In December 1987, over 150 representatives of the range of fields and interest groups that make up psychiatry in America met at the American Psychiatric Association's National Conference on the Future of Psychiatry. The APA planned and organized the Conference.
The Conference was co-sponsored by 20 organizations, representing academic psychiatry, hospital psychiatry, various psychiatric sub-specialties, and psychoanalysis. Representing the American Psychoanalytic Association were Richard C. Simons, M.D., Association President, Arnold M.Cooper, M.D., an Association past-President, and Stephen M. Sonnenberg, M.D., who serves as the Association's Liaison to the APA for Public Affairs and Special Projects, and as Chair of its Committee on Public Information. Many other members of the American were in attendance, in other capacities.
The Conference was planned around several working papers, one dealing with “The Future Environment for Psychiatry”, and others with the future of psychiatric research, teaching, economics, organizational structure, and the delivery of clinical services. Groups of approximately 15 members worked together throughout the day discussing the working papers and offering amended and additional perspectives on psychiatry's future.
At the close of the meeting, Simons noted that the members of his working group had seemed genuinely enthusiastic about the future role psychoanalysis and dynamic psychiatry would play in general psychiatry. Sonnenberg added that in his group, which included three members of the American, focused on the future of psychiatric education, the members united behind the position that significant exposure to psychoanalytic principles was an essential component of the residency learning experience including a significant opportunity to perform in-depth psychotherapy under supervision, which allows the psychiatric resident to recognize the powerful impact of unconscious process in both the patient and the therapist. Further, it was recognized that psychoanalytically trained psychiatrists must participate in teaching this skill.
Sonnenberg went on to say, however, that Conference discussions confirmed the view that American psychiatry now sees itself as a complex array of treatments, answering the needs of many patient groups. Psychoanalysis is seen as but one treatment, (however important some psychiatrists may believe it to be) a system for understanding the workings of the mind. Thus, the APA has a complicated scientific, educational, and political agenda, and self-consciously works to support many psychiatric subspecialties and orientations.
Sonnenberg also observed that while American psychiatry “as an institution” appreciates psychoanalysis, and sees an important educational role for its practitioners, his experience at the Conference reinforced the impression that psychoanalysis will have to assume responsibility for itself, if it is to flourish as an economically viable treatment, and as a vital component of future psychiatric science and education. In some areas the American will be able to work in complete harmony with APA, while in others it may have to work more independently, to secure goals it considers to be in its own best interests.
When the final Conference report is available, its contents will be reported in this Newsletter.