We invited Professor Hale to contribute an article relevant to the history of the Association on the occasion of our seventy-fifth anniversary. He has been a guest member of our History and Archives Committee for a number of years. He is Professor Emeritus of History at the University of California at Riverside and one of the foremost scholars on the history of psychoanalysis in America. He is the author of several books and numerous articles in this area. One of his best known major works is the book, “Freud and the Americans: The Beginnings of Psychoanalysis in the United States, 1876–1917.”
At this seventy-fifth anniversary of the founding of the American Psychoanalytic Association, a brief review of two intertwined issues affecting its occasionally stormy history may be useful—professionalization and lay analysis. From the start, Freud's intentions in founding a formal international psychoanalytic organization were clear: to define what constituted a reliable analyst, to promote friendly communication in the face of an often hostile outside world. Ernest Jones, then teaching in Toronto, took the initiative in starting an American branch, partly to please Freud and strengthen the fledgling international, partly to protect psychoanalysis from amateurs and charlatans. Jones feared that wild analysts might be a particular danger here, where the initial enthusiasm for psychoanalysis might become associated with a public passion for “mind cures” of every variety. He planned to found a “Pan American” society that would meet once a year and encompass the interested few scattered from Boston to Omaha.
But the exclusion of laymen was far from Jones's intent. The first circular letter of invitation was sent to at least three psychologists, as well as to physicians. The original eight who attended the founding meeting in Baltimore May 9, 1911 were physicians and they were there probably to attend the sessions of the American Psychopathological Association and the American Neurological Association. Most of them were young. Five were in their thirties, one, in his twenties. The oldest were James Jackson Putnam, professor of neurology at Harvard, then 65, and Adolf Meyer, then 44 who had just moved to Johns Hopkins as professor of psychiatry. The others were Ralph Hamill, an assistant to the leading Chicago neurologist, Hugh T. Patrick; Trigant Burrow; John T. MacCurdy, a medical student at the Johns Hopkins medical school; G. Lane Taneyhill, an instructor in neurology there; G. Alexander Young, an Omaha neurologist; and Ernest Jones. Psychologists soon joined. They included Rudolph Acher, who taught at the State Normal School in Valley City, North Dakota; Harry Woodburn Chase, professor at the University of North Carolina; and Louville E. Emerson, with a Ph.D. from Harvard under William James, who worked with Putnam at the Massachusetts General Hospital. G. Stanley Hall, who had invited Freud to Clark University in 1909, was president of the Association from 1917 to 1919.
However, in the immediate aftermath of World War I, a spate of dubious
laymen proclaimed themselves psychoanalysts, especially in New York's Greenwich Village. Among them were the anarchist Andre Tridon, who pirated an edition of Freud's Interpretation of Dreams and several Jungians, including the journalist, James Oppenheim. The issue was complicated by laymen who returned from psychoanalytic training in Europe and wished to practice, and by state laws against the unauthorized treatment of patients by non-physicians. In 1924 the New York Psychoanalytic Society restricted membership to physicians and stipulated that they be satisfactorily analyzed. The American, which was dominated by the New York Society into the 1930's, also required the medical degree that same year.
With the founding of Institutes in the 1930's, training became more rigorous and systematic, and in 1938, three years after the American became an organization of constituent societies, it established uniform standards. These included a medical degree, a year's internship and a year's full time residency in an in-patient psychiatric hospital. Laymen trained earlier or who already were members were exempt from the new qualifications. These American regulations created a temporary rift with the International Psychoanalytic Association and its Training Commission. Not all the reasons for the new requirements are known. One can only speculate that during a severe Depression in which some analysts were having difficulties making an adequate living, especially in centers such as New York, competition from European lay analysts was one motive. Indeed, attitudes toward the refugees were ambivalent: they often were welcomed with unusual generosity yet some Americans expressed the fear that too many would gather in the larger cities where analysts already were concentrated. A more important motive for the new requirements of the American may have been A. A. Brill's consistent policy of making psychoanalysis a specialty within the framework of American psychiatry and medicine, a policy which Sandor Rado, the first director of the New York Psychoanalytic Institute, also espoused.
It was from a basis of growing medical and psychiatric strength consolidated in the 1930's that the American psychoanalysts made their extraordinary impact on military psychiatry in World War II. In this important mission the refugees played little role. Major policies and studies in both the Army and the Air Force were initiated by psychoanalysts such as William Menninger, the
chief psychiatric consultant to the Surgeon General, John Murray, consultant to the Air Surgeon, John Spiegel and Roy Grinker assigned to the Air Force in North Africa and Ralph Kaufman who slogged through the Okinawa campaign directing psychiatric policy for the 10th Army.
The remarkable post-war expansion of psychiatry and particularly of psychoanalysis was a direct result of war time experience and the training of more than a thousand young psychiatrists in the services. Moreover, use of psychologists, social workers and aides as ancillaries in the individual and group psychotherapeutic treatment of neuropsychiatric casualties created strong precedents for non-medical practitioners. The war began a period of major influence for psychoanalysis within American psychiatry that lasted into the 1970's.
In the face of unprecedented demands for psychoanalytic training and therapy just after the war, the problem of whom to admit and to qualify became a major issue. Those who had completed their psychoanalytic training in the new institutes hoped to maintain the highest possible standards and were loathe to see their diminution. The American Psychoanalytic Association was reorganized once more on the basis of individual membership in 1946. Indeed, the Association made requirements for membership even more rigorous. Members not only had to have completed training in an approved institute, but also be screened by a national membership committee. Soon there were serious proposals, accompanied by heated debates, over the possibility of a national board of certification for psychoanalysis. But these foundered for many reasons, among them the difficulty of defining an official body to represent psychoanalysis in the face of new organizations of former members who had left the American or psychoanalysts who had never joined. Since the early 1970's, membership has included special nonmedical candidates and graduates, although the number of laymen has remained small.
Current debates need to be seen within the context of two tendencies that have characterized the American from its early beginnings. The first was symbolized by the inclusiveness of Ernest Jones's circular invitation, the second, by the serious discussions over professional qualifications that have surfaced from time to time since the early 1920's.