Dr. Arnold M. Cooper became the 50th President of the Association in May, 1980. He is a Training and Supervising Analyst at the Columbia Institute; Professor of Psychiatry and Director of Training at the New York Hospital-Cornell Medical Center.
Soon after he assumed his new position, Dr. Cooper expressed his views on the various issues confronting the Association and psychoanalysis, in general, in the following interview to the Newsletter.
Newsletter: What are your first impressions as you assume the presidency.
Cooper: I am enormously buoyed by the support and cooperation offered by our members and staff, by their creative ideas, hard work and devotion to the American. I am also more than a little impressed by the range of problems confronting us, some familiar and close to the heart of our analytic interests, others seemingly distant and imposed from outside. For better and worse, we are increasingly required to participate in governmental initiatives and to concern ourselves with health care regulations which will affect our capacity to carry out our clinical and educational functions. I suspect many of us resent this claim on our time and energy, feeling that it is not a necessary part of our functioning as psychoanalysts.
Newsletter: Could you give an example.
Cooper: Yes. My introduction to the Executive Committee really began last year with my involvement in the Committee's response to the effort of a group calling itself the National Association for the Accreditation of Psychoanalysis and Psychotherapy (NAAP), to be recognized by the federal government as the official accrediting agency for psychoanalysis. This group is composed of persons who with few exceptions do not meet any of the standards which we would hold for the accreditation of a psychoanalyst. Their stated minimal standards for acceptance into training (a B.A. degree or equivalent) or for certification as a psychoanalyst (an M.A. or equivalent) are, in our view, dangerously below what is required for the protection of the public. If the NAAP were successful it would mean governmental sanction of a new group of mental health providers who lack the qualifications required for the care of persons seeking help for serious problems. We are also concerned that accreditation of this group would seriously debase the meaning of the term “psychoanalyst.” I am pleased that the American Academy of Psychoanalysis, the American Psychiatric Association and the American Psychological Association have joined with us in the effort to prevent NAAP from achieving this power.
I am cautiously optimistic that we will prevail, but NAAP has been energetic and extremely well organized and this has required that our response be equally intense. We must write letters, organize our institutes and societies to provide information on the care they provide and so on. It is not easy to begin to adapt to the idea that our involvement with issues of governmental regulation is a part of our clinical responsibility to our patients to assure that they will receive the best clinical psychoanalytic care.
Newsletter: Would you say something of the internal issues which seem to you important.
Cooper: Another important issue familiar to everyone and previously discussed in the Newsletter is the proposal to revise our membership requirements. This matter has aroused great feeling and I believe it is important enough to deserve the most thoughtful consideration. The reexamination of our membership qualifications is timely and is an appropriate next step now that we have firmly established an excellently functioning Committee
on Certification, and certification status. It is my own view that the secure establishment of certification, separate from membership, towards which the American has strived for many years, now provides the opportunity to arrange an appropriate role for our fully trained institute graduates who, for whatever reason, remain uncertified, but who wish to participate in the national organization of the profession for which they have trained. (Several recent letters have referred to the dangers of extending full unlimited voting membership to non-certified graduates. I agree with these concerns, but to my knowledge, no such proposal has been made.) Depending on how one counts (the data are not simple) somewhere between 1/5 and 1/3 of all regular institute graduates who have received full clinical training are not now certified and probably for varieties of reasons some significant number, even if small, will continue not to be certified. I agree with those who feel that the accrediting and certifying functions of the Board on Professional Standards must be carefully protected, that only certified members should have a role in Board affairs, and that we should in no way weaken our commitment to excellence. I also believe that physicians who have received full clinical training from institutes approved by the American, and who are accepted in their local societies, some of them contributors to our literature and institutes' teaching, should have the opportunity to participate in the scientific and professional affairs of psychoanalysis on the national level. I think a form of association with The American for these persons could give us the benefit of their support and wisdom during perilous times and would enable us to provide these graduates with a close association and continued identification with professional peers, perhaps even stimulating some of them to wish to be certified.
Concerns have been expressed that we will damage the authority of the Board's control over quality or we will be supporting a decline of standards if we embrace graduates of our member institutes who have not been certified. I believe these concerns are groundless. The Board on Professional Standards, more than ever before in its history, is properly asserting its accrediting and standards setting functions with institutes. The authority of the Board in this respect is unquestioned and its competence in carrying out these functions is steadily improving.
The graduates of our institutes are meeting the rigorous standards set by the guidelines of the Board and they deserve respect and recognition as psychoanalysts. If graduates of accredited institutes are not appropriate for recognition by the American Psychoanalytic Association, then the Board has the power and capacity to intervene with those institutes which are not carrying out their responsibilities.
Newsletter: What form of association with the American should be given to uncertified graduates?
Cooper: This is, of course, an issue for the Association to decide after the fullest discussion. My own view is that non-certified individuals should not be permitted to hold national office or to serve on the Board or to vote on issues within the domain of the Board. There is no legal problem in establishing by-laws which present a permanent barrier to the involvement of these individuals in Board matters; such members would not have a vote on any by-laws change which affects the Board or qualifications for office or if one wished, even qualifications for membership. Therefore, regardless of their numbers they could not decide these matters. The issue is, as I see it, not one of egalitarianism versus elitism, but rather one of assuring that psychoanalysis as a science and profession continues to have available the fullest talents of those who are able to contribute, while developing excellence in educational, scientific productivity and professional care.
There is much more to be said on this question, but I want to mention two other issues that are probably equally important immediately and in the long run. The Alcohol, Drug Abuse and Mental Health Administration, under Dr. Gerald Klerman, is developing guidelines for meeting a request of the Senate Finance Committee to establish proof of safety and efficacy for the varieties of psychotherapy, including psychoanalysis. There have been several meetings on this topic in which Dr. Herb Schlesinger and I have participated as representatives of the American. We are being presented with both a demand and an opportunity to develop high quality outcome studies utilizing the best available resources. Many of our members have long felt that this is a pressing need for the scientific development of psychoanalysis and some of our members feel that the methodology for a sophisticated psychoanalytically meaningful outcome research is now available. A project of this kind would probably require a consortium of institutes and societies, and some significant funding for a pilot project with a view towards obtaining funding for the major project. I think that it is incumbent upon us, after many years of clinical experience, to begin to make this effort and it is essential that it be made by psychoanalysts who alone can provide appropriate outcome measures. I look forward to our progress on this research front.
Finally, I would remind you that the Committee on Psychoanalytic Practice has submitted its final report, which is currently being edited, and will be released in the fall. The findings of this report are, I think, of considerable interest and importance and should lead to an informed discussion of ways in which the American and its member societies and institutes can provide assistance to individual psychoanalysts towards maintaining the highest level of professional growth, identification with psychoanalysis, opportunities for psychoanalytic practice and excellence of psychoanalytic care of patients.
Newsletter: In your interview of July 1979, you mentioned as three major areas of challenge our continued scientific development, our relationship with students and younger members, and our relationship with the external environment. Do you want to elaborate on any of these issues?
Cooper: I have already touched on aspects of all of these questions. I would like to stress the importance of our gathering the help of the most dedicated and talented psychoanalysts-clinicians, researchers, educators, and administrators—as we continue to grow and I hope thrive in the future. Dr. Larry Hall expressed his concern for searching out new talent in his address to the Board in San Francisco. I would like to second his plea. As an example of the problem, at the present time, four of the eight appointed members of the Coordinating Committee come from a single institute, while ten of the 15 chairmen of committees, sub-committees and task forces of the Board come from three institutes. This was not intended by anyone, but represents a stage in the natural evolution of the administration of the Board as the Board functions become more complex and the organization becomes too large for one or a few persons to know personally the availability of dedicated contributors throughout the country. It is, of course, a first requirement that all appointments should be made on the basis of excellence and capacity to do the job, but it is a second requirement that excellence should be sought and recognized. I know that Dr. Hall is dedicated to finding better ways to seek out appropriate individuals who might serve significant roles. We are all aware that a failure to do so would have a stultifying effect on our scientific and organizational life and might ultimately lead to a form of internal discontent and dissension.
Newsletter: Do you have a single major ambition for your term of office?
Cooper: I feel that psychoanalysis is in a period of enormous scientific excitement, productivity, and optimism. Psychoanalysis is again providing the intellectual and clinical stimulation which will, I believe, attract the brightest minds in medicine and the related professions. Even now, when the number of persons entering psychiatry is diminishing sharply, we are managing to maintain psychoanalytic training at a high level and we will continue to improve our educational programs. The American Psychoanalytic Association is the most important organization for enhancing the opportunities for our continued professional and scientific growth. The maintenance of analytic excellence requires that we find the ways to support a superior research establishment, that we maintain our capacity to stimulate and be stimulated by a variety of professional and intellectual fields and that, while maintaining our independence, we are also able to demonstrate our importance to society which ultimately must support us. I think we are up to the task and I would hope to advance a few steps along that way. We will clearly face many difficult decisions, some of which I discussed and some of which, for example, the issue of non-medical training, we will be discussing in the years to come. There is an old Chinese curse: May you live in interesting times. I feel that it is more blessing than curse, but there is no doubt that we will have interesting times. I will be satisfied if I have been helpful. I even expect to enjoy it.