Are we seeking psychological cloning through our selection, progression, and curricular educational processes? Are we selecting and training candidates who are already or will become similar, if not identical, to ourselves? Do we only advance those graduates who can be perceived to be like “us”? In the course of my visits to many psychoanalytic institutions throughout the United States and overseas, much private concern has been voiced that our selection criteria for candidates, for training analysts, and for prestigious offices are too conservative and smack of cronyism and convoyism. I am convinced we indeed have an issue here that warrants serious thought.
What is the meaning of this perpetuation? To reassure ourselves of our own validity? To perpetuate ourselves unchanged? To achieve symbolic immortality? Why is it so difficult to effect change? Cornford has observed that “nothing is ever done until everyone is convinced that it ought to be done, and has been convinced for so long that it is time to do something else.” John W. Gardner has noted that “a common strategem of those who wish to escape the swirling currents of change is to stand on high moral ground.” Standards of quality and ideals are to be applauded, but they can be used as well to maintain the status quo, avoid change until it is too late, or cover deeper anxieties and threats.
“‘My dear, we live in a time of transition,’ said Adam as he led Eve out of Paradise” (W. Inge). All of us are familiar with the positive arguments for gradualness, careful deliberation, and maintenance of high quality standards, and I will not elaborate upon these essentials to orderly change. Instead I would like to stress the new realities facing our profession.
I have been told that for the past two years over half of the psychiatric residencies in this country have remained unfilled; that the number of medical students selecting psychiatry as an area of specialization is at an almost all-time low; that there seems to be an erosion in the quality of those who are entering psychiatry; that some medical schools are thinking of making psychiatry elective for medical students. Since primary care physicians can manage psychopharmacologic treatments very capably, and since prerequisites for medical school entry still rely heavily on physical and biological science performance in college, the more humanistic orientations may (unless the scene changes drastically) be found in colleagues who come from disciplines other than biological medicine.
We are a unique association in that we simultaneously regulate who can be trained to be a psychoanalyst, accredit local training institutions, certify the graduate as a psychoanalyst, and control admission to membership into our professional association. We also provide continuing education to our members, encourage the science of psychoanalysis, and act as a political body involved with local, national and international issues. We sponsor and publish books, newsletters, journals and anthologies. We offer research funding. This is an admirable list, especially in view of our relatively small size. But we do not always have healthy dialogue; instead, reverberatory discrimination and exclusion occurs. All should be encouraged to participate in important matters that come to our Association, yet this does not always happen. Cliques, convoys, cronyism still exist. We have our power brokers, but do they always reflect the concerns of their constituencies?
Concern about the future supply of psychoanalytic students is not unwarranted. Unless we consider the reality issues seriously and consider appropriate action, we may find ourselves without a pool of recruits to replenish our discipline. Then we would have to resort to cloning to replenish the supply of ever-aging colleagues. Can we address the issues in time?
George H. Pollock
Chicago