Reply to Melvin Sabshin on the Question of Nonmedical Candidates

We appreciate Melvin Sabshin's (1985) candor in not attempting to conceal that his argument against training more nonmedical candidates is rooted in his avowedly political and organizational concerns. He believes that admitting more nonmedical candidates would lead to "a further separation and/or divorce" between organized psychoanalysis and organized psychiatry in this country, whereas continuing to limit such admissions would be in line with the strong, harmonious marriage between the two groups that Dr. Sabshin desires. And, indeed, he might be right.

What this argument bypasses, of course, are fundamental questions about the nature of psychoanalytic investigation and whether its essential methodological stance and mode of therapeutic action lend themselves to genuine conjugal harmony with psychiatry. Many contemporary psychoanalytic thinkers (Gill, 1976); (Klein, 1976); (Schafer, 1976, to mention just a few) have argued that psychoanalysis is, in its essence, an interpretive discipline devoted to the illumination of unconscious meanings and organizing principles and, further, that its healing power lies in the transformation of these psychological structures through an analytic dialogue (Atwood and Stolorow, 1984). In this characterization, psychoanalysis, in both its methodology and curative action, is pictured not as a branch of medicine, but as a psychology. What we wish to stress is that where psychoanalysis should be situated among the sciences of man is a question that should be decided by serious, systematic reflection on its mode of inquiry and implicit philosophical assumptions, not by restricting the number of its nonmedical candidates or by other such organizational expediencies.

While Dr. Sabshin grants that "a significant number of non-M.D.'s have conducted analyses with good technique," he feels that such favorable outcomes are outweighed by concerns about nonmedical analysts' diagnostic competence. (The related issue of pharmacotherapy