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Greenson, in his classic text on the technique and practice of psychoanalysis notes that
Those who wish to suggest innovations or modifications of technique do not usually confer with others who are more traditional in their viewpoint. They tend to form cliques and to work underground, or at least segregated from the mainstream of analytic thought. As a consequence the innovators are apt to lose contact with those groups in psychoanalysis that might help validate, clarify, or amend their new ideas. The secluded innovators are prone to become “wild analysts,” while the conservatives, due to their own insularity, tend to become rigid with orthodoxy.
The American Academy of Psychoanalysis founded in 1956, remains at the vanguard of providing psychoanalysts, dynamic psychiatrists, and other mental health professionals with a forum for the exploration and reporting of such innovations and modifications.
I have earlier described my work as support-group facilitator for the professional staff of a hospital's AIDS unit. It has been my observation that “trained both medically and psychodynamically, the medical analyst has the comprehensive technical understanding and experiential skills to offer a group experience for patients, as well as professional caregivers” (Merlino, 1996).
It is my position that as the role of the psychoanalyst in the 1990s continues to change because of the many forces that beleaguer our profession including managed care and increased competition from nonmedical therapists. Our profession, however, has new and exciting opportunities to enrich the lives of our patients and society. In order to do this we may need to leave our offices and the security that the therapeutic dyadic relationship offers us.