Upon returning from San Francisco I have felt the need to communicate some impressions and feelings of disquiet. The city's dramatic beauty came as a pleasurable shock. The opulent service, splendid decor and fine food at the St. Francis made us comfortable, and the fellowship of colleagues was warm and genial. The scientific program was stimulating and sometimes exciting. Yet while at the meetings I developed a feeling that all was not well, which grew as the days passed.
I have tried to identify the source of this concern and keep returning to the sense of insularity. Having come to this notion it is difficult to describe further what I mean by it. Perhaps it is a certain softness, an unwillingness to confront hard issues in the face of changing realities in the world around us. In a time of diminishing applications to our analytic institutes, reflecting in part a fall in the number of medical students going into psychiatry, the issue of qualification for membership continues to be argued in largely the same terms as when I served on the Kaufmann Committee nearly a decade ago. The need to maintain high standards of psychoanalytic practice is always asserted in such debates, and this provides an unassailable argument. For who can be opposed to the highest standards, even if we have never established precisely of what they consist. One might have thought that the establishment of certification would have given us a way to designate the highly qualified, enabling us thereby to open up membership to those who possess appropriate credentials. But instead we cling to our exclusionary policy. I cannot help wondering whether the issue might at its root be the protection of turf or the fear of opening our Association to those who might wish to change its character in unpredictable ways. If this is the concern then surely we are embarked on a course which bodes poorly for our future vitality, if not for our survival.
We have always been concerned lest the “pure gold” of psychoanalysis be diluted by the baser metals of the psychotherapies. But even from the point of view of our own self interest it is important to consider whether our current techniques and modes of practice are suitable to the shifting economic realities of the individuals seeking our help, or of the society around us. Furthermore, changes or advances in technique applied to new populations or cultural groups may yield advances in the body of our theory that are not possible if we restrict our focus too narrowly to the patients we customarily treat.
As psychoanalysts we encounter every day the limitations of our understanding of individual human beings even in a familiar clinical setting. It is not inappropriate, therefore, that we should hesitate to extend our activities into realms where we are perhaps even less certain of our ground. Yet psychoanalysis, in collaboration with the social sciences and the humanities, is potentially a powerful tool for understanding many social, political and cultural phenomena if we can learn more about how individuals think, feel and behave in various small and large group contexts. We do include in our scientific program ventures into these broader realms. But such efforts tend to be side shows of the main events, and the participation of scientists or scholars from other disciplines is quite limited.
At the recent meetings I had the pleasure of taking part in a re-examination of Freud's Civilization and Its Discontents upon the occasion of the 50th anniversary of its publication. In this great work, full of sober prophecy and anxious portent, Freud poses many fateful questions about the future of civilization, and the capacity of mankind to master the destructive forces which, in 1930, threatened its existence. It hardly needs to be said that this threat is far more immediate now than it was a half century ago. In the concluding pages of his biography of Freud, Ernest Jones wrote that the most important part of Freud's legacy may be the contribution we can bring to the understanding and control of man's destructive nature. I do not see that we are striving enough to make that contribution.
In 1976 Heinz Kohut suggested that the psychoanalytic community might undertake the task of self-scrutiny. His notion was that we might thereby contribute to the understanding of group psychology and, ultimately, to historical processes, in much the same way that Freud's self analysis opened the way for the exploration of the inner life of the individual. But there are problems with this. Several years before Freud published his Group Psychology, the German sociologist, Georg Simmel, wrote of “group egoism” and of the tendency of groups to become separated from their environments. All groups resist change, and ours is no exception, as Kenneth Calder noted nine years ago in a colloquium on the psychodynamics of organizations. As a group I do not believe that we are more resistant to change or intolerant of criticism and dissent than other groups. But we do have at our disposal more sophisticated means by which to discount it.
John E. Mack, M.D.
Boston