Psychoanalysis, a form of treatment for mental illness, will flourish best in the general context of treatment and its traditions. In that context we can continue to maintain standards of training and practice. We can pursue the generation of data in replicable form and the development of appropriate empirical research methodology. We need to focus on the construction of outcome measures for the comparison of psychoanalytic results with those of other forms of treatment. Priority concerning our place in a reformed national health care system, if meaningful reform actually takes place, should be given to the right of patients to contract for care outside the system. It is unlikely that psychoanalysis would ever be covered by public insurance, and such coverage would probably be unwise. Seeking exclusion from the system, however, is neither necessary nor judicious.
Organized psychoanalysis, primarily in the form of The American, has an important role in maintaining the integrity and promoting the self-interest of our profession. For our own interest, as well as for public relations purposes, external certification has too long been delayed; it should be pursued with vigor and in conjunction with other analytic organizations that command our respect. Continuing progress toward democratization of The American is in order, and local institutes and societies should also be encouraged in that direction. At the same time, however, we need a more nimble executive structure, a real Board of Directors with executive authority and the ability to act expeditiously. The bylaws changes suggested by the Kris, Pyles, and Fox committees are largely identical and should be adopted: separate and equal educational, professional, and scientific divisions, each with its own chair, all reporting to the Board of Directors, chaired by the president of The American. The chairs of the Board on Professional Standards, the Executive Council, and the Division of Scientific Activities would each have a seat on the Board of Directors.
This is a time to spread our umbrella more widely, but with due regard for maintaining our commitment to excellence, and allowing the time necessary to evaluate the changes we have been making. This is a time for rededication to the rigors of scientific method in the exploration of formal psychoanalytic treatment, and to the ethics of service to society aside from formal psychoanalytic treatment. This is a time to continue the democratization and rejuvenation of our organization and our profession.