Solomon: What influences were you aware of that led you into medicine, psychiatry, and—ultimately—psychoanalysis?
Curtis: One of the major influences was the fact that my father was a physician, a general practitioner, and I was exposed to his practice as I grew up. Sometimes he would see patients at home on an emergency basis, and he would also take me on house calls. As I would sit in the car waiting for him, I knew he was in the house doing something that seemed mysterious with patients. Occasionally, as I got older, and with patients with whom he was particularly friendly, he would take me into the house with him. I was fascinated to see how he was received and what kind of effect he had on patients, not only his giving medicine and maybe setting a broken bone, but also his presence, which seemed to have a calming and healing effect on them.
Solomon: So this was your first exposure to the power of transference.
Curtis: Yes, but at that time it was thought of as bedside manner, and it was a very impressive experience. It solidified my own feelings about how nice it would be to help others, be respected, and occupy that special status of healer.
Solomon: So at an early age, then, you decided to go into medicine?
Curtis: Yes. Although periodically I had questions and doubts, it seemed to me the thing I was headed for. I guess it wasn't until medical school, though, that I really fixed on the idea of psychiatry.
Solomon: And what was psychiatry like for you in medical school?
Curtis: Well, it was a rather small psychiatric department at the University of Utah, and it was under the Department of Medicine at the time. I had begun to do some reading—not only of psychiatric books, but Freud and other analytic literature—and that seemed to hook me. We had to write a thesis for graduation, and I chose to write on electric shock treatment, which at the time—this was the early forties—was one of the few therapeutic modalities that was available. I spent some time at a state hospital working with psychotics and seeing ECT used with them. I researched the literature and wrote about the efficacy and problems of the treatment.
Solomon: What about your postgraduate training and military experience?
Curtis: I went into the service, having had a wartime internship and a wartime internal medicine residency of nine months each, before they finally insisted that I go into the army. Effectively, though, I had almost two years of internal medicine. During that time I was still interested in psychiatry, and with the dearth of psychiatrists I was sometimes called on to do consultations, which whetted my interest even more. I went into the service in 1946, and after a basic course in military medicine requested assignment to the neuropsychiatry school, which was a course of three months. George Pollock, Ken Calder, John Weber, and a number of other people were there, and we were influenced by teachers who had an analytic orientation. After my military experience, I began residency training in 1947 at the Institute of the Pennsylvania Hospital, which at the time was headed by Earl Bond.
Solomon: What was the residency training in psychiatry like then?
Curtis: Well, it was quite exciting. There was much ferment because many of the young residents had just returned from the service and felt very fortunate to have gotten into such an excellent program. Edward Strecker was here, of course, and also there were a number of analysts, including G. Henry Katz and John Eichholtz.
Solomon: What was Streckers attitude toward psychoanalysis?
Curtis: Strecker was a charismatic figure and held monthly “Strecker Seminars” at the home of a former woman patient who had an interest in psychiatry. He invited various guests to speak and involved many of the younger psychiatrists in these exciting discussions, many of which were about psychoanalysis. His attitude was that people should be interested in analysis and get some treatment. He felt there were problems with analysis, and of course he did not need analysis himself, though he thought it helpful for most others—for the common folk, so to speak. There was a lot of interest among the residents in getting into analysis.
Solomon: Who were some of the analysts on the scene at that time?
Curtis: Spurgeon English was at Temple, and LeRoy Maeder was president of the newly formed psychoanalytic society. Some of the others were Robert Bookhammer, George Sprague, Morris Brody, Herbert Herskovitz, Gerald Pearson, Sidney Biddle, and George Smeltz. That was one of the most exciting periods. Many who had been in the psychiatric branch of the Medical Corps were very enthusiastic about analysis and wanted to get into analytic training. There was in fact such a demand for analysis then that a bottleneck was created. Finally, after completing my residency in 1950, I entered analysis with G. Henry Katz.
Solomon: Wasn't 1950 the year of the split in Philadelphia?
Curtis: Yes, though it began in 1949. I was in the latter part of my residency. The question who would go with whom was very much on people's minds. I was already on Katz's waiting list and was inclined toward the group he was associated with. It included Biddle, Pearson, and Waelder, who for a time remained in both groups.
Solomon: What do you remember about your understanding of the issues?
Curtis: It seemed to go along the lines of who was liberal and who conservative, who was Freudian and who was neo-Freudian. Crucial issues were social contact with one's candidates and referring patients to them. Leon Saul was one of the controversial figures. It was reported that he had one of his analysands pick him up and drive him to his office, while on the way conducting a quasi-analytic session. Biddle, Katz, and Pearson felt such actions were a serious encroachment on the analytic process; they felt that socialization with candidates would jeopardize transference. There were also questions about the frequency of visits, and about the length of some analyses, which some felt were unduly short.
Solomon: At that time had there been splits in other groups?
Curtis: Yes. There were splits then in Los Angeles, as well as in Baltimore and Washington. I recall there were similar issues in Los Angeles, issues surrounding Franz Alexander, as there were also in other areas around people who had been influenced by him, such as Saul here in Philadelphia.
Solomon: We often hear of personality conflicts and political issues involved in splits.
Curtis: There is no question that there was a power struggle, but I think some of the personal problems grew out of differences in the approach to analysis, the nature and conduct of it. Several analysts were famous for their fees. Their charge of twenty-five dollars a session was an astronomical amount, whereas the prevailing fee was ten to fifteen. Interestingly enough, as part of the atmosphere at the time, a candidate had
written a takeoff on the Twenty-third Psalm, called “the Twenty-five Dollar Psalm.” “My analyst is my shepherd,” it went, “he shall not want.” I don't know whether that poem is still in anybody's file, but I wish I had a copy of it. Another analyst was referring the wives of his candidates to his own wife, a social worker, for analysis. Thus he and his wife analyzed husband-and-wife patients. There were also many personality differences, as I guess there always are, but they do tend to get crystallized around differences of opinion about what constitutes good analysis.
Solomon: Was there much conflict about choosing one group over the other?
Curtis: Yes, for a long period of time there was a lot of overt struggle. I think the outcome was that over time the two groups became more like-minded and the people who were considered “wild” and controversial were side-lined. One of the key points at that time was Cal Settlage's appointment as director of the original institute. He was the point man of the majority group that felt dissatisfied with some of the controversial practices.
Solomon: I guess ultimately this led to the two groups establishing a mutual collaboration.
Curtis: That came about only in the seventies, when Gene Baum and I used to get together in New York at the meetings. We would talk about ways of getting something going between the two groups by way of rapprochement and collaboration. We had a workshop at a meeting of The American where Gene and I spoke about the split and our efforts to alleviate some of the problems. We reported on the collaboration that he and I had, and how we had begun a liaison committee to promote our working together. So by 1983 it certainly was very much better, and as time has gone on our efforts have progressed to the point of having joint scientific and social functions together, as well as exchanging teachers and supervisors.
Solomon: When you started your training in 1951, were there formal courses?
Curtis: There was a tutorial system then because of the small number of teachers and candidates after the split. Each candidate was assigned two preceptors; they would discuss various topics in analysis with the help of reading lists. This became progressively modified until finally, when there was a sufficient number of candidates and teachers, classes were instituted. There were also visiting analysts coming from New York and Baltimore, and this influenced the eventual changeover to a more conventional curriculum.
Solomon: Were there teachers who particularly influenced you, either through their writings or through personal contact?
Curtis: Well, locally Waelder was, of course, a very influential person. Sidney Biddle was a very interesting man, not charismatic in the usual sense, but quite an appealing person. He had a quality of Quaker humility and good clinical sense when talking over cases. He was a very gentle soul, rather otherworldly in a way, whom everyone respected. John Eichholtz I remember as a good teacher who emphasized the importance of reading the basic literature; I think he customarily read the dream book once a year. Some of the younger graduates were also very good. Ott Raezer and Bill Wermuth were good teachers. George Sprague, too, was a very good teacher, as well as Eli Marcovitz. I didn't have much contact with George Smeltz, because he lived in Atlantic City. Gerald Pearson was also very important, especially in initiating the child curriculum. I had a control case with him, and that was an excellent supervisory experience. Anna Freud was an important influence for our group and came over to give the First Freud Memorial Lecture in 1954. She came back again in 1974 when I was chair of the lectureship committee. I saw her again in 1975 in London, specifically to pick her brain about nonmedical training, because I had been appointed
“Anna Freud was….very insistent on the validity of the whole idea of training nonmedical people. She didn't see them as necessarily any more talented than M.D.s or any more worthy of training, but felt we should take the widest possible range of people who were suitable.”
chair of the Committee on Prerequisites for Training.
Solomon: What were her thoughts on that issue?
Curtis: Well, she was of course very insistent on the validity of the whole idea of training nonmedical people. She didn't see them as necessarily any more talented than M.D.s, or any more worthy of training, but felt we should take the widest possible range of people who were suitable.
Solomon: Did you have much contact with analysts from other cities?
Curtis: Jenny Waelder-Hall was a very good clinician, and her seminars were very enjoyable. Berta Bornstein and Hermann Nunberg came down from New York on occasion. He was much older then, very crusty, and had a reputation for being impatient with students who weren't very sharp. He originally came here to Philadelphia to teach psychoanalysis at the Institute of the Pennsylvania Hospital. I might say that the first supervised case that I took, starting in 1951, paid me the sum of fifty cents a session, and I had a few others for the sum of a dollar, and some for as much as five dollars. I had six control cases and graduated in 1955.
Solomon: When you graduated, what was your clinical practice like?
Curtis: I was building up a practice then and had some hospital patients. I did have, from early on, at least five or six analytic cases going, but was also doing psychotherapy. I began teaching soon after graduation, as we soon had classes and groups rather than just individual tutorials.
Solomon: At what point did you become active in The American?
Curtis: I became a member in 1957 and an Executive Councilor in 1962. In 1966 I had my first connection with the Board, when I became a member of the Committee on New Training Facilities, which I went on to chair from 1969 to 1975. Then I was appointed chair of the Committee on Prerequisites for Training. I continued as an Executive Councilor through much of that time, and was also on the Board on Professional Standards.
Solomon: What were the areas of controversy and interest during the fifties and sixties?
Curtis: That was during the time of Alexander, and I remember a very famous panel with Hartmann, Waelder, Alexander, and Hendrick, where Alexander presented some of his ideas on the “corrective emotional experience,” leading to a very lively discussion and much controversy.
Solomon: Do you see any of Alexander's ideas currently, perhaps expressed in a different form?
Curtis: Yes, but now in a more thoughtful way, picking up on some of the British object relations school of Winnicott and Fairbairn. There is a useful aspect of that dimension that needed to be brought into the picture. To round out the view of analysis that focused primarily on drive and defense, one began to look into ways in which the rest of the personality might be involved. Also, that was a time when research into infancy and childhood, as represented by the work of Spitz and Mahler, became popular, along with the works of Zetzel and Greenson on the therapeutic alliance. There was also a great deal of attention to the work of Hartmann, and also opposition by many analysts who felt that this would take away from a focus on the inner life.
Solomon: What were some of the major issues you faced when you chaired BOPS and served as president of The American?
Curtis: The first thing I had to deal with was the growing movement toward membership for everyone, with or without certification, while the so-called limited voting rights proposal had also been advanced. Various committees considered this, and we made a compromise back then that instituted Extended Associate Membership. Although this satisfied some people for a while, it
became increasingly evident that a lot of graduates never applied for certification, and we were therefore left with a large number of people who were half in and half out. Applications for training as well as for membership seemed to be going down. I was one of those who supported retention of the certification requirement, but the handwriting was on the wall. Some of us were concerned that dropping the requirement would diminish the significance of membership, that it would no longer carry the same prestige it would if all members were required to undergo a peer review process to demonstrate their competence. There was also a concern that a large number of non-certified members, without necessarily having malignant motives, simply would not be as dedicated to maintaining standards.
Solomon: And what is your assessment of the situation at this point?
Curtis: I'm more encouraged now, although I don't think we really know what it will ultimately mean to The American. I think what passed finally was reassuring, and I'm hopeful that some of the efforts to improve certification might solve some of the problems there and make it something that is desirable once again, and perhaps less formidable. It will be interesting to see if some of those who felt unfairly excluded will take any greater interest in the organization now that they are active members.
Solomon: What do you foresee in regard to the membership issue?
Curtis: Although I don't know what to predict, the hope is, of course, that if people become more active in The American a commitment will be carried over into the maintenance of standards. The whole egalitarian movement carries with it the subtle interest in having large numbers, which can be politically and financially important to the organization. However, the question is whether we may sacrifice some of the emphasis on high standards.
Solomon: What are your thoughts about the inclusion of nonmedical training and membership in The American?
Curtis: The movement, I think, is in the direction of psychoanalysis becoming an independent profession, something not part of psychiatry. I do think it's important to keep connections with medicine and psychiatry, and I fear we are in some danger of feeling that to maintain those connections is not in our best interests. I think the selection and training of some really good nonmedical people will move us in the direction of being an organization that will take people of high quality and standards, whatever professional background they might come from. I see this as causing turmoil in some people already in the field, but if we are careful, and take only the very best people, it will be good for analysis.
Solomon: It seems the rush of nonmedical people seeking training in The American that many anticipated has not happened.
Curtis: That's true. It was slowed down partly by the careful way in which the whole process of deliberation was extended over twenty years or so. People were educated gradually and agreed then to allow nonmedical people to be trained first via the CNMCT waiver procedure, which screened out what might have been a rush, and we did get some excellent people. By and large the institutes have been very pleased with these candidates, and I know that's true here. What one hopes is that with the decreasing number of psychiatric applicants, people of lesser quality will not be accepted just to fill slots in a class.
Solomon: What are your reflections about the future of psychoanalysis and its viability in the difficult times that seem to lie ahead?
Curtis: I think that while psychoanalysis will never be as popular as it was back in the fifties and sixties, it nevertheless has a secure place in the field of mental health. There will probably be a swing back to the importance of the psyche after a lot of the enthusiasm for psychopharmacology and neuroscience has run its course and established
“Environmentalist theories stress that the trauma has molded the mind and so one must have a new kind of experience to correct that, while not attending to the transformation one has undergone in attempting to master the trauma.”
those fields as important parts of the greater picture. I think people will hang on to the pendulum as it swings back to a greater integration of things having to do with the workings of the mind and not just rely on medications to solve problems that are a part of the psychological aspect of living.
Solomon: What do you think of some of the changes that have occurred clinitally in psychoanalysis, such as the much greater use of psychotropic medication with analytic patients?
Curtis: I think of medication as having some limited place in treating certain kinds of patients at certain points. Patients for whom it might be indicated are probably those for whom psychoanalysis as we usually think of it may not be workable. In such patients there may already have to be some careful application of measures that one would not need with the so-called good neurotic. So, extending that to the use of medication—better if administered by someone other than the analyst—I think it is still possible, with careful attention to analyzing the implications of this modification in technique, to have an analytic process.
Solomon: Are there any current trends in analysis today that you find either valuable or misguided?
Curtis: I think that the increased attention to object relations theory is very important, as long as it isn't seen as something divorced from the valuable things we know, from long-term experience, about working with intrapsychic conflict and our drive-defense model of the mind. Awareness of object relations can be a very important expansion of a dimension that has always been there, and been attended to in certain ways, but not with the specific attention and theoretical study it deserves. There is a sharpening up, for example, of the way in which the relationship between analyst and patient can be seen in a multiply determined way. It is a human relationship within which certain very unique and specific things can be done to broaden awareness of the patient's inner life and add important information and insight for the person to work with. I don't see any basic antagonism here, as long as the insights of object relations theory don't seduce us away from recognizing the importance of intrapsychic conflict. We've talked of Franz Alexander, who certainly tended to pull in the direction of environmentalism and the role of experience with the analyst. The important thing is to learn what meanings the patient assigns to that experience. With all the emphasis on trauma that we see currently in the mental health field, that too can provide a setting in which there is a swinging in the direction of environmentalist, experiential thinking to the neglect of what is done inside the patient's own mind with the traumatic experience. Environmentalist theories stress that the trauma has molded the mind and so one must have a new kind of experience to correct that, while not attending to the transformation one has undergone in attempting to master the trauma.
Solomon: What about the current attention to the psychology and experience of the analyst and their interplay with the experience of the patient?
Curtis: I think that's important. I'm alarmed, though, by some of the excesses that people have gotten into with the idea that the analyst can divine what is in the patient's mind by his or her own reaction, never taking into account what the idiosyncratic contribution of the analyst might be. Instead they assume that it is a kind of one-to-one thing where one finds an answer magically, as one responds in certain ways to the patient's affects and experience. I think that those empathic and intuitive experiences that merge over into countertransference are potential sources of guidance and information that can be useful, not just as an experience that is shared with the patient, but rather as indicators toward understanding the patient's very unique way of responding.
Solomon: Well, our time has gone by so quickly. Thank you for sharing your thoughts with us.