To begin with, I would like to emphasize that I consider certification in psychoanalysis to be very important in maintaining the high standards of our profession. Psychoanalysis is, above all, a healing profession, and our decisions and considerations should be guided by the need to maintain the highest quality of patient care. To achieve that aim, we need to double check the credentials of those who practice psychoanalysis as we do of those who practice medicine. Graduation from a medical school does not entitle graduates to be licensed to practice medicine, and completion of a residency program does not entitle trainees to be certified without examination. I see the certification process in psychoanalysis as comparable. Graduation from a psychoanalytic institute indicates that the individual involved has met the requirements of the institute attended, but certification indicates that the applicant meets the national standards of our profession.
All good educators, whether at the local or national level, make every effort to maintain their objectivity and evaluate the candidates and applicants in the fairest way. Evaluation of a candidate at the local level, however, is bound to be considerably more personal and somewhat less objective than that at the national level. Perhaps the reverse can be said about the certification process, where applicants' work is reviewed in a more neutral and objective way through written reports that tend to compromise the applicants' ability to convey the wealth of their personal experiences. There are obvious advantages and disadvantages at both levels; nevertheless, when combined, the two offer the opportunity for a comprehensive and thorough evaluation of graduates' abilities and limitations and their readiness to function autonomously as analysts.
I am well aware of the complaints voiced against the certification process. In the five years I have been on the Committee on Certification, I can, however, think of no situation in which the Committee as a group has not done its best to reach the most reasonable and fair decision that it possibly could, as observers we have invited to all these meetings have attested. The certification process is, in essence, a peer review that enhances analysts' self-inquiry into their level of functioning as clinicians and as professionals and facilitates communication with colleagues nationally. Certified analysts have an advantage over those who are not certified, because they have demonstrated their ability to present and explain their clinical work, not only to themselves or to professionals of their immediate environment, but to colleagues from other parts of the country whose professional referents and experiences may be different. The certification process is an important safeguard against professional isolation and against the danger of idiosyncratic notions about clinical psychoanalysis.
Psychoanalysis needs a shared language both nationally and internationally so that the psychoanalytic professional can communicate clinical experiences and insights in a coherent and organized fashion. When viewed in this light, the linkage between membership and certification implies that all prospective members of this organization must first demonstrate their capacity to use the shared language of clinical psychoanalysis before they can qualify for membership in the national organization. Most of them can demonstrate such capabilities, but a few cannot, and many others elect not to try.
What, then, would be the effect of delinking membership from certification? Obviously, there would be less emphasis on a shared language and greater emphasis on increasing membership by admitting into the organization a relatively large number of colleagues who so far have shied away from communicating with other analysts through the national organization. Increasing the number of members, however, will not necessarily increase communication or prevent a sense of professional isolation. We all know from experience that membership in professional organizations can have little or no affect on an individual's professional thinking and development unless a shared common language has been developed in a systematic and deliberate effort to participate in a dialogical exchange. Will the new members make such an effort if membership without certification is extended to them? Perhaps a few will, but most will not. It is unlikely that the majority of those who did not apply for certification are really interested in communicating with other analysts through our national organization.
It is my impression that the impetus for delinking membership from certification has been primarily generated from within the organization and not from without. In its essence, delinking is an internal organizational issue that has little to do with scientific and educational concerns and much to do with an effort to democratize the organization by enlarging the electoral base and sharing power and influence more democratically. For the last two years I have participated in the democratization process of the Chicago Institute for Psychoanalysis, and I have great sympathy with those who feel that our national organization must become a more democratic organization. We must, however, achieve democratization without compromising the certification process and the high standards of our profession.
If the American Psychoanalytic Association is to follow the example of the American Psychiatric Association, then it becomes essential that the Board on Professional Standards be delinked from the membership organization. Such delinking is a much more complicated process than the delinking of membership from certification; yet it must be addressed first.
In my opinion, the issue of delinking membership from certification should be tabled. Instead, the members of The American should elect directly a truly representative reorganization committee to study and provide recommendations for the following: 1) a more autonomous BOPS, and the ways by which such autonomy will facilitate a greater sense of trust in the fairness and effectiveness of its function; and 2) a more democratic and representative structure of the American Psychoanalytic Association that would include all qualified professionals. After the recommendations are made, the membership will debate them and eventually put them to a vote.