Auchincloss: Arnie, I've been reading your curriculum vitae. You've been involved in every imaginable aspect of psychoanalysis over the last forty years. What are you doing now?
Cooper: I'm having the time of my life. I became professor emeritus at Payne Whitney a year ago, opened my own office, and took two new jobs that were offered me at just the right moment—North American editor of the International Journal of Psycho-Analysis and deputy editor of the American Journal of Psychiatry. I continue to see patients, teach in several settings, carry on some tasks at the medical school, try to write, and chair the Committee on University and Medical Education at The American. The package seems to suit me just right.
Auchincloss: Tell me how you see your role at the International Journal.
Cooper: Vann Spruiell preceded me as North American editor and I inherited a superb editorial board from him. We have expanded our reviewing process, bringing in a large number of readers from around the country who work very hard and produce extraordinarily scholarly reviews of manuscripts. We are about to appoint a number of new members to the board, including a group of younger associate editors from institutes that have not previously been represented. I also have the good fortune to have Ted Shapiro as the new book review editor. Submissions from North America make up almost half the published matter in the Journal, and I hope that North American authors are aware that their papers are reviewed by North American peers. David Tuckett, the editor, has the power of final decision, but so far he and I have had no occasion to disagree. I am excited by the topical reorganization of the Journal, and I hope it is clear to authors that we are eagerly seeking papers from the broadest spectrum of psychoanalytic activity—applied analysis, empirical research, clinical case reports, and so on. It is interesting that the three major English-language journals, JAPA, the Quarterly, and the International Journal—all have new editors, and I can safely say that we see eye to eye in taking a very broad view of psychoanalysis. The International Journal enjoys a huge circulation, over seven thousand, has a distinguished history, and has been an important influence in reducing what at times has been an insularity in American psychoanalysis. I feel it is a great privilege to play a role in the Journal's development at this time.
Auchincloss: Are any trends detectable in the submissions that you're receiving?
Cooper: I think so. There is great interest in the detailed account of analytic sessions, especially the analysts contribution to the patient's behavior. Intersubjectivity and countertransference are “hot” topics. There is a difference of tone in today's theoretical papers, with much more careful argumentation and clinical documentation,
and, I am happy to say, an absence of the dogmatic assertions that once characterized a lot of our literature. Although most authors have strong theoretical preferences, they are knowledgeable about different orientations. There is also a significant increase of empirical research, both in infant and adult psychiatry. We are interested in the influence on psychoanalysis of new ideas from neighboring disciplines, such as the neurophysiology of memory, or sociology or philosophy. Applied analytic papers now are more concerned with deepening our appreciation of the artistic or literary work, and it is no longer so exciting to find that an analytic proposition is supported by a work of art. I could go on. In general, the submissions are of very high quality, and our review process is intended to help the author to improve a paper whether we plan to accept it or not. I should put in a plug, and say that we have reduced our backlog and can usually publish within six months of a manuscripts acceptance.
Auchincloss: What will your role be at the American Journal of Psychiatry? Are you a general editor, or are you specifically assigned as editor for psychodynamic psychiatry?
Cooper: Nancy Andreasen is the editor, and Jack Gorman and I are deputy editors. It is, I think, reasonably self-evident that I would not be competent to function as the editor of a paper on GABA metabolism. Each of us takes a third of the papers, and the administrative offices in Washington are wise enough to send us papers in our areas of major interest. I assume that Nancy's asking me to be a deputy editor is an indication of her desire to keep the Journal well-balanced, representing both biological and psychosocial areas of psychiatry.
Auchincloss: What kinds of papers are you getting in the area of psychosocial psychiatry?
Cooper: The range is enormous. I like to think that the AJP, which has the largest circulation of any psychiatric journal in the world, is to psychiatry as the New England Journal of Medicine is to general medicine. We are eager to inform the profession of any basic research, clinical developments, professional issues, and interesting ideas that may be relevant to psychiatry. We publish a broad spectrum of papers on psychosocial topics, including ethics, the etiological significance of trauma or socioeconomic status or family constellation, the history of ideas, personality disorders, epidemiology, psychotherapy techniques, psychiatric education, and health care policy, to mention just a few. Many psychoanalysts are regular contributors. While most articles are original research, we publish special articles and editorials on a huge range of topics. The AJP has long had a policy of not publishing single case reports except as letters. This has made it difficult for some dynamic psychiatrists to make contributions in this major psychiatric journal. It does encourage dynamic psychiatrists to gather case material, pool observations, and make their contributions in a format that meets Journal standards. An interesting new idea, with some clinical support, is always of interest.
Auchincloss: Is it necessary that psychodynamic studies meet standards for controlled large N studies?
Cooper: Not at all. The Journal has always been willing to publish preliminary reports in interesting areas, as well as special articles that present important ideas or review a significant area of psychiatry. Our aim is to be certain that information of value to clinicians as well as researchers is reaching the people who need it.
Auchincloss: Let's talk more about psychoanalysis. You've written an unusual number of articles that take an overview of the field and are obviously fascinated by attempts at synthesis. I suspect your holding these two editorships is part of that same disposition. First, why this interest? And then would you tell me about your latest overview?
Cooper: Let me give you a bit of personal history. Like so many others, I came to analysis from a background in literature, having discovered Freud while an undergraduate, and I went to medical school when I was told that it was a prerequisite to becoming an analyst. From the start, one of the things that fascinated me about psychoanalysis was that it seemed an open-ended system with no limits to its investigative domain. I also spent a few years in physiology research and internal medicine before doing a psychiatric residency. Although I was already in analysis, I was entirely naive when I applied for analytic training. After being accepted at both New York and Columbia, I chose the latter because they seemed to have closer academic ties and a research interest, and I always had the notion that I would end
up as an academic. I didn't know that Columbia was then considered renegade, dissident, culturalist, revisionist, insufficiently analytic, and not particularly welcome at The American. Since being excluded aroused powerful personal feelings in me—I grew up as the only Jew in an anti-Semitic neighborhood—I was quite interested in how we were different. I never tried to “pass,” but I did want to know what it was that I was excluded from, why I was not “fitting in.” What did they know that we didn't, and vice versa? I wasn't so sure that what I had learned about analysis was the right way to do it. I have always wanted to know how “others” thought. You can easily make up a story of the dynamic roots of that. I am sure that is part of my interest in psychoanalysis generally, as well as one source of my interest in different views of the field. I have always been allergic to any system that laid claim to the “truth.” More practically, when I graduated from the Institute I was appointed to the faculty and told to take a year to prepare a course on what were then called the “dissident schools.”
Auchincloss: And what were they then?
Cooper: Klein, Homey, Thompson, Reich, Jung, Adler, Fromm, Sullivan—those types. I spent a year reading, not understanding a great deal of it, feeling totally inadequate to teach it, but I tried to present each worker in the most positive light, asking the students to take “unacceptable” ideas seriously and discover for themselves their positive and negative aspects. After teaching this course for several years, I began to see many good ideas in authors who were not being taken seriously by mainstream analysts, even at Columbia. It began to seem then, and it still seems now, as if the “my school versus your school” attitude was costing us dearly in a loss of good ideas and an excessively slow rate of change. The situation today is much improved. Most of us recognize that no single theoretical system today provides the overarching synthesis that Freud attempted, and we are eager for new ideas. Klein is now very much a part of the American psychoanalytic landscape. Sullivan, though rarely quoted, is a very significant contributor to contemporary thought, as is Horney, and so on. We should be aware of what others know, so that we can borrow, bend, or steal good ideas, rather than having to shut our ears to new knowledge. I confess to a pleasure, obviously multidetermined, in seeing one after another of our “orthodox” analytic shibboleths fall. It is surely a sign of our good health and vigor, and our developing maturity. It may be difficult for younger analysts, in today's far more open intellectual atmosphere, to appreciate the stifling weight of authority and conformity that pervaded the profession not so long ago. It was very easy to make a misstep and be labeled a nonanalyst. Being involved with a major psychiatric and psychoanalytic journal certainly keeps me alert to what we can learn from each other. I also have an interest in trying to heal the breach of academic psychiatry and psychoanalysis that has been apparent in recent years.
Auchincloss: Are you suggesting a kind of eclecticism?
Cooper: I don't like eclecticism.
Auchincloss: I didn't think you would like that characterization.
Cooper: I don't think we want a little bit of this and a bit of that. I think we should hold our positions as passionately as our state of knowledge justifies. What I oppose is the closed mind and the refusal to examine alternate views because they are different. With as little data as we have in our field, we must know what someone else thinks—he might be right. As for my current overview, I think that right now we cannot get along with a single point of view in psychoanalysis—we are all borrowing aspects of self psychology, object relations theory, ego psychology, interpersonal theory, and so on. I don't think that is particularly desirable; it is simply the best we can do at the
“What I oppose is the closed mind and the refusal to examine alternate views because they are different. With as little data as we have in our field, we must know what someone else thinks—he might he right.”
moment. But I am delighted that this atmosphere of uncertainty is leading to new efforts at rethinking our positions, doing research, looking for ideas from neighboring disciplines. I think this is one of the very exciting intellectual periods in psychoanalysis.
Auchincloss: You say it was an accident that you went to Columbia. You weren't some kind of renegade to start with?
Cooper: I don't think so, except insofar as I have had, for reasons I alluded to, a hostility toward any exclusionist in-group. Clearly that played a significant role in my actions as president of The American.
Auchincloss: How do you mean?
Cooper: When I became president, having previously been chair of the Program Committee, but not having been part of the inner group of The American, several things seemed clear to me. First, I was convinced that The American was stifling itself by not permitting graduates who were not certified to become full members. Now that “delinkage” has passed and the sky did not fall, it may be hard to recall the ferocity of the fight against membership for noncertified graduates. The chair of the Membership Committee of the Board recited 'The Barbarians at the Gate“ at a Board meeting, and he meant it. I think today it's completely obvious that psychoanalysts who have graduated from institutes of The American benefit both their careers as analysts and The American by being members.
Second, I discovered that the Board on Professional Standards had, quite inadvertently I am sure, become an increasingly closed group. The vast majority of those serving on committees and as chairs came from a very few institutes, and nominations for chair of the Board were controlled by the outgoing chair. In addition, a number of Fellows reported that they hesitated to disagree too vigorously in debate with the Board leadership. I thought this was an undesirable state of affairs, because it threatened to stifle ideas. To help bring about change, I published the data on Board committee memberships in the newsletter, urging more open participation, and fought to have the nominating procedures changed. I am gratified that changes were made and that today the Board is a much more democratic body.
Third, I thought that Councilors did not take their responsibilities seriously and that the Council was not functioning as the board of directors it legally was. I think that is still a problem. I might mention that until I was nominated as presidentelect, I had never seen analytic politics from the inside. It was an extraordinarily painful experience, but that's another topic.
Auchincloss: Did delinkage go far enough?
Cooper: I would have gone farther. I think graduation from an institute that we have approved and monitored should be an adequate credential for full membership in The American.
Auchincloss: Would you support an outside certifying agency?
Cooper: I certainly did years ago, but I no longer am sure what a certifying agency is for. Our numbers are small. Are we certifying analysts for the sake of our patients? I think that patients pay very little attention to such matters. The problems of setting qualifications that go beyond institutes of The American and the International are formidable. Are we certifying for ourselves, so that we can establish a hierarchy of merit? If so, I'm not sure it's worth the money and the trouble. The Board has great power over institute standards, and I think tight graduation requirements at the institutes and maintaining a high quality of education are our best guarantees. I know that some of our members have thought about these problems more deeply than I have, and I would bow to their wisdom.
Auchincloss: Some people think you were against opening The American to lay analysts. What was your role in the opening of The American to nonmedical people?
Cooper: As I have said many times, there was never any question that nonmedical people are
excellent analysts. I was concerned, however, that the membership make an open decision to change the character of The American from a medical to a nonmedical organization. The many proposals that came forth from committees before, during, and after my term all had the effect of changing the organization without the membership ever voting on it. It was always clear that after admitting nonmedical personnel to full training, it would be grossly unfair to deny them full membership. I was never concerned about lay analysis. I did think that there had been a special place in America for an organization of medical analysts, that we had developed great influence in medical education, and that we should carefully consider whether we wanted to jeopardize that. But I was convinced, long before the lawsuit, that we should give up our “exclusive franchise” with the International. That was not a popular view.
Auchincloss: You mentioned that you had not been part of the “in-group” at The American. How did you get to be president?
Cooper: Ray Raskin, a Columbia Councilor, complained to George Pollock while he was president that no one from Columbia had ever chaired a major committee. In response, George appointed me chair of the Program Committee, a job I hugely enjoyed. We started the Seminars for Psychoanalysts, the Symposia for Mental Health Professionals, and other innovative formats during that time. A few years later, I was asked if I was willing to be considered for nomination as president-elect. I said sure, reassuring my wife that there was no chance of my being nominated. In fact, I made a bet with her at odds of ten thousand to one—real money. To my surprise I lost the bet, and Madge bought a painting. Once nominated, I was delighted to be elected.
Auchincloss: Your appointment to AJP seems like good news for analysts. Does this mean we are still alive and kicking in American psychiatry?
Cooper: I think so, though in recent years, for all kinds of reasons, psychoanalysis has had a terrible time in academic psychiatry. It's not an easy place for psychoanalytic psychiatrists to survive in, and the situation's probably not going to get much better. The analytic institutes have been very late in waking up to how important it is to help candidates make their way in the academic world, and in fact have often placed obstacles in the way of their having academic careers at all. The net result, in my own experience at Payne Whitney, is that a generation of analyst teachers has by and large brought up a generation of non-analyst academics. Most of our full-time successors on the faculty at Cornell are psychodynamically sophisticated, but they have not had analytic training. I think that's too bad.
In another direction, however, the big fight between biological and psychodynamic psychiatrists ended some time ago, with each side recognizing how much it could learn from the other. For example, a psychodynamic point of view can provide an organizational context valuable to biologists, and analysts have realized that pharmacological help may make a patient more available to participate in an analytic process. I look to more eager collaboration between the two groups and to greater recognition of what each has to offer. My recent article on the psychodynamic aspects of panic disorder, written with Kathy Shear, Ted Shapiro, and Fredric Busch, is perhaps evidence of this new spirit of collaboration, as is, I suppose, my appointment to the AJP.
Auchincloss: I know you hold the analytic establishment somewhat responsible for our current poor standing in academic psychiatry. Tell me about your work on the Committee on University and Medical Education (CUME) and what you think we should be doing.
Cooper: I think actually that the attitude among analysts has changed dramatically over the last few years. For example, Council and Board approved a CUME initiative a couple of years ago to allow appropriate candidates from academic psychiatry to undertake some clinical training as part of their research and other academic responsibilities. This initiative invites institutes to start this as an experiment. To my knowledge, no institute has taken it up yet, but I think it would be useful to make analytic training inviting to some young academics who don't have to bind themselves to a whole career before they start training.
There is a rebirth of analytic interest on college campuses, and we're now putting up a proposal whereby appropriately chosen academics who are teaching about psychoanalysis in the humanities could be taking not just the theory courses, but could also sit in on the clinical courses and supervision. Often these people are autodidacts who are teaching Freud as if that were still all there was to psychoanalysis. These are experiments which I hope will bring a group of people closer to us who might otherwise not have a good sense of what analysis is like today. I think it's too bad that in some humanities departments, where psychoanalysis is often of great interest, it is being taught by people who have never been even near anything we would recognize as clinical psychoanalysis. It would be an enormous help to bring these people into contact with the kinds of experiences from which analysts draw analytic propositions.
Auchincloss: Obviously, there's a lot more to talk about. It sounds as if you're very busy.
Cooper: That never seems to be a problem.