To the Editor of the Newsletter:
Since the Committee on Policies and Problems of Membership, chaired by Dr. Jay Katz, practically presented its interim report to the National Candidates' Committee not long ago and thereby gained student support prior to a real discussion of the committee's proposals in the deliberative bodies of our Association, it seems appropriate now to ask the use of the columns of the Newsletter to inform the membership about these issues. I am concerned about the emotional momentum which these apparently attractive suggestions may build up before their drawbacks are recognized.
The proposal to abolish the review of an applicant's education now conducted by the Membership Committee appeals to students who would thus escape both the task of preparing the record of their training and the anxiety of being examined. However, it is noteworthy that no one on Dr. Katz' Committee, despite having had years to study the problem, is prepared to attribute the decline in applications to Membership Committee procedures! In fact, although the committee was charged with investigating the reasons for the decline, inadequate attention was given to this area once it had settled on the seductively popular proposal to ablate the Membership Committee. It is time for us to consider what will be lost to the applicants and to the Association if our quasi-certifying role is surrendered — especially in the likely event that there will be no great change in membership trends once our national body has been so mutilated.
The present role of the Membership Committee developed after the Lewin and Ross survey of psychoanalytic education and the subsequent decision of the Association to strengthen its central organization in order better to maintain standards. It was recognized that this task was an on-going one which could be accomplished better through regular observation than through inspections at long intervals. It was thought that the Association had an obligation to protect patients against inadequately trained practitioners and to alert the Institutes when some lapse from educational standards had occurred. Correspondence between the Membership Committee and the Institutes on these matters became an established practice. It seems obvious that this outside and impartial review, being free of local prejudice or blind spots, is an asset not lightly to be relinquished.
When it is argued that the Association should supervise the Institutes and not “penalize” the students who “in good faith attended” a recognized training facility, there is an appeal to sympathy and an avoidance of the issue of actual qualification. For example, those candidates who were allowed or encouraged to interrupt their supervised analyses in order to place their patients in group therapy, or to treat them with individual psychotherapy in lieu of an analytic termination of their cases were deprived of an opportunity to learn psychoanalysis and were in fact not properly trained. In some Institutes powerful local forces, with doctrinaire attitudes, can dominate an educational committee and graduate people with inferior training. To accept such applicants at the national level dilutes the significance of the APsaA for all who already belong. Our Association can be distinguished from the Academy of Psychoanalysis by the fact that we have standards we actually seek to maintain and we have not lapsed into that kind of eclecticism. We have just adopted revised standards for training after six years of discussion and debate. This step will lose significance and become a mere gesture if the careful scrutiny of the implementation of standards were to be abolished.
It is sometimes said that either the present Committee on Institutes or some other device should take over the Membership Committee's reviewing function. It should become generally known in this connection that Dr. Weinshel and others experienced in that committee's work not only feel that the task cannot be performed by the Committee on Institutes but that any attempt to do so would seriously impair its present effectiveness. Those who glibly propose “something else” should be required to detail a concrete proposal whose comparative value could be
explored, rather than comfortably content themselves with such a vague recommendation. Without the active exercise of the present functions of the Membership Committee, the Board on Professional Standards will lose a great deal of its meaning.
Some have written about “being examined at age forty” as an indignity. This argument seems to be intensified for polemic reasons, as if relief were urgently needed. What needs to be recognized is that Membership in the American has taken on much of the significance of a specialty board examination — it is the only equivalent we have on a national level. This has proven important in our exchanges with government agencies in the past, and this may occur again in the future. For this function to be meaningful, each applicant needs to be gauged individually as to how apt he proved to be for training and how well his education was absorbed.
My own Membership Committee experience spanned eight years. Many experienced and active psychoanalytic educators from all the Institutes throughout the country served on the Committee during that period. Without exception, each found the reviews of individual records meaningful — to the individual applicant who could profit from the identification of deficiencies in his education and to the Institutes where educational problems could be raised for discussion. Even for the 85% majority of applicants who obtain membership without difficulty, the task of writing three to five page summaries of their supervised cases must have been a useful exercise in concise analytic thinking.
A revision of the established policy of delaying applications for membership for two years after graduation is also being urged. Again the issue of quality education is involved. The analytic termination of at least one case becomes part of the candidate's education after graduation in almost all instances. The Institutes now can graduate students earlier with the expectation that the American will review the record for the fulfillment of this requirement. Unless a general policy is adopted by the Institutes of so delaying all graduations for the completion of a case before graduation — a most unlikely event — this standard will be surrendered. In addition, the stability of a graduate's identification as an analyst when he is beyond Institute surveillance, can be gauged after two years in a way not possible just after graduation. Repeatedly, problems of various types become apparent after later review which were not so evident during student days.
I hope that the coming discussions of the new proposals on Membership in the Executive Council and Board on Professional Standards will preserve what has proven valuable.
Leo S. Loomie, M.D.
(Dr. Loomie was Chairman of the Membership Committee of the Association, May, 1963–May, 1971.)