Beginning his two-year term as President of the Association at the Boston May meetings, Dr. Morton F. Reiser brings to the office his multiple talents as a clinician, teacher, researcher, and administrator. In addition to a distinguished career within psychoanalysis in education and research, he has brought his strong psychoanalytic identity to his important work in the academic field, first as Professor of Psychiatry at Albert Einstein College of Medicine, and since 1969 as Professor and Chairman of Psychiatry at Yale University School of Medicine.
A member of our Association since 1963, Dr. Reiser has served with distinction on a number of important committees, including the Board on Professional Standards, CORST, COPER, the Fund for Psychoanalytic Research, the Committee on Scientific Activities, and the Ad Hoc Committee on Feasibility of Nonmedical Training. He has been a Training and Supervising Analyst at the Western New England Psychoanalytic Institute since 1972.
The following interview with Dr. Reiser was conducted just before he took office in Boston. He expresses his views about pressing and controversial issues, speaking strongly regarding the role he sees for himself in dealing with them.
Newsletter: What do you believe to be the most pressing issues that face the Association today?
Dr. Reiser: In my view, the most pressing problems we face today are internal. Considering the myriad external pressures that currently challenge psychoanalysis (as well as many other health, scientific, and educational professions), this answer may seem paradoxical. Let me clarify what I mean by it.
As clinicians, when we deal with individual patients, we recognize that sustained adaptive challenges greater than defensive and coping capacities eventually tax and diminish internal strength and lead ultimately to adaptive failure. Often in such situtations, disruptive internal tensions arise or are aggravated in reaction to external pressures and can then be viewed in part as reflective of them. It is not that different for organizations. Even though the actual vectors and parameters are not the same for individuals, the principles are largely the same.
It is for this reason that I would assign primary importance to internal problems and urge that we devote a good deal of attention to developing mechanisms and processes for maintaining and supporting organizational composure and strength in dealing with problem situtations. We must resolve conflicts within the organization in ways that will sustain and enhance, rather than compromise, our ability to deal with conflicts on our boundaries.
Newsletter: I suppose you are referring to problems such as the current membership question and the proposals for changing membership requirements?
Dr. Reiser: Yes, that issue is an excellent case in point. It embodies issues intrinsic both to our internal affairs, such as educational standards and our relationship to our members (including potentially or actually disaffected ones), and also to our external relationships with those outside our field proper. Certainly our membership policies can influence the way we are regarded and approached by other groups with whom we share common interests and concerns.
Changing times and circumstances may, as they are currently doing, create needs or demands to determine whether — and if so, in what ways — it may be necessary or desirable to reformulate policies, without compromising basic principles, in order to reach working consensus and committment within our own ranks. To achieve this requires adequate time for debate to explicate issues clearly and permit the decisions that emerge to be as rational and fair as possible.
Newsletter: That sounds good, but is it perhaps too optimistic to expect to achieve a process such as you describe, when the issues are as complex and feelings as strong as in the membership issue?
Dr. Reiser: I hope and indeed expect not. As a matter of fact, the first steps are already being accomplished. The issues have been under active discussion for at least two years, and this has permitted their clear and explicit definition. Several proposals have been advanced and discussed, and the arguments pro and con for the limited voting rights proposal have been summarized and circulated before each scheduled discussion to all members of the Board and the Council.
At the Boston meetings, it became clear that there were serious ambiguities in the wording of the proposed bylaws amendment prepared by the Association's legal counsel. Neither Board nor Council approved it, and the proposal was withdrawn by its sponsors. Council then took the initiative by a large majority vote, directing me as President, in consultation with Homer Curtis, Chairman of the Board, to appoint a committee to prepare for its consideration a mechanism that would provide some form of permanent membership for graduates in good standing of approved institutes. This committee will be charged to act expeditiously.
As a result of this process, a proposal to accomplish this goal may come from the Executive Council within the year — perhaps even after
the December meetings, where it will also be discussed by the Board. The final step would then be mailing it with an appropriate summary of prior discussions to all active members of the Association for a mail ballot.
It is, I think, reasonable to expect that we will by that time have “worked through” to as good and fair a decision as is possible, considering the complexity of the issues and of political group process. At the present moment, we do not know what the final outcome will be, but I do feel it is reasonable to hope and expect that all members of the Association will subsequently be ready to work together in implementing the policy that will reflect the best judgment that the majority could reach, after careful and thorough consideration of the facts and issues. If that is the case, I cannot imagine that we will fare badly in achieving the respect and constructive collaboration of outside groups and individuals whose interests and activities are consonant with our own.
Newsletter: What are your views about another controversial issue —the proposal that we train nonphysicians in general, and psychologists in particular?
Dr. Reiser: My thoughts about this issue follow in a similar vein. I think the important role for me as President, is to try to identify what I consider to be the critical questions that will need to be faced. To begin with, there are, in my opinion, some “givens”, some things that are not in question and so should not require extensive debate. First, medicine does not encompass all of psychoanalysis; rather, psychoanalysis extends to and articulates with a wide spectrum of disciplines, extending from the biological and neurosciences to the social sciences, arts, and humanities. Second, two Board committees have concluded that medical training and experience is not an absolute prerequisite for psychoanalytic training and that it would be feasible for us to train nonmedical candidates.
Psychoanalytic training for persons with nonmedical backgrounds is already widely available and practiced. We hold justifiable pride in the quality of the training provided by our institutes. And although many outside our ranks, as well as ourselves, regard it as the best (indeed, maintenance of highest quality and standards has been the most important and highly valued function of the American Psychoanalytic Association), we do not hold a monopoly on psychoanalytic education. Psychoanalysts have been and are being well trained at institutes outside the purview of the American Psychoanalytic Association.
The central issues around which our discussions should, in my view, revolve are: first, whether there still is an appropriate, rational, worthwhile, and desirable role for psychoanalytic training, conducted primarily on a base of prior medical and clinical psychiatric training; and second, if so, whether we want to continue to follow in this special and focused context, as we have done so successfully in the past.
The pros and cons have already been under discussion for some time now, and a new committee chaired by Richard Isay is beginning to explore these issues in further depth. I see my role as ensuring that the ensuing deliberations and processes leading to decision will be as fair and adequate as possible, and attempting to monitor internal tensions so as to prevent serious erosion or compromise of our collective problem-solving strengths. I am not sure that any solution will be entirely right or entirely wrong in an absolute sense. I am sure that we will need to muster all of our best resources to find the one that will be best for us.
Newsletter: Do you see your goal of consensus and consolidation without erosion of our strength, standards, and goals as realizable within your term of office? If so, what do you foresee for us after that?
Dr. Reiser: I'm not sure that such a goal can ever be totally realized in an absolute sense, but I do think it is attainable to a sufficient and practically effective level. By this, I mean a level that would support us, not only in continuing to meet enduring established standards and goals but also in adapting to new developments in our knowledge base and to changing circumstances in our professional environment. It is not possible to anticipate the problems (or, for that matter, the exciting opportunities) that may lie ahead. It is reasonable to expect that, whenever challenges of any nature arise, it will be important for all members who are interested and who wish a voice in shaping the structure and policies of the Association to participate actively.
In my previous experience in the affairs of the Association, I have been impressed by the mutual benefits that derive from the serious and devoted concern that members of our numerous task forces and committees give to their work. This contributes not only to the effectiveness and high quality of the work and to the personal satisfaction of the individuals involved but also to the organizational morale and strength that derives from shared endeavors and commitment. It is also a way to begin to make one's presence felt and one's voice heard. This type of participation is open to many who are as yet uninvolved.
Newsletter: How might individual members who wish to participate in this way do so?
Dr. Reiser: I want to invite and urge all members who are interested, but not yet involved, in the ongoing work of the Association to let me know personally, so that I can consider them when committee assignments arise.