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Home , Argentina, Oscar Masotta, Vittorio Guidano

Psychotherapeutic Professions in

Elena Stein-Sparvieri and David Maldavsky

Instituto de Altos Estudios en Psicología y Ciencias Sociales (IAEPCIS) Universidad de Ciencias Empresariales y Sociales (UCES)

1. Identity of the psychotherapeutic professions

The beginnings of the psychotherapist as a psychoanalyst in APA

In order to understand the theory and practice of in Argentina it´s of foremost importance to examine its connections to Argentine culture, institutions and politics throughout the last 60 years. Psychotherapy had to overcome many difficulties to gain its present status in this country therefore it´s amazing that it expanded with such force and sophistication throughout the past decades. One of the reasons that might account for its powerful development is the fact that during the Second War many Europeans, having to escape their country, chose to live in Argentina which was a flourishing country in those days. When the Second World War ended Argentina, which had a reputation of the world’s greatest grain supplier, possessed a new social class that stood out for its European culture and values. This sophisticated social class soon became landowners and prosperous businessmen who set the standards for a quick paced cultural life of ideas that they brought from their multiple trips to . Special consideration was given to the topics of literature, paintings and music, , psychotherapy and so on. This is the scenario in which the Argentine Psychoanalytical (APA) was founded, in 1942. The founders were: Angel Garma, Ernesto Cárcamo, Marie Langer, Guillermo Ferrari Hardoy and Arnaldo Rascovsky. APA soon became an avant-garde movement of psychoanalysis whose founders became famous not only among the members of the Argentine sophisticated social class but also world-wide. Parallel to this movement, which was steadily concentrating psychoanalysts among APA members, another one was slowly making its way. Unlike the first one, this second movement was taking place at the university.

The beginnings of the psychotherapist as a psychology graduate from university

It was not until 1954, after the first Argentine of Psychology had taken place in the city of Tucumán, that specific guidelines were proposed for the careers of psychology in the national universities and, some years later, in the private ones. In those days, the focus of the career was on clinic, on work and on education. Yet, contrary to what is sometimes thought, university emphasis was not on psychoanalysis in the 50’s. Although the different theories were considered and discussed the accent was on psychometrics. Many important psychology university careers were organized in those days, first in the national universities of , Córdoba, , Rosario, San Luis and Tucumán, then in provincial and private universities. In the period that goes from 1956 to 1959, the Perón was removed from the government and, as a consequence, many university professors were replaced. In time, during the 60’s, psychometrics lost importance to psychoanalysis, probably due to the fact that the psychoanalysts from APA took over as professors at the university. As a consequence, the training of the psychology career became rather a training of a role. Even the name of the career changed. It became: clinical psychologist, work psychologist, educational psychologist (psychopedagogue) before it changed again to Licenciado en Psicología (with mention of the specific application). This emphasis on the role, on the profession of the psychotherapist with psychoanalytical training explains the tradition of psychotherapists with a psychoanalytical orientation that is prevalent even in our days. The that began in 1972 didn´t prove helpful for the development of psychotherapy. On the contrary, it was restrictive and limiting. The military government pointed out that the psychologist had to act as a collaborator of the doctor or psychiatrist. Accordingly, national resolutions issued much later forbade psychologists to engage in any other practice. Psychologists couldn´t engage in the practice of psychoanalysis, psychotherapy nor in research. Their only responsibility and right was to administer psychological tests. The limited participation of psychologists in psychotherapy and research was not the only consequence of the ruling military government of those days. Their terrorist acts originated many disappearances, one of which was that of the president of the Asociación de Psicólogos de Buenos Aires (APBA) and another was that of the president of the Federación de Psicólogos de la República Argentina (Fe.P.R.A.). In the decade of the 80’s, with the end of the military government and with the support of the new democratic government, the role of the psychologist as a psychotherapist was finally established. The number of active members of the Asociación de Psicólogos de Buenos Aires (APBA) increased and psychologists started working as psychotherapists in hospitals, schools and the social care institutions. Yet, not all graduates from the career of psychology chose psychoanalysis as an orientation. Neither did they choose behaviorism since it was considered outdated. Michael Mahoney’ s rupture with traditional behaviorism in favor of a recognition of the role of emotions in human development and changes, as well as ’s concepts on attracted young psychologists. As a result, in the decade of the 90´s, cognitivism became important in Argentina. Besides, the creative personality of Vittorio Guidano, who came to the country, and his new ideas on post rationalism captivated the graduates´ minds and spirits. Soon pioneer cognitivist institutes developed. Among them, AIGLÉ and CTC, are the most famous along with CETEPO, which is the newest of them.

Other professions in the field of psychotherapy

As a result of the recognition of the profession of the psychologist as a liberal one and with the role of psychologists as psychotherapists definitely established health centers, school offices, outpatient clinics and private practice offices were opened and made available to a large proportion of the population. It can be said that in those days Argentinians developed the craze for psychotherapy that is still a typical feature of the average Argentine of our days. In fact, Argentina is the country with the highest rate of psychotherapists per inhabitants in and maybe in the world. Since the identity of the psychotherapist has both historically and politically been closely linked to that of the psychoanalyst, psychodynamics has always had a stronger influence on psychotherapists than other frames of reference. Psychoanalysts gather round Asociación Psicoanalítica Argentina (APA), Asociación Psicoanalítica de Buenos Aires (APdeBA), Asociación Escuela Argentina de Psicoterapia para Graduados (AEAPG) and Sociedad Argentina de Psicoanálisis (SAP), among others. Yet, even though psychoanalysis has typically been a domain of preference, the history of Argentine psychotherapy unfolds in many directions. Accordingly, it would be pretentious to claim one bears in mind all the names of psychotherapists, associations and orientations that have shaped psychotherapy in the country. At present, the traditional Freudian and Kleinian psychoanalytical perspectives compete with the Lacanian one. Indeed, during these last decades, the Lacanian standpoint has become quite significant in Argentina. The interest in Lacanian theory started when Psychoanalyst Pichón Rivière met with Lacan in the 50’s. With the introduction of Lacan´s ideas in Argentina, both APA members and other scholars, such as linguists, philosophers and sociologists, uninvolved with the APA entourage, became familiar with the new theory. In the 60’s though, it´s this second group the one which had acquired a large number of followers and therefore began disseminating Lacan´s ideas in different fields. Then, in the 70’s, , one of the intellectuals in this group, founded the Escuela Freudiana de Buenos Aires. In time, other Lacanian institutions were established in Buenos Aires, Tucumán and Santa Fe. In Buenos Aires, some names are: Escuela Freudiana de la Argentina, Círculo Psicoanalítico Freudiano, Institución Psicoanalítica de Buenos Aires. These Lacanian institutes train psychoanalysts, offer psychotherapy and supervision services. Supported by the many associations, the Lacanian movement became strong and active, producing publications consistently. In consequence, eventually Lacanians came to occupy posts at the university. In fact, during the 80’s, with the advent of democracy, university professors were renewed and Lacanians took over. To conclude, it can be said that global trends in Lacanian thought, such as that of Moustapha Safouan, Jacques Alain-Miller and many others who travelled to Argentina, permeated the ideas of Lacanians in this country contributing a new, personal angle to Lacan´s concepts. Psychologists are not the only professionals who can perform psychotherapy. National regulations establish that psychiatrists as well as doctors with certified training either in psychoanalysis or in other theoretical frames can perform as psychotherapists. Regulations state that psychiatrists can medicate which is something psychologists can´t do. In consequence, when working with patients who need medication psychotherapists who are not psychiatrists work in connection with psychiatrists. But apart from psychologists and psychiatrists whose profession as psychotherapists is regulated by law, there are many other lines of work that engage in services of psychotherapy although they cannot, by law, call their practice psychotherapy. Among university graduates who cannot call themselves psychotherapists there are doctors, social workers, sociologists, philosophers. When they engage in services of psychotherapy they do so as consultants or supervisors since they are generally well known professionals who are required for their knowledge and experience in the field of marital problems, work organizations, schools, and so on. Apart from the mentioned university graduates who can´t call themselves psychotherapists formally, there is a group of tertiary graduates who cannot call themselves psychotherapists either. They are counselors, coaches and social psychologists1. They are sometimes grouped in associations that struggle for recognition but they are not well accepted by formal psychotherapists. The reason for this is probably that it has taken psychotherapists so long to have their practice regulated by law that now they intend to defend their newly acquired status. Some counseling schools are well connected to the educational and work environment and this fact enables them to work in this setting. However, most counselors, coaches and social psychologists find

1 There are two kinds of social psychologists. A psychologist holding a university degree can choose the field of social psychology. A tertirary level degree graduate student coming from a social psychology institute can also call himself a social psychologist. In this second case, he´s not formally allowed to perform psychotherapy. it difficult to make their way. In private practice they have to lower their fees in order to compete against psychologists. For coaches the work arena is even harder than for counselors since their tertiary level career is newer and their field of work specific. In addition, there are institutions which offer informal training in Psychoanalysis, in Gestalt theory, in Jungian psychology, in Neuro-Linguistic Programming, in , etc. And also there are Bach Flower and Essence courses that have become famous in Argentina due to the rich herbal selection, typical of Latin America, which can be found in the country. All the above mentioned psychotherapy resources, whether regulated or not, have a place in Argentina. In fact, Argentina is a country that has acquired a taste for different cures. One of the reasons for this is that it has always been open to people from all nationalities. Apart from the Spanish, the Italian and the Irish who have quickly merged and adapted to the Argentine culture, the English, the French and the German who settled in the country, mostly during the Second World War, tend to keep their culture intact. They make friends with people having similar roots; their children speak their language and go to English, French or German schools. This is true especially for the city of Buenos Aires since in the immigrants have rapidly mingled and acquired the Argentine identity. Among the many different communities living in Buenos Aires nowadays it´s peremptory to include the large migratory movement coming from the far eastern countries. However, in the case of this migratory movement which comprises Chinese, Taiwanese, etc. the situation is different from that of other immigrants since they aren’t rich enough to afford their own private schools and clubs. This community will privilege psychotherapeutic strategies that focus on group harmony and holistic logic, since these values are aligned with eastern country cultures. Apart from the migratory movements which have given Argentina an identity of a myriad of cultures there are the local aborigines and the , the latter best described as Argentine cowboys. The aborigines live in the far corners, in extremely poor conditions. They´re illiterate for the most part and their mental resources are sometimes very limited due to their hard living conditions and lack of proper nutrition. This sector of the population lives by their superstitions, religious rites and herbal remedies. Through constant contact and exchanges with the other communities some of their legendary myths have come to enrich Argentine citizens´ beliefs and ways of life. As regards the gauchos, they are farmhands, talented horse riders, silent and gloomy by yet strong and proud, responding with violent reactions when they feel their autonomy restricted. Because of the fact that the figure of the is a symbol of national tradition gaucho culture also has a strong impact on the population´s beliefs, attitudes and values.

2. Relation of the professions to the health care and/or social care system

Even though in the chaotic decade of the 60’s the psychology career was in its beginnings and had little or no identity regarding its potential, with José Bleger as professor at Universidad de Buenos Aires (UBA) psychotherapy training acquired the social, integrative, caring orientation it still shows in present times. Bleger brought to the discipline a growing interest in the social sciences that translated into concern for public well-being, intervention practices in hospitals and organizations, the desire to link psychotherapy to social values and problematic areas. José Bleger changed the hybrid profile that characterized university in those days for a social profile. He worked at applying the formal set of ideas and practices that involved the training of the professional psychotherapist to the troubled, needy, social scenario. Since Bleger’s days, the role of the psychotherapist has been perceived in connection to social . Following the tradition of concern for social welfare begun by José Bleger, now the public health system offers psychotherapy sessions free of charge in hospitals, for neurotic or distressed patients, families, addicted or terminal patients. It also offers psychotherapy to prison inmates and their families. Most private health insurance companies also offer their members therapy sessions. These therapy sessions are limited to an amount of 20-30 and are either free of charge or available for a small fee. They take place at the psychotherapist´s office. Although psychotherapists working for the public or private health system don´t make as much money per session as they would in private, independent practice, they benefit from the fact that patients are routinely referred to them. In addition, it´s important to take into account that patients paying for private health insurance are not willing to pay for services outside the health care system. Only famous psychotherapists have the privilege of assisting patients who are willing to pay a large sum of money for their services.

3. Basic competencies required for training and practice in the psychotherapeutic professions

The psychologist´s competencies as psychotherapist are relative to career training as well as to the national resolutions that regulate professional practice. The national resolutions will be considered in the first place and career training in the second place. The trainings considered will be those of the professionals who are certified psychotherapists by .

National regulations

The first national resolutions for the preparation of the psychotherapist were issued by the 3rd Assembly of the Council of Heads of the National Universities (CRUN) in 1980. The resolutions considered the rights, the obligations and the limitations of psychotherapy practice. According to those resolutions the psychology career had to grant the competencies necessary to counsel and to make use of methods and techniques pertaining to the discipline, such as interviews or psychological tests, with the aim of promoting mental health and personal growth. Psychotherapy was defined in terms of analysis and guidance of behavior in human interaction whenever personality adjustment was required, either for the individual alone or for the individual in group process. Competencies for the educational, work, judicial were also considered. By 1985 it was finally agreed by all the Argentine provinces that the profession of psychologist was autonomous and that it involved different fields of practice including psychotherapy. The Resolution 2447/1985 of the national government (Ministerio de Educación, 1985, pg.6) states the competencies as we know them nowadays. It acknowledges scientific as well as professional competencies in the clinical, educational, judicial, work and social-institutional-communitarian fields. It acknowledges psychotherapy incumbencies explicitly stating that the psychologist´s duty regarding psychotherapy consists in treating patients, in diagnosing, in following-up and in envisaging results. Both psychologists and psychiatrists who want to specialize in psychoanalytical theory and techniques take up courses on psychoanalysis in institutes such as APA, APDEBA and others. Other professionals, such as social science professionals who take up courses in psychoanalysis can call themselves psychoanalysts but they cannot call themselves psychotherapists. Because the practice of psychotherapy is regulated, foreign psychotherapists who want to establish their practice in Argentina must have their degree validated. However, in the case of foreigners whose country of origin has an education agreement with Argentina validation is not necessary. On the other hand, psychotherapists wanting to settle in Argentina on a temporary basis can obtain an authorization to do so. The authorization is renewable.

Undergraduate training

During the last 20 years, the training of the psychologist has changed. Changes concern academic structure, curricula and assessment methods. The aim is to train psychologists / psychotherapists with competitive and realistic competencies to act in a globalized . The first studies regarding the training of psychologists in Latin America were coordinated by Amalio Blanco for the Organización de Estados Americanos (OEA) in 1998. These studies follow the general guidelines of the St. Mary´s College Conference which took place in Maryland, in 1991. The Maryland conference stated that the main concern of the university was to teach students to study behavior scientifically. That general aim implied the acquisition of the following competencies: in depth and in breadth knowledge, solid methodological skills, applied practice to acquire experience in different areas, good communication skills, high ethical standards. Given the fact that the world was then already globalized, consideration for human diversity was strongly recommended (Lloyd & Brewer, 1992). In addition, the Maryland Conference strongly recommended collaboration not only between the psychology departments of the different universities but also between the psychology departments and the social sciences in general. Following the guidelines of the mentioned Sr. Mary´s College Conference, Amalio Blanco insisted on a generalist type of training for psychologists to remediate past deficiencies. Deficiencies mentioned in Blanco´s studies regarded the fields of application: education, research and mental health as well as the professional role of the psychologist which appeared entangled with the role of the psychoanalyst and with the role of the psychiatrist. As a result, since then the curricula design has concentrated on the training of different psychotherapy frames of reference and not only on psychoanalysis. The curricula design has also taken into account the acquisition of more assertive skills for the application fields. With the new curricula, the career finally was considered not only as a profession, as it had been until then, but also as a science. Blanco´s studies for OEA also recommended that all the countries grouped in the Latin American train psychologists similarly to support the construction of political and economic blocks such as the . The net Red Iberoamericana para la Acreditación de la Calidad de la Educacion Superior (RAICES) was formed in 2003 by the Latin American countries which agreed to establish the minimum standards of education that would guarantee the free circulation of people in the countries of the Mercosur and in other Latin American countries associated to it.

Undergraduate and postgraduate training

In the decade of the 90’s, the interrelation of the universities was also a matter of special concern. This concept originated the Asociación de Unidades Académicas en Psicología (AUAPsi). It was created in 1991 in Córdoba city and later met in Rosario city with the aim to encourage expertise and high achievement in the undergraduate and postgraduate courses and to guarantee homogeneity of curricula content and of the diplomas extended throughout the country. AUAPsi issued recommendations based on the many deficiencies perceived: deficiencies connected with: lack of qualification to coordinate research, insufficient libraries with unsatisfactory databases, few material resources, few extension activities, low academic budget and low professor salaries. Although some of these problematic areas are being looked into there is still a lot to be done. In conclusion, as regards undergraduate training, nowadays psychotherapists are trained as psychologists, as generalists, and they learn different theoretical perspectives, not only psychoanalysis as they did previously. As regards postgraduate training however, following the psychoanalytical tradition of the country, psychoanalysis is still the favored orientation.

Family therapy

Family therapy deserves special attention because it has always been an area of interest for Argentine psychotherapists. The history of family and group therapy started with renowned APA founder, psychoanalyst Enrique Pichón Rivière, in the 50’s. Pichón Rivière was well known for his groundbreaking ideas in social psychology. He founded the Escuela de Psiquiatría Social, institution which would give birth to the famous Instituto Argentino de Estudios Sociales (IADES) and, in the 60’s, to the Escuela de Psicología Social. Both these institutes trained psychotherapists in a new role, that of social operators. Following the creation of these institutions other autonomous institutions were created. Because these institutions were independent from APA, in time, psychoanalysts belonging to these institutions began to be called psychologists because the name of psychoanalysts was reserved for those still dependent on APA. Mucho of Pichón Rivière´s work is not documented because he didn´t write many books. Yet, his work has survived him through the important psychoanalysts whom he tutored, such as José Bleger, David Liberman and Edgardo Rolla. David Liberman was one of the most innovative psychoanalysts in the field of family therapy. He introduced the notion of family neurosis and marital conflict. In addition, he was the first to apply communication theory to psychoanalysis. Since he was interested in the intersubjective relation that forms between patient and therapist he applied the communication principles as an instrument for diagnosis. As a result, Liberman gave new significance to the terms psychoanalysis and psychotherapy. In fact, until then, in the 60’s, psychoanalysis had implied individual fifty minute couch therapy three times a week; any other practice was classified as psychotherapy. With the new conception of interpersonal links in and based on the communication theory Liberman changed the previous perspective. Arminda Aberastury, another well known psychotherapist, was the first psychoanalyst who took into account the relationship between child and parent in her analysis. The Asociación Argentina de Psicología y Psicoterapia de Grupo was founded in the 50’s by APA members. Important personalities in this Association included Isidoro Berenstein, Telma Reca, José Bleger, Edgardo Rolla, Janine Puget who later became an APDEBA member, Eliseo Verón and Carlos Sluzki who was responsible for importing the American notions on Family Therapy and communication theory to Argentina. Carlos Sluzki later settled in the . The North American ideas on family therapy originated standpoints which were different from that of psychoanalysis and, as a consequence, other lines of thought developed. One line of thought involved a systemic paradigm. This school originated several institutions in the 70’s. Some of these institutions were the Sociedad Argentina de Terapia Familiar (SATF), founded in 1978, the Centro de Familia y Pareja (CEFYP), in 1979, and the Asociación Sistémica de Buenos Aires (ASIBA) in the 80’s.

4. Research in the field of psychotherapy

The decade of the 60’s was a good decade for research. In those days, political regulations favored research. Therefore, funding could be obtained on a regular basis from national and international organizations. Some researchers of the 60’s onwards worth mentioning are Eliseo Verón and Carlos Sluzki. They researched the communication strategies of neurotic patients. Their research was published in the book Comunicación y neurosis, by Instituto Torcuato Di Tella in 1970. Sluzki later became a member of the Mental Research Institute of Palo Alto and undertook to research the types of communication present in schizophrenia. Besides Verón and Sluzki, the names of María Luisa Siquier -also known as Pichona Ocampo- and Renata Frank stand out because of their research contribution in the field of psychodiagnosis and the therapeutic use of projectif techniques. Guillermo Vidal, Enrique Rosnati and M. Matrajt are other researchers of those days whose work contributed to the development of the sciences of mental health in Argentina. Following the Argentine psychotherapy education reform of the 90’s many research groups formed, mostly to deal with the issue of the training of psychologists. In Universidad Nacional de , the names of Alberto Vilanova and Cristina di Doménico can be mentioned. In the Universidad Nacional de La Plata, there were important personalities such as Piacente, Compagnucci, Schwartz & Talou and Klappenbach. At present, research, which is central to science development, is encouraged partially, mostly in government institutions and public universities. As a matter of fact, government funds are generally devoted to the state university UBA and to institutes such as Consejo de Investigaciones Científicas y Técnicas de la República Argentina CONICET. Research that takes place in private universities is usually not subsidized. However, following the tradition of intellectuals and scholars of Argentine academic circles quite a few researchers, from private as well as from public universities, have become well-known. It´s impossible to name them all in this report, therefore we will name those whose work we´re most familiar with, either from SPR meetings or from other circumstances. Among Facultad de Psicología UBA researchers, Adela Leibovich de Duarte investigates psychotherapy practice. Her research focuses mainly on the differences between therapists working within a cognitivist orientation and those working within a psychoanalytic one. Susana Quiroga investigates psychodiagnostic issues. Both Leibovich de Duarte and Quiroga research within the psychoanalytic perspective. Other researchers within this perspective are Rubén Zukerfeld and Raquel Zonis-Zukerfeld. Ana Luzzi, investigates mainly therapy issues regarding children, within the English School of Psychoanalysis perspective. Finally, Clara López Moreno, APA research coordinator, looks into clinical supervision with Silvia Acosta. Andrés Roussos, from CONICET, researches at Facultad de Psicología UBA and at private university Universidad de Belgrano UB as well. His research deals with the psychotherapist´s styles and with computer-aided methods in psychotherapy; the latter in collaboration with Wilma Bucci. His approach is cognitivist. Other researchers work exclusively in private universities. Elena Scherb, a researcher from Universidad Argentina de la Empresa UADE, investigates the therapist- patient relationship from a cognitivist angle. David Maldavsky, co-author of the present , from UCES University, is recognized for his research in discourse analysis with the David Liberman algorithm (DLA) methodology. The method, devised by him and an extended team of collaborators, is founded on Freudian theory. Among team collaborators, there is Cristina Tate de Stanley, Liliana Alvarez, Clara R. Roitman, Rita de Durán and Adela Woizinski. Elena Stein-Sparvieri, co-author of this report, is member of this team. Universidad de Palermo (UP), Universidad Nacional de Mar del Plata (UNMdP), Universidad Nacional de Córdoba, FLACSO, Facultad de Psicología at Universidad Nacional de Rosario are other universities interested in research. As regards researchers from spheres outside the university, Fundación Aiglé is renowned for researchers dealing with psychotherapeutic styles within the cognitivist perspective. Some Aiglé researchers are Héctor Fernández-Alvarez, Beatriz Gómez, Verónica Rial and Fernando García. From Centro Privado de Psicoterapias. Hirsch is well known as president founder of Asociación Sistémica de Buenos Aires ASIBA and as researcher of effects and prediction in psychotherapy. Some journals dealing with psychotherapy research are: Acta Psiquiátrica y Psicológica de América Latina, edited by Fundación Acta Fondo para la Salud Mental, Investigaciones en Psicología and Anuario de Investigaciones de la Facultad de Psicología, UBA, edited by UBA University, Revista Argentina de Clínica Psicológica, edited by Fundación Aiglé, Perspectivas en Psicología, edited by Universidad Nacional de Mar del Plata (UNMdP), Psicodiagnosticar, edited by Asociación Argentina de Estudio e Investigación en Psicodiagnóstico ADEIP, Psicodiagnóstico de Rorschach y otras técnicas proyectivas, edited by Asociación Argentina de Psicodiagnóstico de Rorschach, Subjetividad y Procesos Cognitivos, edited by David Maldavsky for IAEPCIS, UCES University.

5. Influence of Argentine psychotherapists in other countries

As a consequence of the repressive military government that ruled Argentina in the 70’s many psychotherapists were exposed to personal threats and had to flee political persecution. Most sought refuge in because of three reasons: the first is that many were Spanish descendants, the second is that the language in both countries is similar and the third reason is that following Spanish political leader General Franco´s in 1975 Spain was on its way to becoming a democratic country. Yet, in spite of the efforts of the Argentine psychoanalysts to disseminate Freudian and Kleinian ideas in Spain it took time for the ideas to catch on. Conversely, Argentine Oscar Masotta´s ideas on Lacanian theory were immediately accepted in the of . Masotta´s study groups later disseminated Lacan´s ideas in the Spanish capital, Madrid, as well as in the other provinces. Finally, Pichón Rivière´s social psychology ideas on operative groups gained adhesion in Spain and were useful to circulate mainstream psychoanalysis notions among the population. The psychoanalysis bridge that was built between Spain and Argentina enabled constant rapport between the two countries. Garma, Raskovsky, Tallaferro, Pichón Rivière, Ferro, Kesselman, the Grinbergs, the Tomás, Barenblit, Shutt, Siquier, Campo and many others travelled to and fro constantly to lecture, to preside institutions and to offer analytical assistance. As a result, it can be said that Argentine psychotherapists are responsible, up to a point, not only for expanding the psychoanalytical culture in Spain but also for participating in mental health reform programs, in the foundation of institutions, in the development of as well as of educational, family planning and judicial programs. Argentine psychotherapists impacted not only on the Spainish mental health culture but on the Latin American one as well. Following the First World Council for Psychotherapy which took place in Vienna in 1996, Argentine Alejandra Pérez organized the first Latin American congress of psychotherapy Primer Congreso Latinoamericano de Psicoterapia in 1999. That event was the landmark for the beginning of the Latin American of Psychotherapy Federación Latinoamericana de Psicoterapia. The federation was formed by seven countries: Argentina, , , , , and . The objective of the federation was, on the one hand, to promote psychotherapy as a practice, as a science and as a profession and, on the other hand, to facilitate the exchange of information among the intervening countries, in order to favor the integration of the different psychotherapeutic perspectives. As a consequence of this agreement, Latin American associations, , accreditations and post grade integrative courses have surged. As regards Argentine influential personalities, Dr. Mauricio Goldenberg deserves special mention as the most prominent Argentine psychiatrist. Humane and dynamic, his teachings, symbol of the psychiatric reform in Argentina still have an impact, reflected, for example, in the 1990 Panamerican Health Organization Declaración de . Goldenberg´s work was influenced by psychodynamics and by Maxwell Jones´communitarian psychiatry. In his capacity of director of the psychopathology service of Hospital Lanús. Goldenberg was not only a clinician but a teacher, leader and creative thinker who developed pioneer programs in Argentina and in Latin America regarding hospital care, outpatient services, structured intervention, research and community extension services. All in all, Goldenberg is responsible for substituting the previous biological psychiatric perspective for a comprehensive, interdisciplinary, bio- psycho-social model. The new model, which he later replicated in Hospital Italiano, integrated the psychodynamic perspective with the systemic one in brief, individual, group and family therapy sessions adjusted to the social, cultural Latin American needs. David Maldavsky, co-author of the present report, participated in one of the groups that Goldenberg coordinated. According to Maldavsky (1991), Goldenberg´s charismatic influence led him later on to collaborate with the training of future researchers in the hospital. In fact, Goldenberg attracted not only well-known personalities in Argentina but also worldwide. Residents, fellows from Latin America and other countries considered Goldenberg´s model inspiring and visited Argentina, sponsored by the regional WHO organization Organización Panamericana de la Salud (OPS). Goldenberg became consultant for OPS, and Mental Health Director for Buenos Aires. In this last capacity he developed and implemented the first comprehensive plan of mental health services for the city which serves as foundation for the present mental health services.

6. The future of psychotherapy

The social scenario in Argentina is paradoxical. There are too many psychotherapists but not enough mental health plans; there are too many lawyers but the judicial system is inefficient; there are too many architects but not enough housing. This situation proves that somewhere along the line between government policies and professional practice there is a fracture. The consequence of this inconsistency is that the professional activities emerge as totally disengaged from the social needs. In spite of the dubious social scenario described, Argentine universities have a good reputation worldwide for generating good professionals. In fact, postgraduate courses in Argentina receive students from other Spanish speaking countries who choose to study in this country, attracted by a good training level and low student fees. But, because of the malfunctioning strategies unable to sustain effective and sustainable work policies many good professionals establish their practice in other countries. As regards a prediction about the future, an alteration of the present situation requires a drastic change in government policies in order to favor alignment between psychotherapy training and work opportunities. However, no drastic changes are foreseeable in the near future. Consequently, if past history is the best predictor for the future one, psychotherapy will continue to be the line of work chosen by most psychologists and the country will continue to supply quality psychotherapists who get their training in Argentina but probably prefer to work abroad.

Acknowledgements

We´re grateful to Denise Defey for reading this report and suggesting the inclusion of a section on Goldenberg´s project in Hospital Lanús and another one on the influence of Argentine psychotherapists abroad.

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