This is the second of a series of articles designed to inform the membership of the functions of the Associations various offices, governing bodies, and committees.
In the mid-1940's, American psychoanalysis and our Association underwent many important changes. It wasn't only that psychoanalysis became popular or fashionable; it was scientifically and culturally necessary that psychoanalysis assume the central position in psychiatry. In consequence, there was a great increase in the number of applications to those institutes already in existence and a demand for the establishment of new institutes. The Association determined that only psychoanalysts could be entrusted to establish standards of training and to define the clinical, ethical, and professional criteria for membership in our organization. The Board on Professional Standards was established to carry out that charge.
Further, the Association decided that the psychoanalysts to make those definitions and to encourage and monitor those training programs and evaluative procedures should be those most directly involved with psychoanalytic education. Hence, the Board was, and is, composed of two elected representatives (Fellows) from each of the accredited institutes. Each Fellow is a training analyst and has power to vote on Board decisions. Representatives of provisional institutes participate fully but may not vote on matters before the Board.
The Board, then, represents the collective will of the Institutes. The arrangement further places the institutes in the position of helping each other to develop through the Board and its activities.
The position of the Board within the Association is somewhat analogous to the situation of an institute which exists as part of a psychoanalytic society. Our Bylaws designate that the officers of the Association shall be members of the Board; the Chairman of the Board is a member of the Executive Committee; the Presidentelect is Vice Chairman of the Board. It is also an established tradition that the officers of the Association serve as members of the Coordinating Committee. These arrangements might induce ominous twitching in a school of business administration experts, but they have served us well.
The Coordinating Committee consists of the Chairman and Secretary of the Board and the Chairmen of the Standing Committees of the Board, together with the Association's officers. It functions as an advisory committee in the sense that matters requiring action between Board meetings can be discussed, thus providing the Chairman with background and guidance to determine if existing Board policies are adequate or if the matter falls into a category which should be brought to the Board.
For example, at the last meeting of the Coordinating Committee, several recent instances were reported of advanced candidates moving to a city at some distance from the Instiute, with a significant amount of supervised clinical work still remaining to be done. Can (or should) arrangements be made for continuing supervision to take place with supervisors present in the new locality? The discussion brought out the potential hazards to the optimum training of such candidates. Although it was recognized that each instance must be individualized, it was agreed that the Chairman should bring the matter to the attention of the Board, emphasizing the dangers to the tripartite integration of psychoanalytic training. That is, what happens if in the new supervision it becomes apparent that more course work or further personal analysis is needed? How useful to the Institute are supervision reports by a supervisor they don't know? How practicable would it be for the new supervisor to attend the Progression Committee and to participate in the important process of such discussions? Should such candidates be best advised to transfer to a new Institute? Always? Sometimes?
The greatest amount of the work of the Board is carried out by the Standing Committees. Here, I will only discuss them briefly, since each will be further described in subsequent articles.
The Committee on Institutes (COI) is charged by the Board to ensure that our accredited Institutes conduct their training programs in consonance with our published “Standards for Training in Psychoanalysis”. Throughout its work, it has recognized that published standards are minimal standards, and the Fellows of the Board and the Committee are continuously engaged in an interactive process not merely of enforcing standards but of studying ways to improve psychoanalytic training. The site visiting program, wherein all institutes are visited every seven years, represents an important part of this process.
The Committee on New Training facilities (CNTF) has a similar purpose and form to that of the Committee on Institutes, but its activities are restricted to working either with those Institutes engaged in sponsoring new training facilities or directly with Provisional Institutes. Like the Committee on Institutes, it works through a series of subcommittees. At this writing, there are only a few new training facilities being sponsored and only one Provisional Institute. There are, however, several potential new training facilities.
The Committee on Certification ascertains for the Board and the Association that an applicant for active membership not only has graduated from an accredited Institute, but also has been able, on his own, to integrate his experience in analysis, in seminars, and in supervision. The applicant demonstrates this integration by writing up his analytic cases, usually those cases which were begun during his candidacy. However, if application is made some time after graduation, more recent cases may also be submitted. This committee must be small and composed of experienced analytic clinicians and educators who are also tireless readers. Membership on the Committee needs to be carefully staggered so as to assure continuity of the criteria being applied.
The Committee on Certification represents an exception to the general need for coordination among Board committees, in the sense that there is a series of privacies that must be carefully attended—those of the applicant, those of his patients, and those of the Institutes. All institutes accept more candidates than they graduate, and every institute graduates analysts who fail to achieve certification the first time around. (Of those who apply, 90 percent are ultimately successful.)
The Committee on Child and Adolescent Analysis (COCA)
combines the functions of the Committee on Institutes and the Committee on New Training Facilities in relation to training programs in Child Analysis. Thus it monitors those programs already established, and it works to assist in the formation of new programs. Although it has occasionally conducted site visits to child programs, it has been found that cooperation with the Committee on Institutes, by supplying a member of the Child Committee to each of the COI regular site visits, has yielded valuable results. This has the advantage of providing stimulus in the case of institutes that have not yet started child programs and of getting a sense of the integration of child 2nd adult programs when child programs already exist. (About one-fifth of the institutes do not yet have child programs, although two of these are getting close.)
The Committee on Research and Special Training (CORST) was formed after the Board adopted a policy permitting the waiver of the usual standards for full training, so that some carefully selected research scientists, scholars, and educators might acquire a deeper understanding of psychoanalysis than could be obtained from reading alone. This Committee, like the others, meets twice a year and reviews the application from institutes which seek waivers for such special applicants. Questions of analyzability and the presence of sufficient clinical aptitude are best evaluated by the institute. The Committee's primary focus is in reviewing the professional and scholarly merits and potentials of the applicant.
Following the adoption of certification by the Association in 1977 and the establishment of a Committee on Certification to evaluate prospective Active Members the Committee on Membership was appointed to help with a series of problems that confronted Affiliate Members and particularly Associate Members. It became apparent that there were a number of analysts graduated from our Institutes who were unable to apply for certification, although they greatly desired membership. The circumstances mostly had to do with incapacitating health problems, but there have been occasional instances of the graduation having occurred so far in the past that records were no longer available. Such tasks are best suited to a small committee, required to work with great tact and sensitivity. It must balance the Board's concern for standards with the flexibility demanded by compassion. More recently, the committee's other function of serving as a study and advisory committee on issues of membership has gained prominence.
The Committee on Psychoanalytic Education (COPE) is the only Board Committee which does not have administrative responsibility. It was formed as a kind of “think tank” whose goal was to stimulate educators and to promote psychoanalytic training. A major task of the Committee is to select important issues to study and to organize the study groups to carry them out. Institutes are always struggling with questions about selection, supervision, and the training analysis, and those topics are always under scrutiny by COPE study groups.
I have tried to give an overall look at the Board and how it carries out its work. There are no proper names. Fifty-two Fellows and over 110 members serving on Board Committees, plus the even greater number of representatives from institutes who participate in the various workshops, make it impossible to acknowledge their contributions more personally.
I have also omitted any reference to the electrical storms which hover over the Board's activities from time to time. Those are inevitable and should not divert us from the process the Association has established, a process which best ensures that the standards of psychoanalytic training and practice will be maintained for all of us as members of the Association and, perhaps even more importantly, for all those future patients who will need and deserve the best psychoanalytic treatment.
Laurence B. Hall, M.D.
Chairman, Board on Professional Standards