“There can't be standards without patients.” Thus Lawrence Chalfin, chair of the Board on Professional Standards, opened the Board's May 13 meeting. Chalfin went on to emphasize the need for The American to promote further public education about psychoanalysis. He mentioned that following the meeting of BOPS last December, Jorge Schneider of Chicago had spoken with him about particularly thorny practice issues. Chalfin then undertook an “informal survey,” asking analysts he encountered about their practice concerns. All too often he elicited defeatism and apathy. As a result, his thinking about the function of BOPS has evolved: he has decided that the Board, whose traditional concern has been education, cannot safely ignore the trend toward smaller analytic practices.
Practice issues affect analytic training on all levels, Chalfin continued. They impact on candidate applications and candidate progression. After graduation, practice levels affect not only income but analytic identity. A lack of patients deprives analysts wishing to become training analysts of the necessary experience and immersion. In the 1950s, Chalfin noted, analysis was part of “the big picture” of American culture. As this is no longer so, The American must work to reestablish an alliance with the educated public.
Many Fellows echoed this tocsin. Suggestions were made for initiatives both at the national and the local level. Representatives from Baltimore, Philadelphia, San Francisco, New Orleans, Cincinnati, and Boston cited ways in which their groups were educating the public.
Some Fellows spoke to the need for a new role model. The anonymous analyst sequestered in his or her office is no longer a desirable paradigm. Stephen Firestein commented on the need for analysts to become actively involved in all aspects of public education. They must develop outreach activities, he said, even when these are not remunerated. Robert Pyles noted that an outreach tradition exists: in the 1920s community involvement was very important in the Berlin Institute. The overwhelming consensus was to develop and support public information at both the national and the local level,
BOPS secretary Donald Rosenblitt commented that it would be hard to imagine such a discussion taking place even ten years ago; the idea of such active outreach would have been too controversial. Rosenblitt mentioned that Judith Schachter had appointed Harvey Rich, chair of the American Psychoanalytic Foundation, and himself to head a Task Force on Public Education.
During the meeting, David Orbison, president of the Affiliates Council, and Glenn Good, president-elect, were seated on the dais at Chalfin's invitation. In introducing them, the chair noted that candidates were the natural constituency of the Board and that members of the Affiliates Council will be participating in the activities of BOPS committees.
Richard Fox, chair of the Ad Hoc Committee on Affiliate Membership, announced that the committee is developing a plan to allow student membership and would reach out to various student groups. Such membership would be extended both to students who upon graduation could apply for analytic training without need of a waiver (e.g., psychiatric residents, clinical psychology doctorate students) and to those who would require further training or a waiver (e.g., medical students, academics). Student membership would provide benefits including a subscription to TAP, reduced fees for national meetings, and special membership programs. The plan elicited favorable comment. Deanna Holtzman, chair of the Committee on Research and Special Training, commended the plan, noting that it will be of significant help in furthering the presence of The American in the academic community. The proposal will be discussed at length at the December meeting.
Reporting as chair of the Committee on Membership, Fox expressed concern about a decrease in membership. Since December, 21 new members have joined (their average age is forty-six), but a loss of 44 members offset this gain. The total membership now stands at 3,052. Fox remarked that only 60 percent of analytic candidates are members and offered suggestions to increase candidate involvement. The Affiliates Council, reported Orbison, plans to telephone the 400 unaffiliated candidates and discuss with them the advantages of joining. In addition, Michael Bader and Eugene Goldberg are completing a pamphlet designed to acquaint new members with the work of The American and its many committees.
Fourteen of twenty applications for certification were approved by the Committee on Certification, chair Arthur Rosenbaum announced. Of twelve new applications, seven were approved; of eight continued applications, seven. Rosenbaum mentioned three problems often encountered in applicants' written reports. First is a poor description of the progress of the analytic process. Second is inadequate documentation that the treatment is psychoanalytic, as shown by resistance, transference, and the inference of a structure of the mind. Third is the lack of an expressed sense of the humanity of both the patient and the analyst. Rosenbaum cautioned that since 1991 a declining number of graduates have applied for certification. He also mentioned that a proposed revision of training standards will be distributed for comments by the institutes.
Chalfin reported that procedures and application forms are being developed for graduates of IPA institutes who wish to apply for membership in The American. A recent bylaws amendment extends membership eligibility to IPA graduates from the four IPA institutes in the United States. Membership criteria for these graduates will be comparable to the training standards of The American. An information packet and application form for U.S. IPA graduates will be presented to them in a spirit of welcome. This plan was approved overwhelmingly.
Kenneth Cohen, chair of the Task Force on Training Analyst Selection, reported on a questionnaire sent recently to the institutes, all of which replied with thoughtful commentary. He noted certain trends. Among training analysts, men are represented more than women. Only two institutes have training analysts younger than fifty. The process of selection varies among institutes, but usually focuses on the curriculum vitae and a clinical audit. Personal qualities are considered very important, scholarship relatively less so. Initiation of the evaluation process relies on procedures varying from self-nomination to recommendation by a special panel. Many institutes commented that the immersion standard of
five ongoing cases over a five-year period is increasingly more difficult to meet, a difficulty reflected in the increase of training analyst waiver requests. The process of appointment takes anywhere from six months to several years. Only a few institutes have an appeal process. No institutes reported a formal policy on the impaired training analyst. Respondents were evenly split regarding satisfaction/dissatisfaction with training analyst selection procedures, but Cohen cautioned that it was training analysts who completed the survey. From the floor came the comment that it is important that the entire faculty have confidence in these procedures.
Approved by BOPS for training analyst status were Lawrence S. Cohn of Florida, Steven H. Cooper of Boston, Karen Gilmore of New York, Janet Hadda of Southern California, James Perkins of Los Angeles, and Michael Singer of NYU. James Robinson of Houston-Galveston and Leon Hoffman of New York were appointed child/adolescent supervising analysts. Humberto Nagera was appointed by Florida as geographic rule supervising analyst for Tampa, while David Turner of San Francisco was appointed geographic rule training analyst for Portland.
Paul Roberts reported for Stephen Morgenstern, chair of the Committee on Institutes. The committee feels that the site visit process continues to improve and wishes to facilitate further its positive relationship with the institutes. To that end, pains are taken to make the final report of a site visit a report of the process of interaction between COI and the institute. This will better represent the results of a site visit than would a more static report.
Samuel Rubin, chair of the Committee on Child and Adolescent Analysis, requested approval of a pilot program for the NYU Institute. NYU will develop procedures and guidelines for selection and training in child psychoanalysis for graduates of IPA institutes. The proposal was approved.
Phyllis Tyson, chair of the Committee on Preparedness and Progress (COPAP), successor committee to CNMCT, requested waivers for nine candidates. All had excellent credentials, and approval was unanimous. Deanna Holtzman, chair of CORST, requested a waiver for one applicant with excellent credentials, also approved unanimously.