The sudden death of Justin Krent on August 31, 1990, in the beginning of his last year as Chairman of the Board on Professional Standards, left a void in the leadership of the Association and also saddened us all. Those of us who knew him over many years and who worked with him on the Executive and Coordinating Committees were especially affected. Our Association has never before suffered the death of one of its two Chief Executive Officers while in office. His premature passing gave us pause to reflect on his unstinting dedication and hard work for The American in the last decades of his life.
It is fortunate that Marvin Margolis was named by the Board last May to succeed Dr. Krent. He was installed by the Executive Committee on September 6, 1990. The sad occasion of the death of Jay Krent has made clear that the by-laws are in need of revision. They are unclear about succession for Chairman of the Board should the office become vacant through death. Had no successor been named, the Executive Committee would have had to appoint an interim Chairman.
Another needed revision would require a run-off among the top vote getters in a national election when there are more than two candidates and none receives a majority of the votes cast. So far, this contingency has not occurred, but contests among more than two candidates have recently become more common. A review of the by-laws seems in order in respect to vacancies in office, nominations, and election procedures.
As the new Chairman of the Board on Professional Standards, Dr. Margolis has resigned as Chairman of the important Task Force on Membership and Certification, which has been designing the by-law amendment on delinkage. I have appointed Edith Sabshin as his successor in that post.
The timetable calling for a vote by the membership in January or February 1991 is still intact, provided that the Task Force recommendation from its October meeting is in final form for the Executive Council Miami meetings. The by-laws require that the Executive Council give their opinion on the final draft of all by-law amendments before submission for vote by the membership.
It is important, therefore, that the Councilors come to Miami fully informed and instructed by their societies on the most recent draft of the by-law proposal, which will have been distributed for local society and institute discussion in November. This timetable is tight due to the unexpected death of Dr. Krent and the resulting change in the leadership of the Task Force.
I want to assure the membership that the Executive Committee will make every effort to adhere to the original timetable calling for vote on the issue this winter. Dr. Margolis, who has agreed to be a consultant to the Task Force, will attend its meetings and will assist Dr. Sabshin in her new undertaking. I want to thank him for his work as previous Task Force Chairman and also thank Dr. Sabshin for her willingness to step in under the time pressure caused by our commitment to an early vote.
In the recent special TAP Supplement, you had an opportunity to read the contributions expressing a spectrum of opinions about the delinkage proposal. There is wide disagreement about the wisdom of this change and about its effect on the future of The American.
The Task Force has striven to provide measures to prevent erosion of the standards of training and of the influence of the Board on Professional Standards, whose province is to protect and maintain them. Many feel that in the long run there will be an inevitable weakening of the Board and lowering of standards, and others are equally sure that there need not be.
Also in doubt is whether there will be a continuing influx of new members after the present group of Associate and Extended Associate members, many of whom have felt disenfranchised and alienated by the linkage, become full Active members. If delinkage occurs, we hope that they will infuse the Association with new vitality.
Another question is whether certification under delinkage can be enhanced as a voluntary educational step and actually increase in popularity and use as an important peer review and credentialing process.
As the contributions in the special supplement demonstrated, there are also members who feel that we must work to bring new people into the organization but who prefer to accomplish this by making certification more “user friendly,” avoiding delinkage until or unless this effort (as recommended by the committee headed by Martin Stein, which reported in December 1989) has been tried more assiduously.
No one knows which scenario is more likely to occur if delinkage occurs, and both sides are convinced that their predictions are justified.
I find myself increasingly concerned about the polarization of the membership that has occurred over this issue, and I trust that if delinkage occurs those who oppose it will rally around the leadership in its efforts to strengthen The American with enhanced standards of excellence in training and to maintain the prestige of membership and certification if they become separated.
By the same token, if the measure is defeated, I ardently hope that those who have fought for it will lend their strength to other efforts for change and vitalization, such as the recommendations of the Stein Committee. I personally believe that the doomsayers on both sides are mistaken.
We cannot afford to have a house divided and a split psychoanalytic family, with some members who feel alienated or disillusioned or who deliberately subvert the organization. We have common goals to further psychoanalysis, scientifically and educationally, even if we differ about the best organizational approach. Only with mutual respect and with determined efforts made by all of us together can we achieve these goals.
That components of The American do work together is evident in the activities of important joint committees of the Board and Executive Council. The membership at large is generally unaware of the amount of productive, time-consuming effort these committees spend.
For example, the Committee on University and Medical Education, chaired by Arnold Cooper, in its May 1990 report told of a workshop on the relationship of The American Psychoanalytic Association to academic medical institutions. The workshop took place at the preceding December meeting and was attended by the Executive Committee, members of the BOPS and Executive Council, and psychoanalytic academicians. The
workshop addressed the urgent problems of the declining rate of medical applications for psychoanalytic training and the diminished role of analysts in academic medicine. Seven issues were presented, and recommended efforts for solution for each were discussed with a fair degree of unanimity.
Recommendations included The American's fostering academic careers for young residency graduates interested in analytic training by providing reduced costs of analytic training as well as other incentives, and the provision of role models for young researcher-academics. Another suggestion was to urge institutes to review their reward and status systems in order to remove any biases against academics and to facilitate Training Analyst status for academics who qualify by the quality of their work rather than by the usual requirement for numbers of hours of clinical analysis. Also recommended was inclusion of academics in institute policy-making bodies and the encouragement of Supervising Analyst status for qualified analyst-academics who may not wish to seek full Training Analyst status. Other ideas that had general support from those at the workshop were to provide partial training for academics who seek enrichment rather than full training, and to seek ways to encourage systematic research in institutes, as well as to facilitate interinstitute transfers for academic trainees or analysts whose careers demand geographic mobility.
This account hits only the highlights of Dr. Cooper's report of the workshop, which was devised by a subcommittee composed of Malkah Notman, Herbert Schlesinger, Harry Trosman, and David Werman. In addition, Dr. Cooper reported approval by the Executive Committee of American Psychoanalytic Fellowships for residents, and this is being implemented. Finally, he told of a newly formed subcommittee of Psychoanalytic Directors of Residency Education under the co-chairmanship of Harvey Schwartz (see elsewhere in this issue) and Nada Stotland. They are already developing a curriculum on dynamic psychiatry and the production of a monograph designed to serve as a psychodynamic guide for residents over their four-year training in university programs.
Another hard-working joint committee is the Committee on Continuing Medical Education under Edward Brennan. The important accreditation for CME credit through an arm of the AMA extended by The American to Affiliate societies and study groups requires fulfillment of increasingly exacting documentation by the local groups. Dr. Brennan has explained this stricter control in a lengthy memo to the members of the National Subcommittee on Joint Sponsorship, which consists of the local society Program Committee Chairman or designated person in each local group who is most knowledgeable and best equipped to supply the required documentation prior to each year's local program undertaking. The continued success of the CME program for the national organization and its components requires very diligent attention to the regulations and guidelines recently distributed. Otherwise, we risk losing accreditation from the AMA.
I hope that everyone has responded to the new questionnaire on psychoanalytic practice recently distributed by the Committee on Psychoanalytic Practice. This update of previous studies on fee scales and on the practice of our members has importance in gauging the decline in the availability of analytic patients in different locales. Credit for distribution of the survey must be given to Helen Fisher and her staff, as well as to Dr. Brauer, the current Committee Chair on Psychoanalytic Practice, his predecessor, Theodore Jacobs, and the principal designer of the questionnaire, Isaiah Share.
Another new development is the request by the new Chair of the Committee on Associate and Affiliate Membership, Edith Sabshin, that we make a systematic effort to place Affiliate members on all committees of the Council and Board as well as on the Joint Committees. Dr. Margolis and I favor this effort, and we will try to implement it. Meanwhile, the province of the committee will be significantly changed by the delinkage amendment if it passes—probably eliminating the categories of Associate and Extended Associate membership.
As this edition of TAP goes to press, we are approaching the December meetings in Miami Beach. I join with Dr. Margolis in informing our members that they are welcome to attend the meetings of the Board on Professional Standards (Wednesday, December 5) and of the Executive Council (Thursday, December 6). Members have traditionally been invited to attend these major meetings of The American, and I would like the Affiliate members to know how glad we will be to see them in attendance.
These meetings present the opportunity for a winter vacation. They are earlier in December than any of recent memory—allowing an interval before Christmas, which some members have wanted. Ideas about changing our meeting places and times are under review by the Committee on Arrangements, chaired by Muriel Laskin, who welcomes your reactions to this year's change and your ideas and preferences for future planning. One idea occasionally suggested is that the fall meeting be held in New York, Chicago, and San Francisco, in turn. For the time being, we are tied to the American Psychiatric Association meeting city for our annual spring meeting. We hope to receive suggestions from the members on changes in our meeting customs, and revisions can be considered after our present commitments have been fulfilled. See you in Miami!