In my last column I dealt briefly with our need to struggle with the divisiveness that has again surfaced in The American, this time focused not on delinkage but on differing approaches to the threats posed to psychoanalysis by impending legislation. Despite these differences, we all recognize the dangers to psychoanalysis that lurk in many of the health care proposals, and can take satisfaction, along with interested consumers, business interests, and other health care providers, that many of these threats to psychoanalysis have apparently been staved off at the national level. The membership deserves our gratitude for reacting as never before with financial support and with time and effort expended in direct contact with legislators and others in powerful positions. The role of psychoanalysis, and its values, have been persuasively presented to many inside the Beltway. We in turn have become more comfortable presenting ourselves, with or without lobbyists to direct us. The role of the societies in mobilizing this effort was significant, and they will become even more important in the next phase of our ongoing campaign, which increasingly will shift to the state level.
Rapid changes within our organization, combined with the uncertain climate for psychoanalysis, place increasing stress on us all. Our recent success in surmounting the contentiousness of our internal health care debate can serve us as a standard here. The spirit of compromise is indeed fragile, but it did prevail at the Council meeting in May when CGRI supported CPR and gave priority to the right to private contracting. In the end we fought for quality mental health care for all, while protecting psychoanalysis. Now we are at the beginning of the long effort we must make to stay on top of what will undoubtedly be a protracted effort waged state by state, issue by issue.
In these struggles the burden will fall primarily to the local societies, supported by the organizational know-how and, wherever possible, the financial support of The American. It is imperative that the careers of our younger colleagues and students, as well as the right of patients to psychoanalysis, be guarded by those of us fortunate enough to have been trained in a more optimistic and openhearted era. Our success in forming alliances will serve us in good stead as we deal not only with legislation but with state regulatory processes, participating in joint legal challenges to initiatives that would threaten the
core of psychoanalysis—its intimate, confidential contract to explore, understand, and relieve internal misery.
On these issues, more collaborative work has been done, with colleagues within and without The American, than has been acknowledged. But we are capable of even more. In addressing the pressing issue of external accrediting and credentialing, we must reap the hard-won rewards of our recent experience in communication and compromise; we must avoid at all costs the painful temptation of splits and struggles between psychoanalytic organizations, or between Board and Council, which only distract us from the danger at our door. Again we must rise to protect the life-work of those who are following us, and who depend on us to speak up for them. Both Larry Chalfin and I place a high priority on consensus and together are determined to battle the possibility that an accrediting body might be recognized that would establish a once or twice a week training standard for analysis. We recognize, as did Board and Council in charging the Joint Committee on External Credentialing to suggest ways of implementing the report tendered by Donald Burnham, Morton Reiser, and Robert Michels, that the establishment of such inadequate standards would not only be harmful to the public, but would debase the image of psychoanalysis. We must now strive to achieve a consensus on how we are to meet the demand that The American exercise a leadership function in this crucial area.
To accomplish the goal of assuring nationally recognized credentialing for our graduates, we must recognize that the path we took in our health care efforts is the only road to success: an alliance with others whose concept of psychoanalysis is close to ours, such as the Coalition of Independent IPA Groups, the members of the Psychoanalytic Consortium, and the Association for Child and Adolescent Psychoanalysis. This was part of Mike Allison's original charge to the committee, a foresighted charge indeed. These natural allies in the fight for high standards will unite with us behind a minimum standard of three times a week for the training analysis. Recently the joint committee, chaired by Allan Rosenblatt, with the support of our attorney and the knowledge of the IPA, has devised a way to maintain our training analysis standard of four or five times a week as a distinguishing and often necessary component of psychoanalytic education. The committee proposes a credentialing board that would allow each component to retain significant control over its own educational program and training standards. Of course, I recognize that we are not yet agreed that the establishment of such an umbrella organization is either desirable or legally feasible.
That there are differences of opinion over such a serious issue should not surprise us. We need vigorous discussion and full examination of the several proposals in order to arrive at a mutually acceptable solution. We must again mobilize our societies and institutes to evaluate alternatives. With determination, we can handle the debate so that it enlivens and educates without threatening our organization. We can afford no delay on this issue, lest we abdicate our role as a leader in the fight for responsibly high standards, and with it our stake in the world of accreditation and credentialing.