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To the Editors: I should like to be permitted a few comments on Dr. Kubie's proposal regarding a “new profession” medical psychology or psychological medicine. Inevitably, this issue becomes a discussion on “lay analysis” and draws a great deal of fire from different factions; participants feel indignant, angry, self-righteous, and virtuous, and nobody changes his mind or his entrenched stance. I do not want to embark on a polemic in favor of “lay analysis” (a term, by the way, abhorrent to non-medical analysts): it would be presumptuous to think that I can add appreciably to the arguments in Freud's monograph, (2) Dr. Kubie's (4) numerous articles, and Dr. Eissler's giant opus, (1) among others.
I do want to describe the effect, as I see it, of the opposition to “lay analysis” by the American Psychoanalytic Association and its affiliates on the actual practice of “lay” psychoanalysis and psychotherapy.
The tremendous need for practitioners, the more and more rigidly enforced certification requirements for psychologists, and the tacit assent of a large percentage of the psychiatric community all make the practice of psychotherapy (psychoanalytic and otherwise) by non-medical professionals a widespread reality. Dr. Kubie writes that, if medical psychiatry refuses to make even pilot tests of a plan to train non-medical behavior scientists, the psychologists will go it alone. They have already done so.
In 1962, New York University began a postdoctoral program for clinical psychologists leading, for the first time, to a certificate in psychoanalysis and psychotherapy granted to non-physicians under the auspices of a university. Adelphi University started a similar program one year later. Setting aside these programs which are still in flux and too recent to be evaluated, let us examine the plight of a clinical psychologist who has acquired the basic principles of scientific method, personality theory, psychiatric nosology, diagnostic methods and psychotherapeutic procedure