To the Editors:
From the recent exchange of letters in the Newsletter, it seems clear that still another major row may soon break out among our membership. The issue again is the training of medical and nonmedical psychoanalysts. We have every reason to be concerned that if another such battle surfaces, that the very existence of our Association will be at stake. Because there are strongly held positions on both sides, I think we all have to be prudent in the arguments we set forth. For myself the issues are so complex that I have yet to resolve them in my own mind. This is because more than who will be trained in psychoanalysis is involved. We are also dealing in this matter with our relationship to education in general, to medical education, to psychiatric education as well as with the equally complicated problems of health care delivery.
Dr. Gene Gordon's recent letter did trouble me on a number of counts. It seems to me that there is an increasing undertone, when discussions of selection and training in psychoanalysis take place, that having attended medical school is a disadvantage. I am saddened that Dr. Gordon joins in that chorus. My psychoanalytic experience has led me to the observation that physicians have no monopoly on the defenses of denial and intellectualization nor indeed on authoritarianism and pomposity.
In addition to my psychoanalytic work, I am dean of admissions at a medical school and wish to take direct issue with some of Dr. Gordon's remarks about the medical school admissions process. He is certainly correct that deans of admissions do not actively seek out psychoanalytic talent. The admissions policy in most private medical schools is to admit as many qualified applicants as possible irrespective of future career choice. This policy is undergoing change because of the requirements of the new national health manpower legislation. And although I cannot claim to know all deans of admissions, I know a number of them, and with few exceptions they look with favor upon applicants with personality traits which are also favored by Institute admissions committees. Dr. Gordon is also correct in his concern about the emphasis in medical schools on intense competition, scientific prociency and academic achievement. He is incorrect in his assumption that personality, character, judgment and empathy are secondary considerations. Quite the opposite is the case. Positive attributes of personality and character are of primary importance, and in the admissions process with which I am familiar, are certainly as important as academic achievement and in many instances override it. Among the deans of admissions whom I know well this is a comon attitude. This beleaguered group has to answer for enough as it is without adding to its burdens.
Physicians, indeed, are not the only group with qualifications for psychoanalysis. But I cannot agree either that medical education, more than other kinds of education, is doing psychoanalysis harm. The American Psychoanalytic Association itself stands as evidence of that fact.
Sincerely yours,
Jacob Swartz
Boston