The Mental Health Professions: Conceptualization and Reconceptualization of a New Discipline

It is a great privilege to be invited to present the annual Gustav Bychowski Memorial Lecture honouring one of the major figures in that pioneering generation of psychoanalysts who brought this new psychology and new psychotherapy to America, planting it firmly as a basic science underpinning American psychiatry (to an extent achieved incidentally in no other part of the world) and permeating it far beyond the mental health enterprise throughout the whole of the academic and intellectual life of this New World. It is at the same time a great pleasure that this invitation comes under the auspices of the Mt Sinai School of Medicine and the Mt Sinai Hospital where I began my own clinical career as intern and as resident, as house officer first in internal medicine and then in psychiatry, the intersect thus of my interests and training in both somatic and psychological medicine—and the soil as well in which grew my own inspirations towards psychoanalysis.

I therefore do regard it as peculiarly fitting to be able to choose for this presentation the accounting of an experiment in mental health education, the effort to create a new profession thoroughly linked to psychoanalysis, but rooted more broadly as well in the whole range of biological science, psychological science and social science knowledge necessary to the fullest ranging autonomous functioning of the professional mental health practitioner. This is an experiment that has been evolving progressively over six years now since the initial planning group convened in 1971—spurred by the pressures and the opportunities of that particular moment in historic time which I will elaborate in some detail somewhat further on—but I do not mean this talk to be primarily a statement of our historical development, or more grandly our saga, of which we do feel proud. That description of our developmental history in its vicissitudes from the originating exciting idea to a now functioning programme established, albeit still prov