Dr. George Pollock, the Director of the Chicago Institute for Psychoanalysis, completed his term as President of the American Psychoanalytic Association in May. He is in a unique position to comment on many issues because of his wide range of interests in allied fields, his activities as an educator and researcher, and his willingness to speak as innovator and leader, often of controversial, farseeing ideas, at what may be a pivotal point in the development of psychoanalysis. Asked to comment on how he viewed the past year, he replied, in part: “I found the past year stimulating, challenging and quite satisfying. I met many of our members personally, visited quite a few of our Institutes and Societies, and have a fuller grasp of our Association, its components, its triumphs and its problems. We are a relatively small but active organization with realistic limits to our growth, scope, and capacity to accomplish things. In order to develop our potential it is necessary for us to operate as a whole. This need not mean unanimity in our theory but in our purpose. We must make distinctions between our clinical therapeutic work and our theoretical assertions which, like other scientific theories, need to be tested in a variety of ways and by using many methods. One of the most important issues I have observed this past year has been the tendency towards politicization based ostensibly on scientific grounds, but which covers other differences and motivations. Several other areas that came to the fore this year and which require our attention can be briefly noted:
One, the psychoanalyst must be involved in continuing education. The Association must make a strong effort in systematizing this education. Our scientific meetings should offer courses, provide a forum for newer scientific discoveries and be concerned as well with administrative and political matters on the local and national level.
Two, the importance of regional meetings should be emphasized and should become part of the Association programs. We should also consider summer programs of a longer length. Let us also think of nationwide learning systems which go beyond local and regional areas, and also a continuum of education, beginning during one's candidate years and extending throughout one's entire professional life.
Three, continual assessment of competency goes hand in hand with continuing education. The responsibility for this must rest with us. If we do not assume this task, others will determine this for us and we will be left out of the decision-making process. Relicensure and recertification are already here. Our Association must actively pursue competency assessment on an ongoing basis for all members.
Four, learning may be non-formal and we should recognize the various forms of this education which exist in local workshops, research groups, etc. Communications from this informal educational network should be shared with the more formal educational centers throughout the United States and, again, means of accrediting these ‘informal’ continuing educational groups should be considered by the Association.
Five, national accreditation of our Association and its component institutes is long overdue. We must also work for the recognition of the certification of our graduate analysts, particularly in terms of qualifying psychoanalysis for health insurance coverages.
Six, the best qualified individuals should be given the opportunity to obtain psychoanalytic training. The existing absolute linkage of psychiatry and psychoanalysis may no longer be optimal, especially when the number of medical school graduates entering psychiatry seems to be diminishing. Should we openly and legitimately welcome gifted candidates from fields other than psychiatry?
Seven, younger people should be more active in the Association and the base of involvement should be broadened. We need long-term objectives in terms of future planning for the next ten to fifteen years, in addition to our ‘short-range’ deliberations and actions. For example, economic factors must be considered in our organizational planning. We must begin to balance income (mainly from dues) against services rendered. If we must do more, we must have monies with which to undertake these activities, and our members must be prepared to financially support such ventures.
Eight, the Association should be administratively reorganized. We need more participation of all members. We should re-examine our membership categories. We should reconsider our administrative structure. E.g. the President and the Chairman of the Board on Professional Standards should each serve two years, with election of these two major offices occurring on alternate years. We should have two Vice-Presidents, one for liaison with local societies and one for liaison with the other extra-Associational groups, each again serving two-year terms. Our Secretary and Treasurer should also have two-year terms. I do not favor paying our officers for their time, but as has been our custom, reimbursement for expenses should continue. With these organizational changes, our continual problem of obtaining people willing to run for election might be alleviated and allow more members to give of their time and energy.
Nine, it is important for us to meet with other groups involved in psychoanalysis. We need communication with the Academy, the C.A.P.S. groups, the A.P.A., the American
College of Psychoanalysis, the American Psychological Association, NASW, and others. We must reach out to communicate.
Ten, we should seriously consider reorganizing the Association into: (a) a professional association of members, (b) a certifying specialty board for practitioners, (c) a federation of psychoanalytic institutes, and (d) an accrediting organization of institutes. Institutes and societies should be required to submit annual reports of their activities to the Association or appropriate accrediting bodies. A site visit every ten years is too long an interval for ongoing assessment of institutes.
Eleven, we must begin to consider the importance of diversification of practice opportunities. Analysts in the future may be distributed differently, i.e. geographically, and in non-metropolitan areas. There may be more work in facilities other than private offices.
Twelve, There should be consideration given to the establishment of a body that addresses itself to ‘long-term thinking’. We must attempt to anticipate and plan for our future. Our ‘reactive reactions’ are increasingly expensive in time, money, and energy. Perhaps the occasional communication of ‘impact statements’ can alert our members to potential areas of involvement that may require attention.“
Q: Where do you see psychoanalysis heading as a science? Will it become an appendage of psychiatry and so lose its individuality or become a very elitist pursuit?
A: We should differentiate psychoanalysis as a therapeutic modality from psychoanalysis as a science. As a science, psychoanalysis is a most powerful theory. I use theory here in the general sense. It already has had its impact in many other fields, for example in the medical sciences, in psychosomatic medicine, in the behavioral sciences, in the social sciences, in the humanities, in the political sciences. I believe that psychoanalysis as a science will continue to develop and have an effect on our knowledge of man in the more general sense for many years to come. This will become increasingly significant.
It is imperative that our Association take cognizance of the essential distinction between psychoanalysis as a therapeutic modality and psychoanalysis as a science in order to separate the pressures and changes on the practice of medicine and its specialties, including psychiatry, from the broad fields of human knowledge that psychoanalysis as a science represents. Pressures on medicine can effect psychoanalysis in such a way that its development as a science may be interfered with. Our Association must plan with these distinctions in mind. Psychiatry itself is in the midst of various crises and these can and will effect those of us who, in addition to being psychoanalysts, are also psychiatrists. But the crises, outcomes, and problems of psychiatry need not interfere with the further development of psychoanalysis as a science—unless we allow it. Psychoanalysis as a therapeutic modality may have difficulties if insurance coverage excludes this form of treatment.
Q: Do you feel our literature and our meetings reflect a certain lack of vigor in our science?
A: If the major focus of our literature and of our meetings is on the therapeutic application of psychoanalysis as a delivery system, then we may not be in a position to deal well with the borderlands and frontiers of knowledge. I believe that our national Program Committee and our local committees are increasingly cognizant of these issues and are increasingly offering more interdisciplinary colloquia, more seminars which attempt to deal with the broadened focus of our knowledge, as well as special workshops that appeal to the needs and desires of most of our members. I am optimistic about future developments in our science. But again here, I feel it is important that we make a distinction between the science of psychoanalysis and the practice of psychoanalysis for therapeutic purposes. Both of these components are obviously interrelated, but our meetings must be balanced to reflect this distinction.
Q: It is said that good papers are rare at our scientific meetings and our Journal is an exercise in repetition. How would you answer the accusation that we are spinning our wheels?
A: I do not share the opinion that “good papers are rare at our scientific meetings and our Journal is an exercise in repetition”. Some papers are excellent and some are of lesser quality. Even if a meeting presentation itself is not of the highest order of originality, it is possible that the discussion that ensues and the stimulation of people in the audience can give rise to newer insights and further researches. I have attended meetings where I thought the presentations were mediocre but the discussions were better if not great. One's own introspective and associative processes can be “turned on” and one can come away from such meetings with new insights which permit one to pursue particular avenues of study at a later time. There are other occasions where there may be little elucidation but where the experience of rethinking, reworking, and rereading certain critical papers of the past proves valuable. Nonetheless, we must aim for the highest order of presentations at our meetings and in our publications. Here again the distinction between those papers with a primarily clinical and therapeutic focus should be differentiated from those that are theoretical and speculative but which nonetheless contribute to the science of psychoanalysis. Many cross-overs occur from clinical to theoretical and from theoretical to clinical so that the distinction I am making is not an absolute one.
Psychoanalysis has a number of opportunities to articulate with other disciplines and we must not lose these chances for examination and exchange. Our science is in many ways on the threshold of great discoveries and it would be unfortunate if our institutes, our societies, and our Association did not foster an ambience that would facilitate greater creativity and opportunity for further professional and scientific growth. How this can best be accomplished will be a challenge to all of us.