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The long view of psychoanalysis

Yale Medicine Magazine, 2009 - Winter


As a high school student in Manhattan, Jocelyn Schoen Malkin, M.D. ’52, found her calling during a lecture by the prominent psychoanalyst Lawrence S. Kubie, M.D. Though Malkin had long been interested in emotional issues, she said, something clicked that day. “I just thought [psychiatry] was the living end,” she recalled, using a colloquialism of the day. Despite the era’s formidable barriers to women in medicine, she made up her mind to become an analyst. More than 60 years after that decision, she continues to practice, teach and advocate for psychoanalysis.

Malkin, who was elected president of the Association of Yale Alumni in Medicine in 2007, has long done things her own way. She grew up in Rockaway Beach, N.Y. Both her mother, who had been admitted to law school but discouraged from entering by Malkin’s grandfather, and her father, an insurance salesman, strongly valued education.

Studying medicine at Yale, though, had not been in Malkin’s plans; it was the unintended consequence of a lark. While an undergraduate at Barnard College, she intended to join her then-boyfriend at Columbia University’s College of Physicians and Surgeons. When Yale invited her for an interview, she decided to have some fun. “I dressed like I was going to a football game. ... like an ‘import’,” she said, using Yale slang from the mostly male era for a woman brought to campus as a date. “Instead of looking like a frump, I ... wore a fur coat.” Fritz Redlich, M.D., then head of the Department of Psychiatry and later dean of the School of Medicine, asked her why she would make a good medical student. “I said I had a sense of humor, so I could tolerate an interview like this. ... He loved it!” Yale offered her early admission to the Class of 1951.

Malkin’s acceptance may have surprised her undergraduate advisor at Barnard, a female chemistry professor who had advised Malkin during her freshman year to forget about medical school. Fond of dating and partygoing, Malkin had earned subpar grades that year. But she suspects her appearance was also part of the problem. “I didn’t look the type,” she said. “In those days, you had to look like an old frump, and I was having a wonderful time. I thanked her and never saw her again.” Malkin raised her grades, and by the time she was pulling on a fur coat for her Yale interview, she was poised to graduate from Barnard a year early, Phi Beta Kappa and cum laude.

In 1948, at the end of her first year of medical school, after parting from her Columbia boyfriend, Malkin married Myron S. Malkin, Ph.D. ’52, a former Marine and a senior in Yale College. Unlike most other men she dated, he was thrilled that Malkin planned to practice medicine. The women in his home town, he said, just “sit and play mah-jongg.”

The Malkins graduated in 1952, he with a Ph.D. in physics and she with an M.D., after taking a fifth year.

In those days eligibility for psychoanalytic training required completion of a medical school internship and a psychiatric residency. After completing a pediatric internship, two years of psychiatric residency and a two-year public health fellowship at the Child Study Center, she applied for a position at the newly established Western New England Psychoanalytic Institute in New Haven. The young mother was advised to “wait until you finish having children—you have enough to do.”

With no positions open to her in New Haven, the Malkins agreed that any move would have to benefit them both. Malkin, her husband and, by then, two children moved to Philadelphia in 1960, where Malkin began training with the Philadelphia Association for Psychoanalysis and her husband worked on a secret project developing re-entry space vehicles.

Malkin and her husband ultimately settled in Bethesda, Md., where she has practiced, taught and supervised trainees for decades. (While there, Myron Malkin went on to head the United States’ first space shuttle program from 1973 to 1980.)

Malkin traces her psychoanalytic pedigree straight back to Sigmund Freud via her Philadelphia supervisor, Robert Waelder, Ph.D., who had undergone analysis by Freud, and her Washington mentor, Jenny Waelder-Hall, M.D., who had undergone analysis by Freud’s daughter Anna.

Malkin presently chairs a biennial seminar in Aspen, Colo., that is attended by psychoanalysts from around the world. She became active in the Association of Yale Alumni in Medicine in 1996 at her 45th reunion, when she asked why there were no women on the executive committee’s nominating slate; she was offered a spot on the committee then and there. Her term as president ends in June.

After a 2006 house fire in which many of her and her late husband’s documents and belongings were destroyed, Malkin began preparations to move to New Haven. She expects to arrive this summer and looks forward to continuing active involvement with the psychoanalytic community and the alumni association as well as spending time with her children, Martha and Peter, who live in Westchester County, N.Y., with their families. Malkin’s granddaughter is a sophomore in Yale College.

Despite the waning reputation of psychoanalysis and the rise of other therapies, Malkin said the older approach has a place in modern psychiatry. It was, she suggests, greatly oversold in the past.

“[Psychoanalysis] is like an appendectomy. It’s a great operation, but you don’t do it on everybody,” Malkin said. “Analysis is the treatment of choice for certain kinds of patients, and [for them] there’s no better treatment.” She is concerned, though, about the future of psychoanalysis. “There are fewer and fewer people going into it, and the analytic organizations are lowering standards to be able to do anything to get bodies. ... [But] I think analysis will survive, and should survive, as one important part of the whole armamentarium available for the treatment of mental illness.”