Ellen Rowntree interviewed Marvin Margolis, Chairman of the Board on Professional Standards while he was in New York on March 6, 1992, for meetings of the Coordinating Committee of the Board on Professional Standards and the Executive Committee of The American.
Rowntree: What would you like to accomplish during your time as Chairman of the Board on Professional Standards?
Margolis: You know, Ellen, my chairmanship began before I had an opportunity to think about what I'd like to do. I became Chairman-Elect in May 1990, and Jay Krent, the previous chairman, died three months later. During the summer prior to his death, we talked frequently by phone, but I was looking forward to going through two national meetings with him and sitting in on all the Board committees and learning how they functioned. Fortunately, my previous stint of five years as a member of the Committee on Institutes and my chairmanship of the Task Force on Amending Active Membership for Non-Certified Graduates had provided me some familiarity with the Board. When Jay died I was asked, What was my vision for the Board? Truthfully, I had no program worked out. My style is to immerse myself fully and deeply in the work and problems of an organization, listen carefully, ask a lot of questions, and seek the counsel of those who preceded me in office, before I begin to formulate my own ideas. I've been immersed in the work of the Board for almost two years, and I now feel I have a plan, but my vision has to do with an open-ended way of doing things arrived at through active dialogue with colleagues throughout the country rather than a rigidly laid out program organized from the top down. In this way, plans evolve that more fully meet the needs expressed by colleagues at the local level. I am very much taken with the ideas of Vaclav Havel. Did you see his recent Op-Ed piece in The New York Times?
Rowntree: Yes. I thought it was wonderful. I cut it out and saved it.
Margolis: So did I. I'm going to assign it to candidates when I teach the class on technique at my institute next week. This is the way we should approach the study of technique. We don't have all the answers and therefore can't rely on formulaic approaches in this area. Ultimately we must become subjectively involved with each individual patient—immerse ourselves in the clinical situation—take the analytic journey together, and finally together arrive at an understanding of the patient's life. When I read Havel, I thought that's exactly where I think psychoanalysis is and should be going. He said it very succinctly: “We must try harder to understand than to explain.” So, we have to understand more before we interpret, not be so quick to interpret but first understand in a deeply personal way. Havel stated this more fully in a speech to the World Economic Forum in Switzerland, in February 1992, when he said, “Things must once more be given a chance to present themselves as they are, to be perceived in their individuality. We must see the pluralism of the world, and not bind it by seeking common denominators or by reducing everything to a single common equation.” Ellen, I think that Havel's perspective relates to psychoanalysis as well as it does to economics.
Rowntree: I suspect there are other ways the ideas of Havel are reflected in your evolving vision for psychoanalysis.
Margolis: Right. The vision has to do with renewal and change. Without throwing out the best of our past, we have to become more flexible and open about the ways we educate, the theories we teach, our clinical technique, the ways we organize ourselves, and our approach to the community. Havel talks about this. He refers to the skeptical attitude of postmodern economic and political thinkers since the collapse of European Communism. He has a distrust of global, total planning by true believers. There are parallels in our psychoanalytic world. Havel speaks to deep roots in me. That is, I came to psychoanalysis through Eric Fromm's Escape From Freedom, which I read in my late teenage years. Then I read The Forgotten Language, Fromm's book on dreams. So it was a dissident in the analytic world who led me to Freud. I feel in recent years that I've returned to some of these adolescent concerns, but hopefully with a broader, more balanced perspective. As a teenager I was interested in how we might better structure society so that the individual could be more fulfilled. I began thinking about this because I came from a Labor Zionist home and looked to the kibbutz as a model. I wanted to go to Israel to be a pioneer and live in a collective settlement.
Rowntree: And did you?
Margolis: In my late teens, I quit the University of Michigan, to the despair of my parents, and went to a training farm in New Jersey for eighteen months. I also took courses in agriculture at Rutgers. I was supposed to leave the country on one of the illegal boats to pick up refugees from the concentration camps, run the British blockade, and take them to Palestine. But Habonim, the organization I belonged to, decided that a few of us should stay behind to do educational work in the youth movement. Because I had some inclinations as an educator, I was chosen for this three-year stint. That's where I learned my organizational skills. Incidentally, Habonim had 3000 members, the same number as The American today.
Rowntree: How did this experience lead you eventually to psychoanalysis?
Margolis: While I was doing this, I returned to college studies and majored in sociology and anthropology—in New York, Chicago, and finally in Detroit at Wayne State University. I received my B.A. and M.A. in Sociology and still planned to settle in Israel, but now as a teacher in a kibbutz. At the time, I was interested in utopian societies, urban renewal, and the concepts of anomie and alienation and how they are promoted by modern industrial civilization. This resonates now with my reading of Havel. During the three years I spent working as a youth movement organizer and educator, I gradually became disenchanted with socialism and communal living. I decided instead to pursue a Ph.D. in clinical psychology at Michigan State, with the thought that I would become a psychotherapist as a better way of helping people fulfill themselves as individuals. It was during my graduate studies that I became interested in psychoanalysis, and at that time the only way to become an analyst was through a medical school education and a psychiatric residency. As I was completing graduate school, I therefore began to take pre-med courses. I was accepted at Wayne State's medical school, and completed my dissertation while working toward my M.D.
Rowntree: What was your thesis topic?
Margolis: My master's thesis was on alienation in the urban environment. For the doctorate, I wrote on the mother-child relationship in bronchial asthma. So you see, my interests were gradually becoming more clinical. I was reading Freud, was in treatment myself, and sought supervision from analysts. I finally saw my path: I wanted to be an analyst. The reason I say that I have come back to my roots is that the alienation of many of our colleagues and candidates from their local institutes and societies and from the American, and sometimes from psychoanalysis itself, is a central concern of mine.
Rowntree: That brings us back to your vision of how The American might change. What can we do to address and resolve this problem?
Margolis: I believe that we must carefully study and rethink the structure and purpose of both our national and local organizations. We must find meaningful ways to include all our colleagues. We have to ask the question, How well do our analytic institutional environments nurture individuals and promote their development as analysts, educators, and researchers? Not as well as we might think.
Rowntree: Would you be more specific about which institutional structures you feel have a negative impact?
Margolis: Because our local institutes and our national organization have not been as democratically structured as they might have been, feelings of alienation have been engendered in large numbers of analysts. Many feel remote from both the national and the local leadership. They don't feel they have input into deliberations or that they've been asked to participate. They feel excluded, unappreciated, and often resentful. For example, many institutes are run by education committees composed exclusively or almost exclusively of training analysts. These are usually self-perpetuating bodies, not elected by the entire faculty of the institute. Too often these oligarchic structures function in an elitist and authoritarian manner. This is not optimal for the development of our science or of our educational institutions, and it even impacts negatively on the way colleagues conduct analysis. We alienate faculty, candidates, and the community around us. So it is not surprising that private practice languishes. We are doing less analysis than we were ten years ago, and our membership is aging and declining in total numbers. This is not to imply that I believe that everyone should be a training analyst or that education committees should be abolished. I believe that ECs should have the final decision on matters of candidate admission, progression, and graduation, as well as the responsibility of selecting training analysts. But other institute business could be discussed and decided by the entire institute faculty. I hope to encourage discussion and consideration of this type of governance at the local level.
You see, originally I wanted to change society; then I wanted to change the individual; now I see that both perspectives are necessary. Even the best personal analysis in an alienating institutional environment can lead to a colleague's dropping out after graduation rather than contributing his or her talents to the analytic community.
Rowntree: What do you think The American do do on a national level to reduce this sense of alienation?
Margolis: I'll give you an example. In the interest of democratization and inclusion, I felt our first priority was to delink membership and certification so that all of our graduates could immediately become full members. I did not feel this would threaten the standards of practice or education. On the contrary, I believed it would strengthen them by earlier involvement of our very well-trained graduates as full members. I don't think our average graduate is any less interested in maintaining standards than are our senior members. I look forward to the day when by consensus we will be ready to eliminate the bylaw that limits voting on bylaw amendments to certified members, but that's for the future, when we have more confidence in one another. You know, I chaired the task force that studied this problem. I began the assignment feeling delinkage was not the right way to go. But upon further study, I changed my mind. The thought that delinkage might deter colleagues from seeking certification is—I hope—erroneous. This is a negative way of viewing our members' interest in their own development as analysts. I would rather believe that the majority of our colleagues want to be certified. At the local level, we must more actively help them in preparing for this task. Relieved of the issue of linkage, more may voluntarily apply for certification as a goal in and of itself, and as part of the consolidation of their analytic identity. I agree with the idea of encouraging our colleagues to present their nontraining cases for certification, thus making this a part of postgraduate development. Certification should measure a higher level of competence than is ordinarily attained by the time of graduation. There already is an upsurge in certification applications, due in large part to changes in the certification procedure as well as to enhanced local preparation.
“… Originally I wanted to change society; then I wanted to change the individual; now I see that both perspectives are necessary.”
Rowntree: What about the fear that is sometimes voiced that educational standards will be diluted by the inclusion of noncertified members who may not be as immersed in analytic practice and education?
Margolis: I worry about that in a different way. I've seen candidates in institutes all around the country who initially are passionately committed to psychoanalysis and analytic education, but become gradually alienated as a function of their experience as candidates. For example, if they are not listened to when they express strong critical opinions about uninspired teaching and supervision, they may simply give up and endure the system, becoming preoccupied with the care and feeding of their teachers and supervisors in order to complete their training, rather than using their seminars and supervision to plumb the depths of our clinical heritage and explore new ideas. Sometimes candidates correctly sense that strong criticism of particular theoretical views will be regarded as a displacement from their analysis.
Rowntree: Just how pervasive is that? You visited a lot of institutes while you were a member of COI. Is it characteristic?
Margolis: No, on site visits I saw some very inspired and excellent teaching and supervision. But there is still too much that is mediocre. I came to medicine from a graduate school background and appreciated the opportunity for clinical immersion, but I saw the difference in teaching the minute I reached medical school, when I was asked to learn the material and regurgitate it at exam time. I was looking forward to my candidate experience as a return to a graduate school environment. Our institutes are midway between the two. We need to have a respect for the analytic lore we've accumulated, but we also need to look upon it more critically as we attempt to increase our clinical understanding. I've seen too much reliance on technical rules. Fortunately, we seem to be in a period of increased openness and scientific ferment. This bodes well for the future.
Rowntree: How are these ideas reflected in your clinical work?
Margolis: My own predilection early on was to work with patients who were more disturbed, which led to my interests in perversions, sexual abuse, and incest. Gradually in my analytic work, I have become less bound by the technical rules I had been taught as a candidate. Paradoxically, I think that I am now able to help establish a more meaningful and mutative analytic experience. My clinical experience with more disturbed patients, often severely traumatized, gradually persuaded me to be more personal, active, and flexible, so
they could come to trust me. Only then did they become deeply immersed in analysis. I also found this to be efficacious with some of my less disturbed patients.
I have had successful analytic experiences with patients I was taught as a candidate to regard as unanalyzable. My inclination toward treating such alienated patients has led me to see a certain similarity between patient care and the care of our institutions, where the problem of alienation is also of central concern. This theme resonates personally with me in a deep way and was a major focus in my personal analysis. I have never given it up as an interest. It stands on its own as something we must think about. It's inevitable that as individuals we will all at times experience alienation, but we do not have to promote it, however unwittingly, in our institutional life.
Some people accuse me of being overly idealistic, in both clinical and institutional work, as though I don't appreciate the darker side of human nature. My clinical experience, my knowledge of myself derived from two personal analyses, and especially my Jewish experience—both contemporary and historical—have amply convinced me of the dark side of human nature. I don't believe man is by nature good and that society alone causes evil, but I do believe we often slight the potential for the positive, affiliative, and creative side of human nature by adopting suspicious institutional approaches. Even in the clinical practice of analysis, we don't always appreciate the potential for love, friendship, creativity, and commitment that sometimes lies behind the hostility, envy, greed, and sadism. By appreciating the intermingling of these factors, I believe, we can be more effective in our clinical and institutional work.
Rowntree: I'd like to pursue that a moment longer. How does this affect your understanding of the therapeutic aspects of our clinical work?
Margolis: I've been accused by some of being idealistic, romantic, a Pollyanna. But I would rather include that perspective in my understanding of human nature. The realistic, often nonverbal human relationship that exists in the analytic situation is part of the healing effect of the analytic process, to a far greater extent than we have realized. I hardly ever give up on a case as being unanalyzable. I've been struck by how this approach helps me stick to the work of analyzing seemingly impenetrable resistances. So I've come to work in a more interactive, subjective, always hopeful way with my patients. I have the same strong belief in the capacities of people to develop and flourish—in the right environment—as I did as a youth, but I now recognize this as a more complex and difficult process. I have the same hopeful approach toward the ability of our institutes and the American to grow and develop. Changing the structures of our institutes won't release the capacities of our candidates in the absence of a personal analytic experience, but the personal analytic journey for candidates can be interfered with in certain institutional environments.
Rowntree: What are your thoughts about the increasing trend in many institutes toward a shorter period of training?
Margolis: Too prolonged an experience—say nine to twelve years—infantilizes candidates. But for most people, spending two or three years in candidacy after four years of seminars can be very fruitful; enough time has elapsed for their patients to be in an intense transference neurosis, and that resonates in their own analysis. The candidate is more self-confident and able to look more openly, in supervision and analysis, at what's happening between him or her and the patient. At the same time, the candidate during this post-seminar period can also be engaged in independent analytic work and have major assignments in societies and institutes, such as teaching in the extension division or involvement on committees. This allows for a gradual transition in which candidates begin to function as faculty even while tapering off their training. I feel that five to eight years is optimal for most candidates. More than that is often counterproductive to the development of professional independence and can result, with some justification, in antagonism toward the institute. Sometimes it is as hard to get out of training as it is to get into it!
“American Psychoanalysis will be enriched by the talent and energies of a wider mix of candidates from diverse backgrounds.”
Rowntree: What are some of the other changes that you feel can be effected by the Board?
Margolis: Another major change we are encouraging through the Board's committees is an increase in the number of nonmedical candidates, largely from the fields of psychology and social work. We are at the very beginning of efforts to train social workers and must do more to encourage and even help prepare these valuable colleagues for psychoanalytic training. Many institutes have begun to plan such efforts, and we intend to encourage and facilitate this trend. I also believe that we should encourage institutes to actively seek out and recruit candidates of minority background, especially Blacks. American psychoanalysis will be enriched by the talent and energies of a wider mix of candidates from diverse backgrounds. We are also promoting a greater inclusion of nonmedical colleagues, younger colleagues, and women in our national committees. In a major way, we have begun to broaden the composition of the national leadership. We hope to encourage institutes and societies to do the same locally.
Rowntree: I know that you have been particularly interested in increasing candidate involvement, both nationally and locally.
Margolis: We must solicit the energies, talents, and contributions of all our members, including candidates. Local institutes should have candidate organizations with representatives on most of the institute and society committees. There should be regular and frequent communication between faculties and candidate organizations. We need to listen with respect to what candidates say, for they are as interested and invested in the educational process as we are. We don't always know what's best for them. After all, they have graduate degrees in psychiatry, psychology, or social work and often themselves have considerable experience as teachers. Hopefully, our greater emphasis on the inclusion of younger analysts and candidates on the committees of BOPS will be a model to be emulated by the institutes.
Rowntree: Don't you have to be certified to participate in the committees of BOPS?
Margolis: Yes, by our bylaws. But the bylaws stipulate also that people who are not certified can have a nonvoting membership on any committee of the American if the BOPS chair and the President are in agreement. There are currently noncertified and senior candidate members on the committees of both Board and Council. This is something Mike Allison and I have done together. It's quite legal, and, more importantly, it's the right thing to do. I am confident that this policy will be continued under our incoming President.
Rowntree: I'm not sure it's widely known how you have gone about including a greater number of people in The American.
Margolis: Early on in our terms of office, Mike and I established a committee on appointments that would be in touch with each institute and society to recruit colleagues at all levels to serve on both committees and task forces. We have specifically asked for senior candidates, recent graduates, women, academics, and nonmedical colleagues, as historically these groups have been underrepresented. We have focused our recent efforts on selecting colleagues from institutes currently underrepresented on our committees. We also have established strategic planning task forces to look at every aspect of the national organization; they have been instructed to seek better
ways of involving members and eliciting their energy, enthusiasm, and active participation. All candidate and graduate members will soon be invited to participate in discussions about our future through their local institutes, societies, and candidate organizations. The establishment of strategic planning is in my mind the most important new initiative of the present administration.
Rowntree: Are you encountering any resistance from within the organization to this program?
Margolis: It's interesting, Ellen. When I took office and began to talk about these ideas, there was a lot of resistance and I saw that I needed to communicate more effectively what I wanted to do. This resistance has lessened considerably. The criticism came from very respected colleagues who were often most concerned with maintaining certification and in general with retaining our preeminent position as a psychoanalytic organization devoted to high standards of education and clinical practice. In the end, I believe, we'll find that a larger percentage of our members will become certified, a larger number of graduate analysts will be more actively involved, the institutes will feel less alienated from The American, and they will themselves become less alienating to their own members. Candidate education will be enriched, resulting in higher standards. Thus, instead of being weakened, the Board will actually be stronger and more effective as an educational force. I think that we are even now beginning to see such results.
Rowntree: I have talked with a number of people throughout the country who want to be more involved but don't know how to go about it.
Margolis: We are systematically surveying the membership, but we also encourage self-nomination, either to an institute director or to Owen Renik, Board Secretary and Co-Chair of the Joint Board and Council Committee on Appointments. We have already broadened participation significantly, but we have a long way to go. There are eight Board committees, and we have enlarged the number of joint Board-Council committees and task forces. For example, there is the new task force on certification, the new strategic planning committee and task forces, new committees on local newsletters, foundations, and libraries, and many others. The Joint Committee on university and medical education has a new subcommittee of medical student education. Another example is the Task Force on Private Practice chaired by Mike Allison, which has stimulated the development of local committees on private practice in almost every society and institute. That was a joint effort of Board and Council. Your new study group on supervision is an example of the study and discussion groups now offered by COPE, which I also hope will soon establish a study group on psychoanalytic pedagogy. These undertakings have required the appointment of many new colleagues, and the infusion of new energy has greatly benefitted the national program. All of our committees are increasing their efforts to be of service to local organizations.
Rowntree: Board and Council seem to be working closely together on these new programs.
Margolis: Yes. At times in the past they have had an adversarial relationship, but this is both unnecessary and no longer the case. Mike Allison and I work as a team, conferring many times each week. The goals of Board and Council are similar, though some of our functions are different. In the past there has been a tendency for colleagues to view the Board as more important than the Council. This tilt is reflected at the local level in the greater prestige of institutes vis-a-vis societies. This has unfortunately resulted in the neglect of such tasks of the societies as the promotion of private practice, a neglect we are currently attempting to redress. This is part of the mandate of our Strategic Planning Task Force on Board and Council.
“The establishment of strategic planning is in my mind the most important new initiative of the present administration.”
Rowntree: As a final question, I would like to ask you for your thoughts on the future of our profession.
Margolis: Ellen, I am very optimistic about the future, both of The American and of psychoanalysis more generally. We can be proud of our past accomplishments. Our high standards of training, practice, and scholarship are widely conceded to be second to none in the psychoanalytic world. Our present efforts will only enhance this solid record of achievement. There are so many areas in which the Board has undertaken new initiatives that I have been unable to discuss them all. Arnold Richards, editor of TAP has agreed to run a regular column about Board activities to keep the membership abreast of these ongoing efforts. Perhaps one day we will even have a BOPS Newsletter. In the meantime, let me sketch a few of the major areas in which we are presently engaged.
Research: We are working on ways to finance and support large- and small-scale research projects. We also will promote research training for candidates at the institute level. The future of our science demands an enhanced effort in this area.
Child Analysis We are seeking new ways to promote it at the local and national levels. For too long child analysis has been kept on the back burner, and advance in this area is crucial both for the children who need treatment and as a vital step in our effort to enhance our knowledge of human development.
Cooperation with other organizations: We are broadening our efforts to cooperate with those of our colleagues in psychology, social work, and psychiatry who are also committed to strengthening the training and practice standards of psychoanalysis. Our increasingly warm and fruitful relationships with Division 39 of the American Psychological Association and with the Federation of Clinical Social Workers are cases in point. We are also working closely and cooperatively with the provisional IPA institutes not affiliated with The American.
Local Foundations: We are actively promoting the establishment of local foundations that will help support the institutes economically, as well as educating the general public about psychoanalysis. Once the local foundations are in place, a national foundation will be established with the capacity to attract the large sums of money required to support large-scale research projects.
New institutes: We have embarked on a national effort to actively promote the establishment of psychoanalytic study groups in localities that currently lack an institute and society. These groups may become satellites of existing institutes or develop into new ones. To speed up the development of these new centers, the Board will become more of a partner with the sponsoring institutes.
Relationship with universities and academics: An ambitious program is in the planning stage to increase the numbers of academics in full or partial psychoanalytic training at the institutes, to establish new study groups of psychoanalysts and academicians, and to study possibilities for formal relationships between institutes and universities. We hope we can have a position of major influence in the university without compromising our educational autonomy.
These are but a few of the areas in which the Board is currently involved. The initial success of our efforts bodes well for the future and adds to my confidence that in the coming decade we will see a flowering of psychoanalysis unparalleled in our history. Thank you, Ellen, for the opportunity to present my views.
Rowntree: And thank you, Marv, for your candid responses to my questions. It has been fun talking with you. I also want to thank you for the time, energy, enthusiasm, and commitment with which you are pursuing your vision, one that I'm sure will benefit us all.