Our upcoming meeting in New Orleans will afford an opportunity to combine attendance at a first-class program of scientific and other professional meetings with a unique vacation in the city where jazz was born. I look forward to a well-attended 80th Annual Meeting and to greeting many of you on that occasion.
Among the highlights of the program is a new format in which a paper by Otto Kernberg on “The Current Status of Psychoanalysis” will be discussed by a panel of leaders in the field. The relevance of this paper to our organization and to psychoanalytic training and practice betokens a strong attendance. It will follow another, more restricted meeting of planners for a future conference on issues of psychoanalytic practice. The goal of this planning meeting is to generate ideas and exchange knowledge about how such a conference will help our members maintain a psychoanalytic practice and their associated identity as psychoanalyst trainers and practitioners. The 1976 survey on psychoanalytic practice by Shapiro and Jaffe showed strong evidence of difficulty in case finding, a difficulty that I think will be shown to be even more prevalent by the current survey being conducted by the Committee on Psychoanalytic Practice. The New Orleans Planning Meeting for a conference on Issues of Psychoanalytic Practice is the first step in the American's efforts to deal with this pressing problem.
The brochure for employers and third-party payers drawn up by the Committee on Government Relations and Insurance has had both enthusiastic and negative reviews. Some negative reviews concern principally the reference to psychoanalysis as a three- to five-times-a-week treatment. It is important to remember that this brochure is an instrument to try to gain employer and third-party payer support for various forms of long-term psychoanalytic treatment (coverage for full classical psychoanalysis is seldom attainable). It does not refer to standards of training, where we firmly adhere to a four- to five-times-weekly frequency.
Nor are we changing the definition of psychoanalysis to a less than four-times-weekly procedure. The 1976 Shapiro-Jaffe Survey revealed, in fact, that many of our members practice what they referred to as “three-times-weekly psychoanalysis,” although a large segment of our members regard three times a week as ipso facto psychotherapy. The scientific issue of whether the evocation of a full transference neurosis and its resolution can occur at a frequency of less than four to five times a week is hotly debated, but there is no question that the four- to five-times weekly principle is required for training analysis and for control cases. The economic exigencies that have resulted in the reduced frequency of “analysis” by many analysts are part of what the future Conference on Practice Issues will address so that the classical definition and practice of analysis can be more firmly held. The debate about efficacy and outcome can then be carried out in a less heated atmosphere where economic realities are not a crucial factor.
On this same subject, in my last column I mentioned the establishment of the Institute for Contemporary Psychoanalysis. This group is derived from a segment of the Southern California Institute and some members from the Los Angeles Institute who want to be free of the constraints of The American and the International Psychoanalytical Association. These constraints are principally those of the Board on Professional Standards, which requires affiliate institutes to adhere to the four- to five-times rule for training and “control” analyses and which also restricts candidates to psychiatrists and nonmedical applicants with equivalent educational backgrounds. The new institute plans to tap other sources of candidates who are less rigorously educated and who will need no oversight by a parent organization. This experiment suggests that the founders are seriously disaffected with The American's and the International's standards, which are identical as to frequency of sessions and which are increasingly close on eligibility for training.
Two other topics deserve at least brief mention: our relationship to the IPA and the by-law proposal on expanded eligibility. The by-law proposal will be debated again in New Orleans and presented to the membership for vote a month or two later. The Task Force on Expanded Eligibility, under Homer Curtis, will present its final recommendation for by-law changes, which as previously presented would allow local institutes to accept for full training applicants who hold clinical doctorate degrees; it also would maintain the Committee on Non-Medical Clinical Training to determine eligibility in other instances.
In other words, if the by-law proposals recommended by the Task Force in December are passed by a two-thirds majority, clinical psychologists, PsyDs, social workers, and others holding a clinical doctorate will automatically be eligible at the local level for full psychoanalytic training without a national waiver process by the CNMCT. Master's degree clinicians and applicants from nonclinical fields like education and anthropology will still be admissible through the national waiver process. The by-law changes expanding eligibility have had the Executive Committee's support and are part of a lengthy evolutionary process begun in the early 70s and highlighted by the passage of the Gaskill Proposal by a two-thirds majority in the 1985 referendum.
The International Psychoanalytical Association has never required a medical degree for membership or training. Our present criteria for admission are thus coming closer to theirs, and we are, of course, a component organization. I believe it behooves us to maintain our close ties to the IPA, to which we lend strength and with which we are allied against the lowering of standards on an international level. We also have rich scientific exchanges. The problems that beset the IPA organizationally and those that beset us have many commonalities.
At the forthcoming 37th IPA Congress in Buenos Aires (July 28-August 2, 1991), our organization will be represented by Drs. Margolis and Pacella and me, as well as by Helen Fischer, our Administrative Director.
The two announced candidates for IPA President to succeed Joseph Sandler in 1993 (see p. 20) and to be elected at the Buenos Aires Business Meeting will speak at our Meeting of Members in New Orleans.
The administrative and business meetings—those of the Board on Professional Standards and the Executive Council as well as the Meeting of Members—are open to all members. We hope that affiliate members and recent graduates especially will feel welcome.
Our relations with the IPA are also connected to our relations with other component groups as well. In 1992, small conferences utilizing a clinical case conference format are planned with our Latin American colleagues and with members from the European Federation. I am interested in hearing from colleagues who have a particular interest in either of these proposed meetings—one possibly in a Mexican resort in the late winter of 1991-92 and the other tentatively in Scandinavia in the summer of 1992. See you in New Orleans!