In May, Dr. Arnold M. Cooper became President-Elect of the American Psychoanalytic Association. A Training and Supervising analyst at the Columbia Institute, Dr. Cooper is also Professor of Psychiatry and Director of Training at the New York Hospital—Cornell Medical Center.
In order that the Membership might have an opportunity to become acquainted with Dr. Cooper's views on a number of questions concerning our field, The Newsletter recently conducted an interview with him. In what follows, Dr. Cooper responds to a series of questions put to him by The Editors and discusses issues of both current and future importance to Psychoanalysis.
Newsletter: From your vantage point, what are the particular problems and challenges that are facing psychoanalysis as we move into the '80's?
Cooper: That is a very large question. I would suggest three areas of challenge: 1) our continued scientific development; 2) our relationship with the younger generation—our incoming students; and 3) our relations with the external environment.
Let me discuss them briefly. 1) It seems clear to me that we are currently in a period of extraordinary ferment scientifically. I know of no time since the earliest days of psychoanalysis when rival points of view were being put forth with such vigor. New ideas and new knowledge are being generated and traditional points of view are being challenged today without any threat of split or ouster from the movement. This period of intellectual and clinical excitement promises to renew the relevance of psychoanalysis to major trends of modern thought and has potential importance in terms of analytic technique. We are challenged to find the ways to foster this spirit and increase our research base.
2) The continued nurturance of this atmosphere of analytic inquiry can be a major element in renewing the interest of the brightest segment of young physicians and intellectuals in the pursuit of analytic training. While we have, in the recent past, not been over-burdened with applications for analytic training, it is my impression that applications to analytic institutes are again rising. Even at a time of an extraordinary flowering of biological psychiatry, there is a growing recognition of the central value of analytic thought as a means of comprehending human behavior. I think we are all agreed on the primary place we give to maintaining the quality of analytic education. I am impressed by the recent survey of our membership, revealing a great complexity and diversity of career tasks, with clinical psychoanalysis being only one of those tasks. I think this is a good time to review our educational programs, to be sure that our enormous educational effort is most fruitful and relates to the nature of psychoanalysis today. I also believe we should do more undergraduate and resident teaching.
3) Finally, we are aware of difficulties we currently face in our relation with the external environment, both in the form
of cultural movements and current governmental practices. My own impression, perhaps unduly optimistic, is that the wave of anti-intellectualism and anti-introspection, which has been prominent for the past two decades, has now crested, and the atmosphere may again be more conducive to analytic work and study. The fact that we are now bombarded with alternate therapies, each promising to do our job better and faster, may, over the long run, help psychoanalysis. Because we are more mature, having long ago given up hopes of magical cures, we are likely to be the beneficiaries of the disillusionment with magical therapies. Our culture may be more narcissistic, but our viability depends on our continuing to be scientifically productive rather than requiring special kindnesses from the culture.
There is little doubt that non-analytic institutions—the government, insurance companies, peer review organizations, etc. will play a growing role in the organization of analytic practice. It is the task of the American to monitor these interventions and to find ways to protect the analytic situation, to preserve confidentiality, and to assure that patients requiring analytic treatment are not discriminated against. We have to face the challenge of how publicly to make our case, concerning the value of psychoanalysis as a unique form of therapy and investigation which accomplishes a task important to society, if we are to ask for governmental support of our activities. We are being challenged to find ways to make psychoanalysis or psychoanalytic knowledge available to a broader segment of the population. It is clearly necessary for us better to understand our own social role and our relationship to other medical-social organizations as we struggle to meet the challenges and threats of an evolving new system of health care delivery.
Newsletter: What are the steps that psychoanalysis can or should take to assure its continued vitality and relevance?
Cooper: The vitality of any scientific field, including psychoanalysis, depends upon a constant gathering in of fresh, young minds for the generation of new ideas. I believe we have been reasonably successful, but we still have massive problems. The encouragement of research and the creation of a significant research cadre of psychoanalysts is an urgent task. To achieve this is extremely difficult because of the nature of our training procedures—the long length of training, the late age of graduation, and the priority given to psychoanalytic practice as the identifying mark of the psychoanalyst. All these factors mitigate against the development of serious researchers. Over the long run, I believe that we must find the ways to help develop persons who can devote themselves to research careers with the dedication and freedom that is required in every other branch of medicine. There has been a tendency in psychoanalysis for there to be only one route to high status—the achievement of the rank of training analyst—and I think this has often deflected people from the pursuit of psychoanalysis in other productive ways. I also suspect that we have an excessive tendency to involve our gifted younger people in administrative rather than scientific tasks.
The question of our relevance is interesting and merits a much longer reply. However, I will mention just a few aspects of it. Basically, our relevance is dependent upon our continued capacity to generate new and interesting ideas and knowledge about the way human beings behave both in their ordinary and extraordinary pursuits. Secondly, our relevance depends upon our capacity to apply this knowledge in significant human endeavors. The methodology of this application is not simple, and, as we know, has often been misused in the past. Finally, we are relevant in terms of having a major therapeutic contribution to make through the conduct of analysis, psychoanalytic psychotherapy, and teaching. Here again, it is important that we begin to introduce evidence of our effectiveness as well as that we make explicit the many tasks which we perform in educational and social welfare organizations. I have no doubt that psychoanalysis is, in its own right, a vital and relevant therapeutic, scientific and social activity for a democratic society. We, however, must take responsibility for demonstrating this.
Newsletter: Do you have any thoughts about the relationship between psychoanalysis and psychiatry at the present time. What do you anticipate in the near future?
Cooper: Issues of national health insurance, confidentiality, and third party payers have been the spur towards a new intensity in the relationship between psychoanalysis and psychiatry. On these kinds of questions our relationship is sometimes concordant, at others, discordant. Psychoanalysis has begun to discover the power and the value of existing psychiatric organizations and I think psychiatry is increasingly aware of what psychoanalysis has to offer, both as a point of view and an organization. It is our job to foster this relationship and to establish our role. Ultimately, the relation of psychiatry and psychoanalysis will probably be determined by our mutual educational task. It is still true that the psychodynamic point of view is at the educational core in most psychiatric departments. For this to remain true in the future, however, requires the devotion of psychoanalysts to the teaching of young psychiatrists and the conduct of research by psychoanalysts. It is our job to assure that psychiatric organizations maintain a psychodyanmic outlook and to help them to understand the importance to all of psychiatry of the psychoanalytic therapies.
Newsletter: Are there other educational or organizational issues in psychoanalysis today that are of particular concern to you as you assume your new role in the American Psychoanalytic Association?
Cooper: Yes, lots. Let me mention a few. Over the past few years there have been several attempts within the American to regularize the training of some groups of non-medical people. The Chicago proposal and the current San Francisco proposal are examples of this. Furthermore, the new guidelines for special candidates do permit the admission of non-medical persons for reasons other than research and a number of institutes are appropriately following this expanded guideline. I think the American will have to come to grips with the issue of lay analysis, however lay is to be defined, and it seems that some modification of the current membership requirements will be introduced. I firmly believe that medicine remains an important nourishing root of our field and we should be wary of any actions which might wither it. I'm sure that we have the wisdom to find ways to take full advantage of the contributions which non-medical analysts can make and still retain a medical identity.
Another organizational issue of enormous importance is that of membership. The desirable establishment of certification procedures for psychoanalysts has, in the minds of many of our members, reopened the question of what the meaning and status of membership in the organization should be. It is apparent that there are psychoanalysts who wish to participate fully in the activities of the American Psychoanalytic Association, but who, for a large variety of reasons, will not apply for, or might not qualify for, certification. Many of these individuals are, nonetheless, deeply committed to psychoanalysis, are often in positions of educational and community significance, and may be contributors
to our literature. I believe this issue of broadening our membership base is one which should now come before the membership for the fullest discussion. The Board on Professional Standards has, for many years, done a superb job of helping to improve the quality of education and establishing a meaningful certification procedure. That task, however, is not entirely coincident with the question of rules for membership, and I believe it is time to re-examine the question of whether graduation from an approved institute should not be sufficient for a class of permanent membership. We should be concerned with the need for diversity of experience in our membership, as this is necessary for the continued vitality of the organization.
Newsletter: Are there particular issues and problems of the American Psychoanalytic Association itself, at this point in its history?
Cooper: There is no doubt that we have a terrible problem with our ever-growing bureaucracy, with a proliferation of ad hoc committees, and with a difficulty in stating our overall goals. The most stable administrative group within the organization, the Board on Professional Standards, has the appropriate goal of scrutinizing all aspects of training, with the aim of achieving excellence. The American, however, is not only an educational organization. Activities such as strengthening our ties to psychiatry and the rest of medicine, the dissemination of psychoanalytic knowledge, and the fostering of research are perhaps not properly balanced within the American. It may be appropriate to reexamine the role of the constituencies which make up the American Psychoanalytic Association.
Newsletter: Do you have any projects or plans that you wish to see accomplished during your two years as President?
Cooper: I think it is enormously important that the by-laws have been changed to provide the Presidency with a more than one year term. This makes the Presidency more than honorific, but leaves an enormous challenge. I would be very pleased with my tenure if some of the problems and challenges I have discussed were a bit closer to solution. The American Psychoanalytic Association does change, however slowly. I would be very happy if a few changes could be made a little more urgently. I know that our membership is composed of extraordinary individuals and I look forward to the opportunity to engage their advice, wisdom and energies. I am sure that my view of my job will be very different a year from now.
Newsletter: On behalf of the entire membership, we want to wish you every success in your new endeavors.