A principal focus of my presidency for the next two years will be on issues of psychoanalytic practice in today's highly competitive marketplace. The 1976 Survey of Psychoanalytic Practice by Shapiro and Jaffe demonstrated that even then our members were struggling to maintain psychoanalytic practices. The updated survey by the Committee on Psychoanalytic Practice soon to be reported will no doubt reveal that this problem is more severe 15 years later.
We are attempting to find means by which the Association can help with this problem, and the chairpersons of the various committees of The American dealing with issues of practice are now planning a Conference on Practice Issues. Stephen Sonnenberg, Chair of the Committee on Public Information, has principal responsibility for the planning. Also involved are the Committee on Government Relations, headed by Drew Clemens; the Committee on Peer Review, chaired by Sheila Hafter Gray; and Lee Brauer's aforementioned Committee on Psychoanalytic Practice. The Executive Committee has expressed enthusiasm for the plan to bring leading society representatives and recent graduates and senior candidates together to consider such issues as marketing techniques, third-party payment, and maintenance of practice, as well as to exchange ideas and information.
“Marketing”—a word some find offensive—refers to the effective presentation of the value of psychoanalytic treatment to employers and individual patients for conditions for which analysis is the best—and often the only—treatment modality. Psychoanalysts must face the necessity to grapple with the underutilization of treatment and the public's need for education and awareness of the value of psychoanalysis. This will be an “upbeat” meeting that I am sure will prove effective with the mobilization of the membership and support from the societies and institutes, which who have an obligation to utilize our talented leaders in the promotion of our work.
A related focus of my term as president is the importance of psychoanalytic research in all its aspects, but especially in efficacy and outcome studies of the psychoanalytic process. The Association is sponsoring a major efficacy/outcome study under the chairmanship of Robert Wallerstein, and we are seeking major funding from foundation sources. This is a multisite endeavor in which outstanding researchers into the psychoanalytic process are coming together to pool their expertise and to study the same clinical material.
It is the first time this outstanding group has been assembled in an ongoing mutual endeavor. They have had all-day meetings at each of the last two national meetings. The project is in part an outgrowth of the Task Force on Research and Information, headed by Norman Clemens, and a subcommittee study of previous outcome studies under Henry Bachrach. His summary paper has been accepted for publication in a future issue of the Journal.
Another important event in psychoanalytic research was a conference at Bethesda in mid-November jointly sponsored by The American and Division 39 of the American Psychological Association. Those of use who attended on behalf of The American came away convinced of the importance of establishing research career pathways in our field while promoting research training for research candidates as well as rank and file students in our institutes. Our science requires a growing research base for its survival, just as our profession requires viable psychoanalytic practices for our members. The Bethesda Conference was particularly encouraging toward a dialogue and collaboration with other fields. It was attended by prominent neuroscientists with whom mutual research endeavors will occur in the years ahead.
Finally, on this subject of psychoanalytic research, I want to remind you of our Fund for Psychoanalytic Research headed currently by Stuart Hauser of Boston. Under its separate Board of Directors the Fund works assiduously to evaluate proposals and provide small grants for those which are most worthy and promising.
The seldom mentioned, but deeply valued and important, Joint Committee on Ethics is undergoing a change in chairmanship from Donald Burnham to William O'Brien. Also retiring from the Committee is Rebecca Z. Solomon, who will be replaced by Frances Millican at the New Orleans meeting. Sydney Pomer of Los Angeles will also join the Committee this spring. The silent, discreet, but dedicated work that this committee performs in our behalf deserves special appreciation and commendation. It's timely to remind each institute and society that a local Ethics Committee should be firmly in place to deal with charges of ethical misconduct when they occur. Our Principles of Ethics and Their Implementation, revised under Alan Eisnitz in his earlier chairmanship and promulgated along with further implementation by Dr. Burnham, should be known to each member. We must also heed Dr. Burnham's advice that under the Federal Health Care Quality Improvement Act of 1986, every local society or institute is required to inform the local licensing authority in its locality of any sanction
for ethical misconduct within 15 days, and stands to incur a $10,000 fine for failure to do so.
The highlights of our meeting in Miami are reported elsewhere in this issue of The American Psychoanalyst. The Board and Council supported the Sabshin Task Force's final proposal for amending Active Membership to include noncertified graduates; this proposal will be voted on by the membership in January or February. The by-law amendment of the Curtis Task Force on Expanded Eligibility, which was discussed by Janet Hadda in the last issue of The American Psychoanalyst, was also supported at Board and Council. In addition, a revised statement on homosexuality from Ray Raskin's Committee on Social Issues was approved in principle at Council and will be published in the next newsletter as well as in Psychiatric News, where an erroneous report of our position appeared last fall. Finally, Donald Meyers of the Columbia Institute won election as Secretary of the Association and will be installed at the May meetings in New Orleans. Elected Councilors-at-Large are Rebecca Z. Solomon and Dexter Bullard, Jr.
This issue of The American Psychoanalyst is being sent to PGY-III psychiatry residents throughout the country, and we hope to expand the mailing to residents from other years as well in the future. Meanwhile, Dr. Richards hopes to enlarge the section on news and notices from societies and institutes, so that we can become more familiar with each other's important events at different places.
I also want to mention several articles in this edition that pay tribute to Karl Menninger, who died last July. He was an important mentor to me also in my early residency days at the Menninger School of Psychiatry in Topeka, which has turned out so many outstanding psychiatrists and allied professionals over the years. The American's new Karl A. Menninger Annual Memorial Prize Award of $1,000 will be granted to the best paper representing his individualistic and often iconoclastic views challenging the conventional wisdom. This award is being offered by Roy Menninger, President of the Menninger Foundation, and will be made at the December Business Meeting. The winning paper will be presented later the same day. In accord with Dr. Karl's emphasis on encouraging young people to write, the Program Committee plans to favor a paper from a candidate or recent graduate in its selection.
I will close with a note on the creation of a Finance Committee to be headed by Treasurer Firestein. The goal of the Committee is to help in our budgeting process and to advise in the setting of priorities. Each committee of the Council and Board is being asked to submit its needs and plans at the beginning of each year. We hope to avoid as much as possible unforeseen ad hoc expenditures, although they cannot be avoided entirely. I expect that the Finance Committee will study and advise us about cost-effective methods in the administration of our work at the Central Office and throughout the Association.
As this column is being written, there is unsettling news of a development at the Southern California Psychoanalytic Institute. Apparently a segment of their members intends to from a new, freestanding institute outside The American. Efforts by a special consultation committee of the Board, headed by John Boswell, as well as other efforts to help heal their internal dissension and conflict with The American appear to have failed so far. Our concern for the welfare of their excellent candidate corps is primary, and we want to preserve their best interests as future analysts, whatever the outcome of this new development.