Response to Melvin Sabshin's Commentary on Psychoanalysis and Psychiatry

June 16, 1985

I would like to comment on the article in the first "Commentary" section of the Journal (Vol. 33, No. 2), "Psychoanalysis and Psychiatry: Models for Potential Future Relations," by Dr. Melvin Sabshin. My opinions will concern both the paper itself and the selection of such a paper for publication at this time in the new section of the Journal.

The paper has many merits and is, I believe, worth studying carefully. It presents an excellent succinct history of American psychiatry and its relation to psychoanalysis in the past forty years. Dr. Sabshin's call for analysts to become concerned with such subjects as epidemiology, diagnosis, and the impact of third-party payments deserves a hearing and may stimulate constructive discussion and debate. His summons to reinvigorating collaboration and communication with psychiatry is timely, and I heartily endorse it.

The choice of this article to be first in the new "Commentary" section of the Association's official journal, however, seems to me unfortunately timed. And its arguments against nonmedical training, written in 1983, threaten to bring confusion rather than clarification among members of the American who read it in June 1985. As many know, in the six months or more between its acceptance and its publication, there has been significant activity within the Association to find an appropriate way to enlarge the candidate body to include some individuals without prior medical and psychiatric training. In early 1985, a proposal was formulated by a small committee chaired by Dr. Herbert Gaskill. This proposal would authorize our Institutes to accept, in consultation with a newly constituted committee of the Board on Professional Standards, a number of nonmedically trained applicants whose essential qualification to receive clinical training in psychoanalysis will be a demonstrable potential to achieve clinical excellence. What