In a presentation to the Board on Professional Standards last May, the formation of the Certification Club, an informal network of active and affiliate members of The American interested in studying problems in certification, was announced. In response, Owen Renik expressed the wish that the group would give BOPS and the Certification Committee more time to grapple with the subjectivity inherent in the process. Although pleased to learn that problems are at last being addressed, members of the club take the position that the general membership is accountable for the certification process and should no longer passively delegate this responsibility.
Before the announcement, members of BOPS and the Certification Committee received copies of the Associates' Network survey report, distributed by the club in an attempt to focus attention on the potential for individual and group bias in committee processes, and on the need for objective validation of certification procedures. The report's initial recommendations were that evaluators be given no information about applicants except what is in the case reports, and that each committee member judge applications independently of the other members.
Many interested observers welcomed Joseph Schacter's proposed study of the certification process (see TAP 26/2), which in effect would have formed an unofficial certification committee whose findings could be compared with those of the official body, and were disappointed to learn, in late May, that the project had been put on hold. Following the May meeting, word circulated that BOPS had voted to discontinue the requirement that applicants submit a detailed curriculum vitae, a development that was accepted as an important first step, though a limited one, as applicants would still be required to sign their case reports, thereby disclosing gender and graduate degree. Unfortunately, however, even this limited progress proved only apparent, as it was learned subsequently that the only changes made were that reports from institutes and supervisors will no longer be requested and that the committee will communicate its decisions to the applicant only. Many felt that this was in fact a setback, as individuals had now lost the option of seeking support from their institutes were they to feel wronged by the committee.
The Certification Club notes that the application form for certification (which currently requires one's name; institute and date of graduation; gender and marital status; place and date of birth; medical or other graduate school and post-doctoral training; other professional experiences; medical licenses; membership status in The American; a listing of all teaching and clinical positions held; the dates of one's psychoanalytic training; all personal analyses, their duration and frequency, and analysts' names; courses and seminars taken; publications; and a description of current professional activities and affiliations) perpetuates a potential for bias regarding the applicant's institute of origin, graduate degree, gender, and personal reputation. A Certification Committee member acquainted with the applicant, they note, could through comment or gesture influence the rest of the committee's decision. Other criticisms are that the committee's procedures depend heavily on consensus, and that membership is by invitation and is nonrepresentative. Although in its report to BOPS the committee mentioned that applicant anonymity had been discussed, it was not yet ready to make a recommendation in that area.
In March 1991 a letter and brief questionnaire were sent to all Associates listed in The American's directory, surveying their interest in forming an Associates' Organization. Over 80 replied, the overwhelming majority encouraging the effort, stressing delinkage, and voicing discouragement or hostility toward The American.
Opinions ranged widely. One respondent cautioned that “the last thing The American needs is ‘a split,’” while a few suggested that dues be placed in escrow until Associates no longer suffer “taxation without representation.” Most opposed the creation of a formal organization, as this would reinforce Associates' “second-class status.” Many requested a clear statement of the proposed organization's agenda. Although very few planned to attend the upcoming Spring Meeting (itself a significant finding), many of these who did go attended an Associates' Network meeting and were quite supportive.
In October 1991 the agenda and a longer questionnaire were sent to Associates. While the recent formation of the Task Force on Certification was a promising development, it was thought that Associates should speak with some degree of group cohesion. As for the questionnaire, confidentiality was stressed and respondents were free to leave questions blank and could identify themselves or not.
A total of 238 responses were received, a return rate of 29%; of these, 200 identified themselves. Although respondents were evenly distributed geographically, individuals were significantly less likely to respond if from the East, and more likely to respond if from the South or West; those from the Midwest responded in proportion to their regional total. Women were more likely to respond than men. Many who have been associates for over eight years were still invested enough to respond.
Only 24 of 238 acknowledged having not received certification upon application. Half the remaining group chose to leave this question blank, very often the only part of the questionnaire not answered, even by those responding anonymously.
The respondents were rather evenly divided regarding having an Associates' Network. Over 40% (98 people) were interested in communicating by mail; only 3 wanted a computer mailbox. Those interested in the network were distributed evenly among new, intermediate, and long-term Associates. Half of those who acknowledged they had sought certification were in this “interested” group.
On the question of applicant anonymity, 45 of the 98 were strongly in favor, with 20 holding no opinion. The latter often added such comments as “I hadn't thought about it” or “Is there a problem?” or “What is the usual procedure?” When preference for anonymity is compared between those planning to apply for certification and those without such plans, those planning to apply are—not surprisingly—twice as likely to respond that the system “seems fine.” Almost 27% (64 respondents) expressed an interest in participating in further study of the certification process. Associates interested in the network are also more interested in seeking a policy of applicant anonymity than is the group as a whole.
When degree of connectedness to The American is graphed against those wanting an active network, it is clear that the group tends to feel disenfranchised. The vast majority of all respondents, however, have a self-assessment of below average-expectable connectedness with The American. Only 9 (4%) said they felt highly connected. Only 52 (22%) rated their affiliation at 6-10, while 142 (60%) rated it at
Ann-Louise S. Silver, M.D., is a principal organizer of both the Associates' Network and the Certification Club.
less than 5. Those interested in a network and those who aren't have an almost identical distribution of “connectedness” scores.
Individuals summarized their experiences of the certification process in some detail. Others offered general comments that ranged widely. For example: “I think it [the certification process] should be done away with, not improved. The process promotes an elitism with a subsequent mischief that is unworthy of the organization.” “I continue to believe that certification in psychoanalysis should be separated from full membership in The American.” “I believe that [the proposed network study] is a worthwhile venture, but I strongly believe that the underlying issues are theoretical and technical issues in doing analysis, not political or sexually biased. I'd like the study to take theoretical bias into consideration somehow.” “I strongly favor anonymity. I have grave doubts about the ‘group wisdom’ of the Certification Committee and found a great disparity of opinion about my work on the committee.” [That writer had recently achieved certification.] “I'm intrigued by the male/female ratios. Someone should look at whether female candidates have more difficulty getting the classical oedipal material the committee wants. Do their cases tend to progress differently?” “I believe a totally independent certifying body should be established for a completely objective process of certification. I would be glad to then submit case reports as required.” “I strongly feel that graduation from an accredited institute of The American should entitle any graduate to join The American, simply and solely by application and payment of the fee. I think that all members of The American should have equal status and rights, as well as voting privileges. I do not think that the hierarchy of members, as now exists, should be allowed to continue.”
Although former Associates are in general pleased that delinkage has eliminated this second-class category, with its high dues and lack of voting privileges, they remain skeptical, as it remains to be seen which issues will be voted on only by those with certification, and which will be decided by the entire membership. Clearly the potential exists for an invidious distinction hardly different in substance from the one now nominally suppressed.
Interest in a communications network was reflected in the high level of donations to cover postage and other expenses. The many who express an interest in studying the certification process do so for a variety of motives, from wishing to obtain certification to a desire to reform the process. Interestingly, a very large number seemed uninformed regarding the current review process. However, over the course of this project several facts have become clear: (1) Institutes often write to the Certification committee in support of applicants they identify as senior and valued contributors to their analytic community; (2) there are no women on the committee, nor were there any in the current group of participant observers, though in May Judith Schachter was appointed as one; (3) in all the years of the committee's existence, only 14% of those certified have been women; and (4) the committee keeps no records of how it works.
With regard to the last point, J. Alexis Burland, a recent appointee to the committee, comments in a letter to Joseph Schachter (TAP 26/2) that committee members “not only review the applications themselves but take part in lengthy discussions of each applicant… . a certain level of group ‘wisdom’ is achieved over time.” Dr. Burland states that the committee's charge had been to assess whether applicants “reveal at least minimal competence in the practice of clinical psychoanalysis.”
Throughout, both the Associates' Network and the Certification Club have proceeded on the premise that organizations can change from within, and that outside pressure is often counterproductive. Further reforms nonetheless seem necessary. Abolition of the Associate category does not redress the procedural problems in the certification process. Members of The American who would like a copy of the Associates' Network's “Report to The Task Force on Certification” may send requests to Ann-Louise S. Silver, M.D., at 4966 Reedy Brook Lane, Columbia, MD 21044.
Membership in the Certification Club is open to anyone in The American, active or affiliate. Participation is totally separate from the official organization of The American. The club plans to continue working within the organization toward greater openness and the establishment of systems maximizing objectivity. Annual dues are $25. By encouraging debate and providing a forum in which the talents of the general membership can converge, the club hopes to contribute to the solution of the many thorny problems concerning certification.