A Conversation with Marvin Margolis

Kulish: You've been immersed in the administration of The American for several years. So you must have some fairly definite ideas as to where you want to go as president, and where you want to take the organization.

Margolis: I was asked a similar question in another interview, right before I became chair of BOPS. I have to admit that then I didn't have a clear vision, and that even after many years of experience, I still do not have a comprehensive plan that would answer all of our problems. I am somewhat suspicious of people with a visionary program for our future. But I have visited most of our societies and institutes in the past decade and have talked to hundreds of colleagues, so I think I have a sense of their concerns. My way is to facilitate discourse about these concerns, and often the best plans for the future emerge from these interactive discussions. So, now to answer your question: clearly, the highest priority of our membership is to strengthen private practice and, in a larger sense, to strengthen psychoanalysis in our country. I myself am particularly concerned about the decline of child analytic practice. Moreover, we have under our aegis hardly any therapeutic nurseries or residential treatment programs for children. There are a few programs, of course — the Lucy Daniels preschool in North Carolina, a new program about to begin in Houston — but that's about it.

Kulish: So the decline in practice is across the board, but is even more serious with child analysis.

Margolis: I'm afraid so, and that is the most vulnerable age group, one on which we could have a great impact. This is the time, I think, to invest a lot of thought and energy into turning this around. I was just in Israel, which is nowhere near our country in wealth and resources, and they have certainly other urgent priorities, and yet they have residential treatment programs for disturbed children and therapeutic nurseries directed by analysts. We should do at least as well. Research is another priority that has been an orphan — we seem to have too many such orphans. While our traditional scholarship has flourished, we also need empirical controlled studies, not only to confirm some of our clinical hunches but to add to our store of knowledge. Especially important in this respect are outcome studies. We also need to address vigorously the eroding image of psychoanalysis in the media, in the universities, and within the general culture. There are certainly many pockets of strong interest, but overall there is too much negative attention directed our way — witness the recent cancellation of the Freud exhibit at the Library of Congress. We have never had a public relations and educational outreach program that was both proactive and prepared to respond rapidly to our critics. In this area, we can multiply our impact through alliances with our parent mental health organizations and other psychoanalytic groups. In fact, we have done this in our recent response to the cancellation of the Freud exhibit. I must say, though, as much as I favor an enhanced public relations campaign, I still believe that our major energies should go to create psychoanalytic centers in every community. Without these centers to promote the benefits of psychoanalysis to our neighbors and friends, none of our goals will be achieved.

Kulish: Could you elaborate on this idea of psychoanalytic centers?

Margolis: Actually, I think it's an old idea. There was a period in the early days of psychoanalysis when we were more involved in outreach activities in our local communities. Then somehow we lost our way. We need to establish psychoanalytic centers that house the full range of our educational efforts — both the training of candidates and psychotherapy students, and outreach efforts directed at teachers, parents, academics, and other constituencies. Such centers would also be the locus of our clinical efforts in the community. I envision such centers eventually sited on a campus whose buildings will house classrooms, a treatment clinic, therapeutic nurseries, a library, an auditorium, and administrative offices. These centers would be very much a part of the community, bustling with activity seven days a week from morning to night. They would both serve the communities in which we reside and enrich us through contact with these communities.

Kulish: I suspect that when people read this, they are going to say to themselves, “ That's pie in the sky” What do you think?

Margolis: Well, it would be understandable — such centers require enormous energy and funding. But I don't think it's a dream, since it is already happening. As you know, here in Michigan we already have our first building — 11,000 square feet — called the Michigan Psychoanalytic Center. We have also significant beginnings in several other societies. Wherever this has occurred, both private practice and scholarship are flourishing. Without analytic immersion, our scholarship suffers. More important, we often turn our disappointment into internecine conflicts. But in Michigan we required over ten years really to establish our center.

Kulish: So, you counsel patience and slow building toward change?

Margolis: Right. I believe in the need for change, even more rapid and far-reaching institutional change than hitherto experienced in The American. We should move in an evolutionary way, reaching consensus through a thoughtful process of reviewing all points of view and then seeking compromises that include the best thinking of all factions in our organization. Minorities should not be ignored. In this way we achieve change that is long-lasting and not disruptive. We should treasure our theoretical, clinical, and even institutional heritage, and not do damage to it in the process of change.

Kulish: While we're on the subject, what kinds of change — organizational, institutional, and practical — are you going to work for as president?

Margolis: Well, many of them are already in place or in the early stages of development. I think first we must create a stronger Board on Professional Standards and an Executive Council whose members are more empowered to run the affairs of our organization. There is no need for divisiveness, because essentially the two bodies work in different areas. The Board's absolute independence with regard to its mandate to oversee psychoanalytic education in our institutes,

Margolis: Of course. Foundations are an extremely effective way of engaging the friends of psychoanalysis — from the professions, the universities, and the business world — and of involving citizens who promote worthy causes. We have not reached out to them in the past, because of concerns about anonymity and neutrality, and an understandable concern that patients and ex-patients not be financially exploited. I don't think we need be so fearful, if only we approach these matters in a careful and appropriate way. We cannot thrive without the financial support of foundations. Where foundations are encouraged, we have seen our influence flourish throughout the community.

Kulish: I know you have been concerned about our need to reach out to the entire community, to embrace the diversity present in our communities. Could you comment further?

Margolis: If you go to our meetings, you don't see many African Americans or members of other racial and ethnic groups. So we have to examine ourselves in this regard to see what we have been doing or not doing to prevent the diversity in the general American population from being reflected in our ranks. There are hopeful signs around the country now of such efforts that could be significantly enhanced. Our Joint Committee on Racial and Ethnic Diversity has been established to study this problem and propose solutions. We need local counterparts that might demonstrate to minorities the relevance of psychoanalysis and would welcome the-special contributions they could make to its development. Without making special efforts, we cannot break down the barriers that now exist. A good example, Nancy, is your successful effort in organizing the Arab/Chaldean American Liaison Committee of the Michigan Psychoanalytic Foundation. It stands as a model of how we can reach out to help and be enriched by contact with an immigrant community that has had little contact with analysis. Through your efforts, a quarter million Arabs in our community are hearing about psychoanalysis, and Arab mental health leaders are becoming a familiar sight at our center.

Kulish: That's one area. You've talked about ethnic or age diversity, but it's not been so long that psychologists have been welcomed into The American.

Margolis: Well, I'm very pleased that we have been moving at such a good pace toward becoming a truly multidisciplinary organization; the contributions of psychologists like yourself have enriched us enormously. Now, I think, we're ready to open up more fully to the contributions that social workers can make to The American and to psychoanalysis. Right now we have sixty-two social work candidates in training throughout the country, and they are doing at least as well as candidates drawn from psychology and psychiatry. I would hope that these facts would allow us the confidence to move forward with a bylaws amendment that would enable institutes to admit M.S.W. candidates at the local level without seeking waivers from the Board. In regard to broadening the candidate pool, I would hope that we could expand our pool of CORST and academic candidates. Most institutes have very few of these extremely gifted and talented candidates. Perhaps a Strategic Planning Committee could be established to consider how we might enhance our presence in universities and bring academics into the mainstream of our field. Though we might be challenged by the need to provide preparatory clinical training for academic candidates, this is

Kulish: I know that on the one hand you have advocated bringing to awareness, and not denying, any ethical violations that may occur, particularly boundary violations. At the same time, however, you're in some way more forgiving, or perhaps simply more open, to helping our colleagues who have slipped, especially through collegial mediation.

Margolis: I think we're all involved in slippages of some sort; it goes with the territory of being deeply involved in the analytic process. Many colleagues who become involved with boundary violations seek consultation, and even additional analysis, to understand fully the causes of their breaches. They deserve our respect and help. In fact, we can all learn from their experience how these incidents occur. Unfortunately, there are colleagues who deny that boundary violations have occurred; they continue to behave in unethical ways, insisting, for example, that it is perfectly all right to have sex with consenting adult patients. These colleagues would seem to be beyond rehabilitation.

Kulish: I know of your interest in mediation as applied also to organizational conflicts. Could you tell us how you became involved in that?

Margolis: My father was often called upon to mediate disputes, and therefore I became involved with this in childhood. So I had a good teacher. Subsequently, I have been impressed how often our colleagues become involved in nonproductive, often damaging conflicts within our organization. Luckily, I have been able, with others, to help resolve such disputes before unalterable effects, even splits, could occur. Our most recent success was the establishment of a detente between CGRI and CPR. Art Farley, Sam Rubin, Bob Pyles, and Glenn Good together crafted an agreement that has allowed us all to work together amicably with a common legislative consultant. Now our members can work together in a common effort to protect psychoanalytic treatment from interference by government and insurance bodies. We will continue to debate priorities and tactics, but we will close ranks and pour our energy into a common strategy. To do this, we need to study the processes that lead to resolution of group conflict.

Kulish: And have you any final thoughts?

Margolis: I could say much more, but I would like to end by restating my belief that The American is an association of dedicated, well-trained, compassionate colleagues who make a great difference in their communities; they care for their patients, they teach, and help others in myriad other ways. I am honored and proud to be elected president by my fellow psychoanalysts and hope I can serve them well in my term of office. A final word? I feel very lucky to be following Judy Schachter into office. She has enormously strengthened our association. I look forward to working together with an excellent Executive Committee: Larry Chalfin, chair of BOPS; Newell Fischer, treasurer, David Hurst, secretary; Bob Pyles, president-elect; and Don Rosenblitt, secretary of BOPS. I know we will make a great team.