To the Editors:
The American Psychoanalytic Association is contemplating a program of certification which I believe will have serious and adverse consequences for psychoanalysis. The Committee on Certification, by its own account, expects financial benefits to flow from certification. Thus by any legal interpretation the American has an economic incentive for limiting certification to its own members and excluding others. Inevitably, whatever certification procedures the American develops, they will be challenged by other groups who claim to be analysts, and the contemplated grandfather clause of the American will force some 800 graduates of institutes accredited by the American to be part of the class of plaintiffs who will potentially join in any law suit. Arguments will then be made that the American's grandfather provision is not only an economic disadvantage to other “practicing” analysts, but also for graduates of accredited institutes simply because they have not joined the American.
The legal challenges to the contemplated program has many other complexities as well. What about those whom the American accepted and who have since resigned? Will they be grandfathered, or is the crucial variable paying dues? What about dues-paying members of the American who have long since stopped practicing psychoanalysis, or who are now incapacitated? How will the American be able to stand on an argument that its purpose is protecting the public when it will say that all and only members of the American are qualified analysts?
The grandfather provision of the American is not only legally suspect, but it is also not prudent. It will alienate some 800 members of the small group of analysts who have graduated from institutes accredited by the American. When the American down the line begins to negotiate with and deal with the law suits that will come from all the other mental health professions who call themselves analysts, they will need as many devoted friends as they can get.
Viewed from another perspective, this point becomes much clearer. The American's Committee on Certification has decided that they will not at this point claim to be certifying any group other than their own. Presumably all the other groups are free to certify all of their members under a grandfather clause. If any third party payer, be it Government or some private insuror, were to recognize such accreditation, the only noncertified psychoanalysts in the United States would be those 800 graduates of institutes accredited by the American who have not joined the American.
The American should postpone action on certification. It should consult with legal counsel about its conflict of interest economically, about its implied warranty of members of the American, about the possible litigation which the American might face from disenfranchised graduates of institutes, as well as by other groups. It is terribly important at this point in the history of psychoanalysis that the American reach out and embrace all members of its family rather than indulge in the narcissism of small differences.
—Alan A. Stone, M.D.