Thomas: Welcome to the pages of TAP. Your becoming president at the conclusion of the May meeting brings the results of the election into the present, hence this welcome.
Schachter: Thank you. I do believe that the agenda that pushed me to seek the presidency has by now been generally accepted, and events are forcing us on. As you know, I was an ardent supporter of delinkage, and the election focused on that issue. My intention was to encourage the various groupings in The American to become more unified. I wanted to see an acceptance of our diversity, so that The American would become more all-encompassing and include all the graduates of our institutes, not just those who choose to seek certification. Delinkage passed, so that is now possible. Now I want to support diversity in other ways, particularly in our candidate body, and thus, eventually, in our membership. So I am looking forward to the work of the newly organized Candidates Council. Organizationally, I want to see the societies get the same degree of support that has gone to the institutes. At the same time, I realize that the needs of smaller institutes may require attention, as do members who practice in cities where there are neither institutes nor societies.
Thomas: How do you see this being accomplished?
Schachter: Probably the most important way is to make all of our members aware that the administration, which includes the Executive Committee, Central Office staff, and Doris Eder, our new administrative director, are there to serve them. Each institute and society should look to the Central Office as a resource. Not only institutes and societies, but local foundations also, will eventually be able to access the Central Office computer using codes that will protect confidentiality. The “server” in the Central Office can be used to store important files now that our consultant and Paul Mosher have installed a backup system protecting data from loss by fire, flood, and other disasters.
Thomas: How do you envision this computer interface between local organizations and the Central Office?
Schachter: Besides the safety function I have mentioned, two other examples come to mind. With the need to focus on practice issues, questionnaires like the ones Lee Brauer has designed and circulated could be sent out, with the responses then being made anonymous by the president of each local society. The answers could then be accessed by the other presidents. I am thinking of such questions as whether societies with open scientific meetings find an increase in referrals to their members. Do their institutes find an increased application rate? Do joint meetings with psychiatric and psychological groups lead to a dilution of analytic involvement by members, or to changes in their practices?
Another role our computers might play is in keeping an analytic calendar on which members could input upcoming meetings and symposia. They could also look for speakers from a file of members who have papers they would like to present. In the same vein, notices could be posted of analysts visiting from abroad, so that program chairs are given access to an additional roster of potential participants. Another aid to society programming might result from Chuck Rothstein's plan to videotape two panels on the May program. We will distribute the tapes free of charge to society program chairs. Showings of the tapes might be followed by informal discussion groups, or they could be presented to a broader audience. This is our first attempt to bring the meetings to those unable to attend. The tapes will also be for sale to individuals. We'll await responses en route, perhaps, to plans for satellite programming. That's still off in the future.
On the more general question of enhanced communication between the national and local levels, I see the Committee on Societies playing an increasingly important role in the coming months. I would like to see a member of the committee visit each society, either with the site visits or independently, to develop a closer relationship between local members and officers and the committee, as well as the Executive Committee and Council. The society would thereby receive a consultation from someone versed in ethical issues, and attuned to the morale of the psychoanalytic community and to practice issues around the country. On their return, committee members would keep the Council informed of the concerns of our members and would strengthen its decision-making capabilities. This will be a two-way street, since the Committee on Societies is charged also with reporting issues before Council to the societies, so they may be discussed in advance of meetings.
Thomas: A lot of energy is being focused on the problem of how psychoanalysis will relate to the new health care plans. What are your thoughts?
Schachter: First of all, I don't believe that as an organization we can opt out of the arena; we must contend with the plans being offered and try to shape the eventual legislation. The demand that we opt out is not acceptable, in my opinion. We will of course give priority to the special confidentiality needed to conduct an analysis. However, I don't believe we are alone in this. Members of Congress are increasingly aware that they want the same protection for themselves, not only in psychotherapy, but with physical tests and procedures as well. We are not trying to educate barbarians. Some of our members may want to have no surveillance of their work of any kind, even by The American. This is a position I would like to hear more about, because I
have always felt that participation in study groups has been helpful in my postgraduate education and has occasioned no loss of confidentiality. Perhaps peer review, by analysts in our organization, might be developed as an option acceptable to those who wish to practice within the health care system.
Perhaps by focusing on a recent survey of Canadian psychoanalysts, the issue we want to impress on our legislators can be more clearly stated. In that survey it was found that 28% of the patients of analysts had been abused as children, and that 80% or so had tried other forms of therapy before seeking a personal analysis. These are not the worried well. Rather, they are seriously troubled and have sought help because of it. A more refined but similar questionnaire has now gone out to a sample of our members. We urge them to respond with their best efforts, because the survey will be an important resource in relating to health plan initiatives. Norman Doidge, a member now in Canada, who originated this research, will process the returns, which will be made anonymous to protect confidentiality, using his computer program at McGill University.
Thomas: You have strong opinions about who should have access to psychoanalysis.
Schachter: I do. I believe that as an organization we should support access to psychoanalysis for people with marginal incomes. I believe also that we should support the provision of therapy to people who are perhaps not analyzable, but who belong to the population of psychotherapy patients that our candidates, and our analytic patients who are themselves psychotherapists, see in their practices.
Thomas: I know that you have been very involved in the Pittsburgh psychoanalytic community. You have said that this has been very important in forming some of the ideas you look forward to sharing with others in The American.
Schachter: My experience in Pittsburgh has been important for me. For a time, we had been less involved as a psychoanalytic community than we should have been. However, in the last five years there has been a great increase in our sense of community, in both the institute and the society. Various barriers had kept individuals from sharing their work with one another, but all that changed with the advent of a number of study groups. Bringing in analysts from other centers, especially to talk about technique, did much to catalyze our dormant love of analysis and to bring people together. In addition, several retreats gathered together all the analysts in the city, including many who had felt disenfranchised. We held weekend sessions that created an ambience encouraging catharsis, working through, and reconciliation.
Thomas: I know that you have been concerned about ethical matters. Clearly, you are encouraged by the work being done in this area.
Schachter: Yes, I am. Ralph Engle, the chair of a new ethics subcommittee, has gathered a group to revise our standards and procedures. We hope that they will add, to the standards applied in psychiatric and psychological practice generally, our conviction of the importance of transference. He will have consultants from the ethics committees of both APAs, as well as Paulina Kernberg, who has been active with the IPA ethics committee. Others on the subcommittee have a special interest in mediation procedures that bring troubled analysts together with ex-patients in an attempt to salvage what was good in their relationship. In addition, the subcommittee will review procedures for prevention of damage by other varieties of impairment. The American's discussion group on the effects of the analyst's aging on the analytic process was started out of interest in a paper by Eugene Kaplan. In Pittsburgh, it stimulated training analysts to begin a review of one another which we hope will begin, sensitively and supportively, to recognize and work with the impact of aging on the analytic situation.
Thomas: Are there other committees you might wish to mention?
Schachter: Yes. A very active committee, chaired by Allan Rosenblatt, is studying the possibility of an external accrediting and credentialing agency, with a mandate from Council to propose how such an entity would function and what its effect might be on BOPS, which, we assume, would remain our “in-house” credentialing body. Recent changes in CORPA will enable us to step back from our reactive position and consider our goals. The Public Information Committee, which was so ably chaired by Steve Sonnenberg for so long, will now be headed by Irene Chiarandini, who is committed to a plan to help the public understand the value of psychoanalysis. Through this committee and a network of interested members around the country, we hope to reach out to various sectors of the print and broadcast media, and to engage those we have previously neglected: those with programming, for example, focused on the Spanish-speaking population and the African-American community. That we can find and engage such under-served groups is demonstrated by the effectiveness of Detroit analysts, who, with Marvin Margolis, realized that the Korean population was suffering from an increase in adolescent suicides and reached out to that community with an offering of expertise that engaged them in our work. This epitomizes the great help we can offer when we move out to meet the public.
Thomas: I have heard you talk about those who get separated from the community of psychoanalysts, yet who are known to be highly capable individuals.
Schachter: It's a subject of great concern that I approach in several ways. I feel there is a need for all of us to actively focus on matters of collegiality. Not surprisingly, this may be as simple a matter as everyone relating to one another with good manners. I've been especially sensitized to the issue by failures to recognize the vulnerabilities of applicants to our institutes; of candidates in classes and as analysands; of graduate analysts applying for certification; and, yes, of certified analysts being reviewed for training analyst status. Good manners have the value of stabilizing relationships and minimizing feelings of rejection and shame. Freud talked about tact. I wonder if he ever considered an analytic society in which tact and good manners could not be taken for granted. The need for empathy with patients is obvious, and I do not think that we usually fail them. But it must also be a priority with our colleagues. Does a statement such as “I appear to have harmed you” fall outside our relating to one another? This is a call to respect the dignity of the other person, and if heeded it can smooth the discourse of our meetings, even when highly charged issues are discussed. It can enhance the value of The American as a magnet for members who have not found respect and collegiality in their local societies. If they find support at the national level, they will develop further and return enriched to their practices and communities.
Thomas: You've stressed empathy as a necessary element if we are to experience the collegiality you would like to see. Could you give an example?
Schachter: I believe that when judgments are made of candidates and their work, these judgments need to be made known to them. In the past, when people were denied certification, much more might have been done to help them understand why their work was not accepted. Had that been done, there would have been a much deeper sense of equality. This, of course, has changed in the last few years, as Art Rosenbaum has supported a redirection of his committee's approach and direction.
Thomas: I understand you are pleased with the way in which the Central Office has functioned during this time of transition.
Schachter: This undoubtedly has been one of the most difficult years the staff has had to cope with. During the meetings in San Francisco, Paul Mosher organized the installation of our new computers so as to occasion only minimal disruption. As you know, our president, Bernard Pacella, made this computerization a priority, and the Council funded it appropriately. Helen Fischer, who is retiring at this meeting, oversaw the contracts, purchases, and the consultant who met with our staff and trained them. Helen leaves us in tip-top shape. With these resources, Steve Firestein is finally able to follow our finances month to month and prepare a budget. Even with the recent flood in the building, the staff has shown excellent morale and commitment.
Thomas: As time is limited, I would ask you to add your own finishing touches to our conversation.
Schachter: Well, I look forward to improved communication among the societies, and between the societies and their national officers. I hope that the Council will be strengthened in the next few years by its new Steering Committee and Committee on Societies. The Bylaws Committee under Anton Kris and the task force chaired by Robert Pyles have both made proposals for streamlining our procedures. The Bylaws Committee will in addition circulate a thought-provoking reorganization plan based on the work of Pyles, Morris Peltz, Carl Davis, and Richard Fox. We hope the changes I've mentioned will help us function better in the nineties and for many years to come.
Thomas: Needless to say, we at TAP wish you every success in your term as president. Thank you.