I oppose the move to remove certification as a requirement for Active, that is, full, voting membership in the American Psychoanalytic Association.
The Task Force on Amending Active Membership for Noncertified Graduates, under the leadership of Marvin Margolis, was charged with preparing an amendment and has approached the issue thoughtfully and with due regard to the need for maintaining professional standards. Perhaps it has done as much as possible to answer the concerns of those who, like me, have serious reservations about awarding voting membership to noncertified graduates. I am impressed by the intelligence and good will manifested in the report, but I am not convinced that it will solve the problems that brought about this crisis. It would, instead, introduce further levels of administrative complexity and confusion, without necessarily reducing conflict. (My remarks are based on the text of Draft #2, April 27, 1990.) Later in this statement, I shall recommend a simpler solution, which should precede and make unnecessary the proposed restructuring of the Association.
My arguments are as follows:
The Task Force has indeed obeyed its charge to draw up an amendment to open Active membership as soon as possible. In an attempt to protect educational standards as determined by the Board on Professional Standards, the Task Force recommends that a two-thirds majority be required for voting at Council or by the entire membership for “all proposals that are Board related.” They propose a special joint committee of Board and Council to decide whether a particular issue is, in fact, Board related. This proposal requires yet another intermediate decision-making body in an organization that already has too many. I doubt that it will lead to fewer disputes over jurisdiction.
The Task Force also proposes the establishment of a Joint Membership Committee of Board and Council to pass on the eligibility of recent graduates, but it is not clear how this body will work in practice. If it functions actively and demonstrates a willingness to make negative decisions (that is, to reject candidates), it will be seen as yet another “gatekeeper.” That new committee would add another level of judgment (and another source or resentment) between graduation and certification. If the Membership Committee were, on the other hand, to be reluctant or unwilling to make negative judgments, it would be a committee without a function. Neither of these alternatives has much to recommend it.
The Task Force has attempted to satisfy not only those who are disenfranchised at present, but also current Active Members who fear that the standards of Association membership will be compromised. By recommending certain restrictions on those who may be called, for lack of a better term, “Noncertified Active Members,” it perpetuates one of the sources of existing dissatisfaction: having two classes of members with different rights and privileges. Those without certification may not be appointed Training Analysts; nor may they attain office in the Association, Council, or Board, or serve on Board committees. They may, however, vote for officers of the Association. In the long run, this compromise is likely to satisfy no one.
The proposed changes would diminish the present meaning of Active membership, which now signifies approval of one's psychoanalytic competence and maturity by peers in a respected national Association.
Such a major change in the structure of the Association would incur substantial risk of deterioration in the quality of psychoanalytic education and to the status of the Association as the most highly regarded organization in the field. The greatest damage is likely to come about because such an amendment would, in spite of the proposed safeguards, do much to reduce the power and prestige of the Board on Professional Standards. BOPS is at present the only official body with the power, limited though it is, to ensure that reasonably high standards for psychoanalytic education are maintained country-wide and that fundamental principles are conveyed by didactic teaching, supervision, personal analysis, and example.
It can be taken for granted that each institute tries to maintain high standards. But it cannot be denied that institutes have at various times experienced difficulties that have threatened to compromise the quality of the education available to their candidates. An effective Board then becomes their only protection.
It is argued that the Board can exert influence to improve the educational work of the various teaching organizations it oversees through its Committee on Institutes. Its impact is, however, severely limited, since the only effective sanction the Board can recommend for an institute that is falling in its duty toward its candidates is tantamount to suspension. The Board is understandably reluctant to take such extreme action, which would affect adversely every member of the affected institute and all its candidates in training, whatever their qualifications. It is inevitably a move of last resort. For all practical purposes, the Board is left with only one way to exert effective influence on psychoanalytic education: by requiring graduates who apply for active membership to present evidence of competence in the practice of psychoanalysis—that is, certification.
The most cogent, and valid, objection to the present system is that it is unfair that graduates be penalized for the inadequacy of their psychoanalytic education. Who is to blame? Is it the Board, which tries its best to judge the adequacy of their training and finds it wanting? Or is it the institute, which has failed its candidates?
Claims of unfairness and prejudice by the Board and its Committees have been made rather freely but are seldom, if ever, documented. The Board is composed of an equal number of Fellows from each institute, whatever its size; this composition should, by itself, confute the charges of geographic or doctrinal bias. The committees of the Board, including the Certification Committee, are similarly representative, and rotation is assured on a regular
basis. That the Board and its committees are made up of experienced training analysts is altogether appropriate for the educational arm of a professional organization; if there is bias, it is in favor of higher standards of education.
It is sometimes alleged, and often implied, that the certification requirement places a straitjacket on progress in psychoanalytic thought and teaching, that only one point of view is encouraged at the cost of scientific development. If this were true, it would indeed be a damning argument. But the allegation is hardly supported by an inspection of the literature, as represented by the Journal and other official or semiofficial publications, or by a study of curricula at various institutes. All these reflect a broad spectrum of views, from ego psychology to object relations theory to self psychology and a scattering of others. While there is a predominant emphasis on learning the “basics,” including the history of psychoanalytic thought, especially the various phases of Freud's work, there is no limitation on teaching other important developments. Whether the latter are presented as significant advances of lasting value or as deviations to be approached with skepticism, will depend on the individual institute and its teachers. The requirement for certification, by insisting on a working knowledge of basic theory, in no way impedes such diversity.
We must ask why more graduates have not applied for certification, or, if deferred, have failed to persist. The Joint Ad Hoc Committee on Organization and Membership, which I chaired, asked the heads of every institute and society about the factors influencing such decisions and solicited suggestions for improvement. The responses were of the greatest value in giving us insight into the complex reasons for the reluctance and occasional outright hostility on the part of a considerable number of graduates from certain institutes. Reluctance was most often based on what was regarded as a burdensome requirement for written case reports and in some instances on the time and expense of appearing for interviews by the Certification Committee. For this objection we suggested a remedy: to simplify the requirement for written material and to establish a one-stage process that would substantially reduce the number of applicants who were deferred for further information but failed to follow through. Interviews to supplement information would be conducted before decisions were made. Teams would travel to meet applicants, rather than the other way round. All this, we were convinced, could be accomplished without lowering standards. The details, which were agreed on by our otherwise divided committee, are listed in the Report of our Committee to Board and Council.
“It is not clear why analysts should be less carefully evaluated than surgeons, internists, or other specialists.”
Hostility to the very requirement of certification is a more complex phenomenon. Some of it has arisen because about half the applicants are initially deferred for further consideration. (Most who persist are accepted—90%, in fact.) This source of complaint, as our Committee suggested, can be substantially reduced if not eliminated by changes in procedure. I believe very strongly that these changes should be tested in practice before recommendations for radical changes in organization are adopted. The current Task Force has taken note of these suggestions for change, and it is to be hoped that they will urge their adoption.
Other sources of hostility are less easily approached. Our committee learned a great deal from the report of an ad hoc committee appointed by one of the west coast institutes, at which such hostile attitudes are widespread. Some colleagues felt that after meeting the criteria for graduation, to have to be examined and judged once again is demeaning. An analogy with other specialties is relevant here; surgeons, for example, who have finished a grinding training of seven years or so must nevertheless take their Board exams, the results of which are by no means foreordained. It is not clear why analysts should be less carefully evaluated than surgeons, internists, or other specialists.
Our committee, having studied the Task Force report, was also forced to consider the possibility that the hostility of certain graduates' stemmed from unresolved transferences left over from personal analytic experience. (That such transferences may outlast even the best of personal analyses and be reflected in attitudes toward institutes and the American Psychoanalytic Association should surprise no one—see the reports of the COPE Study Group on Training Analysis, c. 1970.)
One may infer that other persons were influenced by respected faculty members who freely expressed negative attitudes toward the American Psychoanalytic Association and all its works. These circumstances are difficult to document, but they are worth considering as contributors to the present problem.
The present state of affairs is unquestionably unsatisfactory and should be relieved. On the face of it is undesirable to have a large number of colleagues who lack the privileges of full membership. I believe, however, that the problem can be solved more fairly and much more simply by instituting a program to ensure that all graduates apply for certification and that they are encouraged to follow through if deferred (which should occur less often than now). If certain measures are taken to make certification less burdensome, with less need to defer well-qualified graduates, almost all of whom retain their interest in psychoanalysis can achieve that goal and become Active Members, with all the privileges attendant upon membership. Certain changes would have to be made in the certification procedure to make it less burdensome without the compromising standards. The cooperation of institute faculties would also be required. This is a far simpler solution than the one now being contemplated and would require no radical restructuring of the Association.
In summary, I recommend that before we undertake radical changes in organization, we make every effort to explore reasons why graduates fail to apply for certification or to follow through when deferred. At the same time, in order to meet valid objections, improvements (already outlined in the report of the Joint Ad Hoc Committee on$$
December Meeting: Fontainbleu Hilton Resort and Spa, Miami Beach, Florida, December 5-9, 1990