, finding only the disadvantages of the shuttle one. On the other side, my analysand carne for the next shuttle feeling better, finding enlarged capacity to listen to the patients with more hope and belief in oneself. The analysands wish to continue, a kind of security and self-assurance about the right place and the right way for going on, left me with no doubts about the usefulness of shuttle analysis. Trying to connect these two seemingly opposite observations, my desperation that nothing can be done pointing directly to my guilt feelings about conducting a shuttle analysis, and the analysand getting on mu ch better, I found a connecting association-an illegitimate child. " born to a couple deciding to have a child without living together. As we know, of ten such parents have difficulties with their guilt feelings of not providing the family nest for the child. Yet, the child may grow up fine, from the beginning adapted to the fact that his parents don't live together; it experiences weekends with one and the week with the other with less of a burden than the parents. I usually interpret the guilt feelings as the parents', not the child's and it is of ten helpful. It is a trap: to be too good, to repeat one's own developmental problems projected onto the child, to be inhibited as an adult, and to devaluate your significance and role. I feel like a weekend parent. Thinking about that situation, the problems may come from the loss of communication between the parents. I often wonder whether the same countertransference reaction comes from the so called East and West Europe: Is it my personal transgenerationa! trauma of the illegitimate [Eastern Europe] children asking for recognition from the IPA, as I'm my self an [Eastern Europe] analyst? While working with shuttle analysands I keep rerninding myself:-Not to nail them. Not to make them feelless worthy-for instance by tracing only separation pains, but to deal with them as new 11

persons, real persons, with the reality. Something as we had intercourse, and now we have children. Let us try to raise them as happy as possible, as competent as possible. Not to repeat our destinies.

If we stay with the developmental analogy, it seems that the success of the shuttle analytic process is not so much in the number of sessions, the rhythm of sessions is as important as the frequency of sessions. It is similar to the role that, in child upbringing, the regular and "predictable" rhythm of infant- primary caregiver exchange plays in creating the background of experience, the continuity of existence, the basic trust. If one of the basic questions conceming shuttle analysis is whether the crust formed during separations is an impenetrable one, it seems that from our exchange with analysts engaged in shuttle analysis, most would state that this is not the case.

SHUTTLE SUPERVISION

Surprisingly, it was more difficult to collect detailed hard/formal data on shuttle supervision than on shuttle analysis. We asked for details about

• the number of face-to-face sessions per year, • the frequency of face-to-face sessions, • the number of e-maii (respectively phone or fax) contacts per year, • the frequency and regularity of e-mailing (respectively phone calls or faxing), and • other (e.g., technique of e-maiI supervision).

From PIEE candidates' data update for 2003 and for 2004, we had 40 replies on upervision (see Table 2). There were six candidates in regular supervision; three /ere in concentrated training, and 31 could be considered shuttle supervision (3 answers were not suitable for assessment). We have more questions than answers regarding shuttle supervisions. Although 'e tried to ask very detailed questions, we failed to get a picture about the preci se frame and method of e-maiI supervision. What does the supervisor ask for in e-mail supervision? How does the supervisor process the material? Does he or she

TABLE 2 Variation in Supervision Details Asked For Replies Number of face-to-face sessions per year 4-10, during ShA visits (typical) 18-22, in condensed analysis, and, in one case, 4x4-5 during ShA visits Frequency of face-to-face sessions Frequency during visits is typically 1, and seldom 2 in a week-actually there is no new material. Number of e-mail contacts per year Cca< 20 (once in a fortnight) 6 cases Cca 40 (once a week) 9 cases Cca 15 (once in three weeks) one case Cca 10 (once in a month) one case Frequency and regularity of e-mailing Typical contact is weekly or biweekly, but there are no closer data about the way it is done. Number of phone sessions per year Weekly (4 cases) Monthly (1 case) Unclear, all-together with face to face session 36 in a year (1 case) In one case the candidates sends written material two days previous to the session. Note. Data collection from PIEE candidates data update for 2003 and for 2004. There were 40 replies about supervision. Six were in regular supervision, and l was only in group supervision. 12

Thirty-one were considered as shuttle supervision, and two were considered as concentrated supervision. There was no fax supervision in the sample. ShA = shuttJe analysis.

comment during reading, step-by-step, in a more interactive-associative way, or does he or she go through the session description like through a submitted paper? Is there a back and forth about the supervisor's comment? Do they agree on a frame of work (e.g., do they fix times and duratien of writing the session notes, or use their spare time for doing e-maiI supervision)? Quite a few respondents misunderstood the question for frequency, and answered the session frequency of the therapy in supervision. Typical contact is weekly or biweekly, but there are no closer data on the way that itis done. Very likely, therealized frequency of supervisory contacts varies highly. In one case of phone-supervision, the candidate sends written material two days before the session.

WHAT MAKES SHUTTLE ANALYSIS WORK? WHAT MAKES SHUTTLE LIFE WORK?

Shuttle analysis (shuttle training, shuttle life) demands extra investment, and consequently extra motivation, which helps to overcome the extra burdens connected with shuttling. The feeling of being one of the "chosen ones" and the creative aspects of adventure raise motivation. As positive indications for shuttle analysis were mentioned: the candidate's capability to contain affects; to cope with separation; to be able to dream between the sessions and during the breaks instead of acting out. Some participants remark that many of the shuttle candidates have suffered early losses. Others speak about the experience that most of the analysands have grown up in rather intact family frames. Among contraindications that were discussed were dramatic losses during early childhood, poor capacity for affect containment, and acting out tendency during breaks. It would seem obvious for many analysts that early loss/traumatization is a contraindication because of the repeated separations. The viewpoint that most East European candidates had early traumatic experiences, broken families and so on, turned out to be a prejudice. Many candidates in shuttle training grew up in intact families, yet there was a clash of publicly proclairned (at kindergartens, schools, etc.) and privately fostered value systems (at home). Typical are not so much the early losses but transgenerational traumatizations. The age of PIEE candidates and applicants in shuttle analysis varies, from those that grew up under the totalitarian regimes to younger ones whose developmental experiences were quite different. The candidate in shuttle analysis suffers extra burdens, because he has to combine private and professional tasks at home with being abroad for several weeks. Feelings of guilt, because of leaving family and patients, play an important role in the process. Financial burdens, both for the candidate and the supporting institute add to the guilt feelings. AlI those contribute to the temptation to make a quick training, with quick results. The burdens should be kept on an emotionally and somatically bearable level.

CLOSING DISCUSSION

We call shuttle analysis a form of psychoanalytic training, where the training goes in blocks, separated from each other in time (German term: Pendelanalyse). The trainees move during shuttle analysis between their home country and the hosting institute. Sometimes the entire traditional tripartite psychoanalytic training is carried out in training blocks. Shuttle analysis and shuttle education is a creative answer to the challenge of growing training demand from the 1990s in Eastern European countries. Shuttle analysis is combined with shuttle forms of other parts of the training. It ch anges the entire professional and private life of the candidate; therefore, we have to speak about shuttle life. One of the consequences is that the internalized practice could become the shuttle analysis. Education should include help to modify this. 13

Shuttle analysis and shuttle training demands higher investment of all parties than regular training. Each case is a special project. Each training analyst and candidate has to find his or her own way to organize the work. There are only a few analysts with broader practice in shuttle analysis and/or shuttle supervision. The question of how to prepare the analysts to conduct shuttle training is open. Shuttle analysis exerts a higher pressure on the analyst as well. He has to conduct a good enough personal analysis before the eritical eyes of their colleagues. He has to maintain the freedom for the candidate and for himself that is essential for the development of the analytical competence. The break-intervals in shuttle analysis can activate separation traumata while the process goes on also during these intervals. The absence of the object fosters the development of internal representations. Shuttle analysis is an experiment in psychoanalytic education. Shuttle analysis is only one aspect of massive change in education within the societies. The question of evaluation is an especially difficult one. At PIEE, the evaluation is the sarne as in regular education. Qualification assessment is done in front of an international comrnittee of invited training analysts. Candidates in shuttle training have contacts that are more international and have experiences with higher number of identification figures of international psychoanalytical community than those in standard training. Currently, candidates in shuttle analysis are colleagues with above average motivation and talent. The engagement in shuttle training is worthwhile. A psychoanalytic process is being achieved. Highly motivated candidates work devotedly and enthusiastically in this process. They show good progress and obtain a full training. Results indicate that candidates, who finished training, were assessed highly. We have enough training analysts of high quality for shuttle analysis. Research on process of shuttle analysis is restricted by the fact that it is impossible to satisfy requirements of anonymousness and confidentiality-a small population where each case can be eas ily identified. A more strict work could be done if shuttle analysts could work together on case material of shuttle analysands in small clinical groups. This, however, seems to be very difficult to be organized because of reasons of confidentiality. We will never have hundreds of shuttle analysands, and many shuttle analysts, to be able conduct a true statistical comparison "of shuttle - regular" analysis, or a factor analysis of relevant issues. Therefore, we are bound to make clinical research of "individual cases" of shuttle analysis.

WHAT CAN BE LEARNED FROM CONDUCTING A SHUTILE ANALYSIS?

• To face a high variation of environmental and setting variables • To meet the special role of language/mother tongue • To meet special forms of defenses, aggressionlregression regulation and dream life • To face "the melody of separation" in shuttle analysis • To meet impressive cultural differences • To clarify indications-counter-indications of shuttle analysis.

Shuttle analysis is always a project, not a routine, because of the organizational overinvestment needed. Shuttle analysis represents new modes-which means, it acts against tradition, traditional rules, and might be interpreted as acting against analysis. Shuttle analysis can be an option for members of established societies if looking for further (second) analysis.

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REFERENCES

Arutunyan, M. (2004), Wanderers and strangers. Paper presented at the 5th PIEE Candidates' Seminar, St. Petersburg. Ekstein, R. (1960), The teaching of psychoanalytic technique. J. Amer. Psychoanal. Assn., 8: 167-174. Kazanskaya, A. (2004), Analysis is a shuttle: mapping shuttle analysis. Paper presented at the 5th PIEE Candidates ' Seminar, St. Petersburg.

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