If the practice of psychoanalysis teaches us anything, it teaches us to respect complexity and to seek out the subtle individuality that lies at the core of all that we try to understand. Psychoanalytic theory does not constitute a static body of received wisdom that needs to be transmitted intact to succeeding generations. On the contrary, it requires constant refinement and revision as a consequence of the acquisition of new data and cumulative experience, and its progressive evolution is stimulated by continuing discourse among us, especially by debate with colleagues who espouse different positions. To provide a lively forum for this ongoing debate is one of the primary tasks of our association, and it is one that lies close to my heart.
In the administration of The American we do not always have the luxury of confining ourselves to raising questions. Immediate practical measures and decisions are often required. Nonetheless, we need not altogether abandon the lessons we have learned from our psychoanalytic experience. Thoughtful study is sometimes seen as a disguised form of resistance to change, but it must not be used that way. Instead it should provide a means to effect changes that take into account our diversity and individual differences, by carefully identifying the threads of agreement and common interest in a complicated matrix.
Take certification as a case in point. I happen to be one of many who have expressed the opinion that the certification process has lost its focus, despite the most conscientious efforts of those who have been charged with conducting it. Before the recent vote on the delinkage amendment, I proposed that, once the result was known, regardless of the outcome, The American would have to tackle the question of certification and decide both what it is supposed to measure and how its procedures are to be arranged and conducted. Although, as I write the fate of the delinkage proposal is still far from settled, the task of reexamining certification cannot be further postponed.
One solution that has been suggested would involve establishing an independent, external credentialing system. There are many difficulties to be solved in connection with external credentialing, and it is likely to be at least several years before a satisfactory method can be worked out, if one can be devised at all. In the meantime, we have a process in place. How can it be improved? The question to be answered is: what does The American want certification to be? We must come to a workable agreement about what is to be certified and how best to do it. A massive national inquiry is currently in progress, one that, is unprecedented in scope, seeking input from all corners of the American; its results should provide us with useful guidance.
Another complexity that requires thoughtful attention is the relationship between Board and Council and the diverse attitudes toward the Board and its functions that exist in our various component institutes. The history of suspicion and friction is well documented. It is important that we take this situation seriously and learn how to employ our strengths most usefully. The image of the Board as a monolithic policing organization is, to say the least, an anachronistic one. A good example of the Boards functioning positively is provided by the Committee on Institutes, which has evolved into an effective outside agency that is able to assist member institutes. The Committee on Institutes undertakes its tasks with sympathetic, collegial objectivity, rather than through hostile criticism or the use of sanctions. As a result, its work is well received and illustrates the advantage of having a constructive central organization.
Ideally, the parts played by the Board and Council in the administration of The American are complementary, not competitive ones. The Board has the responsibility to promote educational excellence throughout The American, and it is probably inevitable that there will be some disagreement at times about how that mission is to be best carried out. Nevertheless, it seems to me that the Board, through its various arms, should and does play primarily a nurturing and facilitating role in that enterprise, rather than a restrictive one. This is all the more essential in a time of increasing theoretical pluralism, which demands of us that we find creative solutions to new educational problems. The more inclusive, representative, and constructive a spectrum of opinion is presented to it, the more effective the Board's decision-making process will be.
We are entering an era of unprecedented educational ferment in psychoanalysis. The nature of our applicant pool is changing, and the preparation candidates bring to the study of psychoanalysis varies from what was expected in the past. At the same time, there is an interest in devising innovative tracks for educating academics and potential researchers in psychoanalysis. Careful formulation of the tasks posed by these changes, and controlled experimentation to accomplish them, will make central coordination and the pooling of our information and resources even more essential than was true in the past. I applaud the enterprise of those individuals who have looked for ways to end useless and draining friction between our governing bodies, and between local institutes and The American. I believe in the democratic political process, in which the forces for change work within the parameters of a broad consensus. I think it is an essential responsibility of the leaders of the Association, in conjunction with the leaders of all our component societies and institutes, to make every effort to mobilize such constructive consensus.
One need not be a prophet to see that psychoanalysis, as a discipline and a profession, is at a major crossroads in its development. The changing face of popular opinion, the influence of third-party payment, and the availability of other treatment options for patients and conditions we are able to treat have among other influences, had an impact on psychoanalytic practice and on the morale and career planning of many of our younger members, candidates, and potential candidates. A multifaceted approach to examining those problems
and finding solutions has been initiated by the present administration of The American, but it will take sustained effort and imagination to bear fruit. Once again, such an undertaking requires an effective national organization, for its scope is well beyond the resources of any single society or institute. Here is a clear instance where a more vibrant, active American can help strengthen and improve all of its component societies.
The same kinds of concerns apply to our common financial burdens. The massive research endeavors we would all like to see take place require funding, as do the public information efforts we favor; most local groups, like many individual practitioners, are already strained to meet their own fiscal needs. Sharing information about fund raising, and more promising still, central encouragement and coordination of approaches to enlist community support are likely to be vital to our future professional well-being. Insurance problems, issues of relicensure, continuing education requirements, new developments and trends in psychoanalysis in other parts of the world a formidable list of important matters faces us. I would call particular attention to the so-called graying of our membership, which is much more than a financial issue. It raises questions about how to deal with the special needs and problems of our older practitioners, as well as how to maintain the necessary flow of youth and vigor into the field. All societies have a stake in these questions, which are too complex for local groups to answer entirely on their own. Again, initiative from our national Association is crucial to an effective approach to our common difficulties. I could go on, but my message would be the same. A strong, healthy American Psychoanalytic Association is our best hope for the future.
All of us who have experienced at first hand what psychoanalysis has to offer people have a shared belief in its unique potential. We have much more than simply the responsibility to preserve our heritage, we also have a joint obligation to sustain its values and enhance its effectiveness. Only a dedicated sense of common purpose can meet those challenges.