Dear Dr. Schachter
I am writing in response to your Proposal for a Study of the Certification Process. As a recent appointee to the Certification Committee, I have participated to date in only three meetings. Nevertheless, I feel I have a good sense of the process and its problems. As this is a committee that spends much of its time examining itself and discussing its concerns and problems in depth, I speak from many hours of careful self-scrutiny by those who know the workings of the committee better than anyone.
I have two problems with your proposal. The first is that it implies that the problem regarding membership lies with the Certification Committee; I do not think it does. Rather, the committee has become the scapegoat for a host of problems best understood in other ways and remedied by other means. Second, the study—extremely demanding of analysts' time and energy—is (a) redundant and (b) somewhat uninformed as to how the committee works.
My second point first: The reason I consider the study redundant is that the Certification Committee has for years included three participant-observers at each meeting. Invited from institutes around the country and representing a broad cross-section of American psychoanalysis, they not only review the applications themselves but take part in lengthy discussions of each applicant and of the committee's procedures. Their comments and observations are welcomed, and their opinions taken seriously. They experience first hand the struggles of the committee to fulfill its charge, and have observed our efforts at being fair to the applicants while at the same time working to maintain standards. It would seem a better approach to answering your questions would be to interview in depth the observers from the last three or four meetings. They would have a far better sense of the committee's work and of the “judgment” of its members than would your randomly selected groups.
What your proposal overlooks in the work of the committee is the central role of group process over time. No randomly selected group of analysts doing this task for the first time could duplicate this. The membership of the committee is changed on a rotating basis, and seeks to include, over time, members from all of The American's institutes. For newcomers like myself, the experience is of coming in on an ongoing committee, being slowly introduced to its procedures, and gradually becoming a part of it. We represent a broad spectrum of the various ways psychoanalysts around the country think. We are, in a sense, an ongoing workshop on the topic of what constitutes analytic process and how it can be identified; as you might surmise, a certain level of group “wisdom” is achieved over time, a level of “wisdom” that though far from perfect would be impossible to duplicate by means of your research protocol. If you are skeptical, ask the observers to confirm this; I am sure the vast majority would. My point is: to have a number of new evaluators read a number of applications would in no way duplicate the committee's work, and would therefore be no “test” of its “judgment.”
While perhaps a laudable goal in the abstract, such a test would seem in the real world to be, if even possible, more costly and difficult to perform than its utility would justify. Committee members are all training analysts, which means they have already been through an extensive evaluative procedure, both locally and nationally. They are recommended by Institute Executive Directors who judge them from their many years of experience with them as skilled, reasonable, and fair-minded. These are clinical appointments, as it were, not appointments based on any “objective” measure. Of course the selection process is fallible. To borrow Winnicott's phrase, the best one can hope for is a “good enough” committee. But how could it be otherwise? What kind of Absolute Measure of Ideal Judgment can there ever be?
Another point your proposal misses is that no power is invested in any single committee member. Each applicant is discussed at length by the entire committee, all of whom have familiarized themselves with the application, three or four of them in great depth; the judgment of any one member is routinely balanced by the cumulative judgment of the entire committee; the ultimate decision is made by group consensus. As with psychoanalysis itself, the process is more than simply the sum of its individuals. For your comparisons to be valid, you would have to set up your randomly selected groups as duplicate Certification Committees and follow their work for a period of years—a task even more demanding of scarce resources than the one you have proposed.
As to my first point, I do not think the “problem” is the committee in the first place. First, the committee is not autonomous; it is a subcommittee of BOPS, and as such simply endeavors to carry out its charge as defined by that body. One problem is that that charge has become increasingly vague. When I first came on, we asked ourselves, Does the applicant reveal at least minimal competence in the practice of clinical psychoanalysis? Contrary to accusations made against us, this did not imply adherence to structural theory, developmental theory, object relations theory, self psychology, or whatever. All these schools of thought were represented on the committee. Rather, competence meant things like: bring the patient into a transference, interpret dreams, make the unconscious conscious, analyze character, etc. We thought we did a fair job. Our dream may have been to be in a position to identify true excellence, but that was not our charge; in any case, the number of truly excellent applicants was very small indeed. Then the controversy about delinkage/membership that has been raging now for many months began increasingly to focus on the committee, and by New Orleans we felt beleaguered and under intense, almost paranoid scrutiny. Even more, it had become unclear whether our charge was still to identify minimal competence or instead to be a kind of Membership Committee. This was discussed at length by the committee itself, and its observers and visitors. It seemed to us that the standards were quite different; a Membership Committee might be charged with simply checking that the applicant had completed the requisite amount of classwork and casework. My point is: The problem was not with the committee; it was with The American. In the end, it is resolution of the debate on delinkage and membership by BOPS and the entire membership that will resolve this issue and once again clarify our charge.
The controversy currently raging over certification, delinkage, and membership is related to the committee only indirectly. The real issues include separatist movements in certain institutes that are frustrated that The American does not relinquish more if its oversight function; a changing culture that increasingly breeds candidates who fear and therefore reject examinations, balk at preparing case reports, and resist externally imposed standards and procedures; the decreasing numbers of applicants and analysands; the declining profile of psychoanalysis within psychiatry and medicine; the need to hold on to, if not increase, the dues-paying membership; and the growing diversity of psychoanalytic thought. Certification is an expression of the cultural value of meritocracy, an idea increasingly out of favor. The current social ideal is that we all be “equal,” an anti-elitist point of view. These are the issues The American needs to confront more directly; scapegoating the Certification Committee is not the answer.
J. Alexis Burland, M.D.