Robert L Bergman, TAP editorial staff member, spoke to Mike Allison, his friend and office mate, in Seattle shortly after the December meeting.
RLB: Your name is George, but everyone calls you Mike. How did that happen?
GHA: I'm not sure. The family story goes that my parents couldn't agree about my name. I was actually named after my mother's uncle, but my father gave me the nickname Mike and it stuck. Everyone who knows me well calls me Mike.
RLB: Tell us a little about yourself.
GHA: After going through the Yonkers, New York, public schools, I went to the University of Rochester, The Navy sent me to Yale Medical School, and I served my internship at a naval hospital in Shoemaker, California I did my psychiatric residency at Menninger's. I began practice in Seattle in 1948; but, because I hadn't completed my obligation to the Navy, I was drafted back into the service at the end of the Korean conflict. I spent two years at Camp Pendleton, California, but was able to maintain a part-time practice in Oceanside and another in La Jolla. I had the best of both worlds—a tennis-playing relationship with my CO and a unique professional status.
If I had been a graduate, I might have stayed in that neck of the woods, but I decided to return to Seattle to finish my training. I had presented my thesis and would have been graduated except for certain problems at the Institute. I had to return to do another termination. I soon became deeply entrenched, and I've not regretted the decision to return to Seattle.
RLB: How did you happen to go to Seattle in the first place?
GHA: When I was at Menninger's, there were over 100 residents in my class. We had a colorful faculty—Robert Knight Karl Menninger himself, David Rapoport, George Devereux, Merton Gill, Margaret Brenman—and there was a lot of excitement in the air. But most of us were poor and could not afford to be analyzed. A troubling situation arose when 100 residents who couldn't afford analysis were craving it. Our therapeutic needs had grown mightily while we were studying psychiatry and Freud.
That was an important factor in my coming to Seattle—it offered me an opportunity to get into analytic training and into personal analysis. Edith Buxbaum and Douglas Orr were founding the Seattle Institute. In addition to the chance to get analyzed, Seattle offered the extra inducement of a salaried job. I had two small children, so the financial incentive was particularly inviting.
RLB: Now you've been president-elect for two years. Your successor was recently elected; and you still have a few months to go before you're actually president. Are you getting impatient?
GHA: Yes, I already feel as if I'm a lame duck now that my successor is in place—and I haven't even started. I feel ready to deal with the issues facing us.
RLB: What are some of those issues?
GHA: The issue of nommedical clinical training is particularly timely. Even before the lawsuit, we were moving, haltingly, toward the admission of nonmedical persons for clinical training. The lawsuit simply accelerated that movement. Now, since the Gaskill proposal was put in place, new concerns have emerged about discrimination between medical and nonmedical people because nonmedical people have to go through the extra step of acceptance or review by a national waiver committee. Many pressures—which I think are mainly economic—are being exerted for local option, giving the institutes autonomy in this decision and allowing them to make the final decisions about which nonmedical people to admit and which not to admit There is a struggle within the American between those institutes which want to make all decisions independently and those which welcome the participation of the Board on most issues of training.
Another major structural change I think we will be undergoing lies in the composition of our membership. The recently proposed by-law amendment to unlink certification from membership marks a fundamental change in the structure of our organization and has far-reaching ramifications. Important provisions have been built in, for instance, to assure the autonomy of the Board of Professional Standards. And it has been suggested that the voting rights of noncertified members be restricted in some way to protect the long-term welfare of the Board and to preserve our standards of training.
“In one of my fantasies, some of the rival institutes seek to come under the umbrella of the American and strive to qualify for acceptance. In this daydream, the American can expand under its existing standards.”
RLB: Some people are concerned that the change in membership requirements might result in the Board itself being voted out of existence or radically altered.
GHA: Yes, some fear that the Board would be eliminated by those people who don't want any kind of centralized control. Those who want to see the changes we have been talking about also want to see the Board preserved and the Board's autonomy and standardsetting responsibilities sustained. The framers of the amendment intended that it should not in any way endanger the autonomy and strength of the Board.
Some people might even see the membership by-law as a regressive change inasmuch as the Board has had some kind of qualifying process since 1952, when, I believe, the Membership Committee of the Board was first instituted. Before then, people became members automatically upon submitting their credentials after they had graduated. In contrast to our current Certification Committee, the Membership Committee did not require long write-ups
of cases, although they did require some write-up. When I submitted my material in the late 50s, it was reviewed with some care, and I was deferred for lack of evidence of a satisfactorily terminated case. Membership wasn't automatic.
RLB: What do you see as the best membership process?
GHA: I favor the retention of a Board Committee on Membership. The process of certification itself has become more stringent and exclusionary. Many institutes and many individuals feel that it has become very burdensome and that they should not have to go through such a stringent procedure once graduation is achieved.
I would prefer that we return to the practices of the old Membership Committee rather than the pre-1952 approach. That would mean a careful evaluation of competence before granting full membership, but not at the current level of rigor and stringency. That level of difficulty could be maintained as a separate certification process for those who wish to seek certification as well as membership, and certification could be retained as a requirement for certain national functions, such as membership, and at the local level for training analyst status.
The Committee on Certification of Membership, led by Dr. Martin Stein, recommended that the matter be studied further but that we move in that direction. At the same time, they recommended that we immediately institute a change in certification that would make it a lot more like membership used to be. We'll see by the by-law vote whether the membership at large agrees.
RLB: With the International recognizing institutes that are not part of the American, what do you suppose the effect will be of the American's losing its exclusivity in the United States?
GHA: I wish I had a clearer vision on that. Along with the general economic issue, it's one of the factors that make nonmedical clinical training so important these days. Now that nonmedical institutes—and institutes of any kind—are eligible to apply to the International, they are applying. So-called shadow institutes have already sprung up in major cities; other nonmedical institutes have existed for a long time. Some are excellent—three have already been recognized by the International.
The competition for good candidates is heightening, particularly in New York and Los Angeles. Many institutes that are struggling to fill their candidate rolls with the best people feel that they need local option so they would not have to require nonmedical applicants to go through an extra hoop. To be competitive with newly developing rival institutes, they strongly favor local option now.
In one of my fantasies, some of the rival institutes seek to come under the umbrella of the American and strive to qualify for acceptance. In this daydream, the American can expand under its existing high standards. After all, on paper anyway, the IPA standards come very close to ours, and many of our members are working for the IPA in this difficult task of evaluating the new applications. How effective the International is enforcing its standards throughout the world is, of course, another problem. In the United States, the American monitors its own institutes by making periodic site visits to make sure that the standards are actually met.
Still another concern is that member institutes that become disenchanted or totally alienated from the American might sever their connection and join the International. I personally don't think that will happea I think that the benefits and importance of membership in the American are sufficient so that most institute will stay. I think that any splits that occur will be within institutes and that at most only a few members might go elsewhere and develop a new institute. Most members would remain loyal to the American.
GHA: How do you see the future of our profession?
GHA: Psychoanalysis as a therapeutic modality is very much on the line today because of the shortage of analytic cases and the competition from other therapies. I think more and more analysts are practicing psychotherapy, as opposed to formal analysis, largely for economic reasons. Sometimes, even where psychoanalysis is clearly indicated, a less intense form of therapy is undertaken for financial reasons. This has been the case for more than a decade.
“We are fighting back, as it were, against analysts doing more psychotherapy than psychoanalysis by our efforts to get third-party coverage for long-term therapy and analysis….”
We are fighting back, as it were, against analysts doing more psychotherapy than psychoanalysis by our efforts to get third-party coverage for long-term therapy and analysis, which is one of the goals of the task force led by Dr. Norman A Clemens of Cleveland. They are studying past research on the efficacy of psychoanalysis and are now proposing new outcome research. There may be other ways to help ourselves in that regard through other Council committees, such as the Committee on Public information, which is doing a bang-up job of getting the word out about what analysis consists of and how it is uniquely beneficial. We should help foster this education individually too. And we must try to secure third-party payment or include coverage under proposed national health insurance, which many forecasters predict will be with us within the next five years.
At the same time, we are beginning to see an upsurge in applications for training from both medical and nonmedical sources. As I said before, I think that local option for nonmedical candidates may be the answer for those institutes that have a source of good nonmedical applicants. Thus, if the Gaskill Proposal restraints are removed, the future of psychoanalysis may see many more nonphysician practitioners. The membership vote on the proposed by-law amendment for local option will tell us what the future holds there. In any case, many more practitioners in the future will be women. I hear that candidate classes around the country have been approaching 50% women.
Of importance also in the future of the profession is the development of research activities by full-time researchers and by practicing analysts themselves. I hope that we can nurture new psychoanalytic researchers, that there will be a greater emphasis in institutes on education for research, and that we will emerge with a larger cadre of full-time researchers. There are ideas on the drawing board now, for instance, to create an institute without walls for psychoanalytic research that would be funded by the membership of the American or by the American and by Division 39 of the American Psychological Association which is the psychoanalytic division of that organization. An initial conference is to be held in New York to consider the establishment of such an institute.
RLB: Is there a prospect for a real relationship between the American and Division 39?
GHA: I think there is. Some of our members are also members of their association, and there are outstanding people like Fred Pine, Herb Schlesinger, Roy Schafer, and others who have been prominent members of Division 39 as well as outstanding members of our Association.
So psychoanalysis is alive and well and full of good potential.