In my last column, I wrote about the movement toward democratization that is reconfiguring our Association. I mentioned briefly the role of our societies in this movement. In this column, I would like to describe in greater depth our emerging consensus about the importance of Societies in the profound change process that is occurring in The American.
Our forty societies are the most inclusive organizations in The American and, as such, they have the potential for harnessing the energies of all of our colleagues and candidates to strengthen psychoanalysis as a science, profession, and cultural influence in this country. This is why it behooves us all to rethink and consider how to reshape our societies to help them realize their potential.
In the past, our societies were largely occupied in mounting scientific programs that were often closed to all but our own colleagues. Even when candidates were invited, they only rarely participated in the discussions. This corresponded to a time when the range of theoretical perspectives was also constricted. In recent years a greater openness to theoretical diversity has characterized these programs. At the same time, we have gradually invited mental health professionals, academics, and students to our programs. Openness, a welcoming attitude, and encouragement of full participation has not led to any diminution in the scientific level of our programming. In fact, programs have often been more stimulating, provocative, and clinically useful. While a few societies' scientific programs are still closed to nonmembers, most now welcome the mental health community. In many societies, nonanalysts now comprise the majority of the audience at scientific programs. These societies, not surprisingly, usually have strong private practices. Analysts from societies outside The American and the International Psychoanalytical Association (IPA) are also appearing more frequently on society programs. Another trend is to invite European and Latin American analysts to participate in our scientific activities; a number of societies jointly sponsor and underwrite their tours.
Increasingly our societies are offering full or partial membership to candidates. Some societies have also established psychotherapist associate memberships. This has been almost essential in new societies in undeveloped areas where the few analysts and psychotherapists dedicated to establishing a psychoanalytic presence in their communities have banded together in a united collegial effort. In established societies, psychotherapists often organize their own associations that are allied as an affiliate organization to our societies. To further encourage these developments, we have recently established a new committee, the Ad Hoc Committee on Psychotherapy Affiliates. Colleagues trained in non-American institutes both in this country and abroad have also been invited to membership in many of our societies; this applies to IPA and non-IPA institutes. These new streams of membership have served to enliven our programming and to broaden the base of membership available for participation in the enhanced agendas of our societies.
We are planning to invite medical and graduate students as well as psychiatry residents to a new student affiliate status in The American and local societies, and we anticipate that this group will prove to be a strong source of support for psychoanalysis in the coming years. This effort is being fostered by another new committee of The American (the Joint Ad Hoc Committee on Student Membership). Six societies have launched experimental programs of this type as part of The American's entry into this new outreach initiative. Many societies have traditionally welcomed students and residents to our scientific programs. Our new initiative will enhance such efforts and allow us to organize special classes, workshops, and social activities to supplement the offerings of our societies. The new committee will help our societies establish programs to supplement the local training programs of mental health professions, which in recent years have shifted their priorities away from the psychoanalytic perspective.
Some colleagues have expressed concern, even alarm, that our being so inclusive of psychoanalytic psychotherapists will pose a threat to psychoanalysis. These critical voices raise concern that such inclusiveness will lead to blurring of the boundaries between psychoanalysis and psychotherapy and to a decreased interest in pursuing psychoanalytic training. Our experience in many societies is quite the reverse, but it remains essential that we articulate the differences in technique and clinical effectiveness, as well as the varying indications for the two treatment approaches. Psychotherapists allied with us usually seek a personal analysis through which they come to know the difference from their own experience. In fact, our societies have reported that these very psychotherapists are demonstrating a strong interest in seeking psychoanalytic training. This developmental process is similar to that which patients undergo when they begin first with psychotherapy and gradually develop an informed interest and capability for undergoing analysis.
Central to furthering this natural progression is the prior need to offer psychotherapy training in organized two to three-year-long courses. Most of our societies and institutes currently have such programs, which also usually encourage supervision and personal treatment. It is crucial to these programs that we maintain a respectful attitude toward psychotherapy as we attempt to clarify the differences between psychotherapy and psychoanalysis.
Our societies would be further enriched by having significant numbers of academics as members, particularly where these colleagues obtain full or partial training in our institutes. At present this has occurred in only a small number of our societies, ones that have reached out to academics and evinced an interest in scientific dialogue with them, especially as expressed in the formation of analyst/academic study groups.
The resurgence of our societies is occurring because of our growing awareness that the survival of private practice of psychoanalysis is dependent upon vibrant, creative, politically activist societies. Educational outreach is basic to this effort at renewal. The education of our candidates has always been the primary function of our institutes, and this has been
developed to a point where we may well offer the most thorough training in the world. In the past many institutes have added on to this central mission the task of educating mental health colleagues and other professionals (e.g., teachers) as well as parents and many other groups. These added demands often overburden colleagues who are already squeezed for time and energy. Perhaps we would be better served if this task could be transferred to our societies?
The larger membership base of the societies would provide more energy, creativity, and teachers to carry out this assignment. If the responsibility for community and mental health professional education was given to societies, our colleagues would rise to the occasion and carry out this assignment with competence. Limiting the responsibilities of our societies in the past has been partly responsible for the alienation and uninvolvement of many of our colleagues, especially those who do not seek training analyst status. Many other functions could be confidently transferred to societies: postgraduate education, library, newsletter, bylaws, ethics, fund-raising, and many others. Local history and tradition might interfere with such a transfer of functions to societies. An alternative proposal would make them joint society and institute committees. It is, of course, most important that these committees exist and are well-functioning wherever they are sited.
Most would agree today that our societies must strengthen private practice through political efforts in Washington and state capitals as well as through advocacy of improved outpatient benefits for patients in direct negotiations with the insurance industry. Often alliances with other mental health groups, medical societies, and consumers are vital for such efforts. Our educational and advocacy functions thus far have been strikingly effective, and they will be necessary for years to come. There is no doubt that we will need to devote even more energy and personnel to these efforts; the broad new membership base of our societies is facultative. Candidates often have more expertise than senior analysts in these political arenas.
As our societies move toward alliances for these purposes, a noticeable trend has developed toward reunification of societies that were originally born of schisms within individual cities. These joint efforts begin with cosponsorship of scientific programs and gradually evolve to active consideration of reunification. Combining the resources and talents of these groups leads to maximal effectiveness in our continuing effort to further psychoanalysis in the communities in which we live.
Our societies are emerging from under the shadow of our institutes because their agenda is vital to the strengthening of psychoanalytic practice, just as the institutes are critically essential in training psychoanalysts of the future. As this recognition has developed, many of our most capable leaders have elected to serve the societies, whereas in the past to serve the institutes was the primary goal of seasoned and talented leadership. This change will not adversely affect our institutes. Regarding leadership, in most of our communities we have many qualified colleagues for both institute and society tasks. Society leadership should no longer be viewed as a stepping stone to leadership in our institutes.
One reflection of the new strength of our societies is the enhanced effectiveness of the Executive Council, the legislative body of our Association, which is composed of society representatives. The empowerment of the Council in turn strengthens our societies. New proposals to increase the voice in our Association of our society presidents will be discussed at the December meeting. Strong democratic societies and effective leadership are not incompatible but rather are complementary.
We must also use contemporary state-of-the-art methods of communication to engage the attention of our extended communities. Our newsletters, public announcements, and Web pages need to be developed to a high professional caliber and reach thousands of interested mental health professionals and students in every local area. For these purposes it is advisable that we use professionals to help us. High-tech promotion, however, can only be of secondary usefulness. Personal outreach to our supervisees and students in the residencies or graduate programs is still the best way to attract young people. Formal and informal mentoring of students is superior to the use of most professional promotional materials. Both approaches make for an optimal program. When students in large numbers are encouraged to attend our society scientific programs, where they are warmly welcomed and where they meet psychoanalysts who are intellectually open, who passionately care about helping their patients, and who have integrity and decency, then many more of them will be inspired to join our ranks.
Our societies today are changing their image in the direction of being more open, caring, and activist for patient rights. Our recent move to stress ethics, particularly to protect patients from unethical colleagues, as well as attempting to be more helpful to such colleagues (where they admit their errors), has helped the public gain more confidence in our societies. Our societies do not want to be perceived as indifferent to patients' complaints or uncaring about social issues in the large society. Many societies now work with police departments, new immigrant communities, hospices, parents, and many other constituencies to help these groups deal more effectively with their real-life problems.
As our societies embrace this enhanced agenda, a new committee, the Committee on Societies, has been established to serve a consultant role. The committee's help is available on a voluntary basis. Societies interested in their services will be able to access the committee's expertise at our national meetings. The value of this committee to societies will one day be seen as similar to the importance of the Committee on Institutes to our institutes.
Our societies could benefit from a closer relationship with the IPA. As we rapidly become a global village, we increasingly recognize the value of scientific and educational ties with the IPA. We discover that we face common problems in terms of government and insurance industry support of psychoanalytic treatment. Sharing our experiences will be mutually beneficial. As evidence of this new perspective, for the first time our societies will have direct liaison with the IPA. The Executive Committee has happily authorized this new development at the request of Otto Kernberg, IPA presidentelect.
American society as a whole is in a state of transformation. Our cities are undergoing renewal, once again becoming centers of learning, providers of comprehensive health care, venues for the arts and music—major ingredients for a civilized society. Psychoanalysis is an additional, necessary leavening agent for this renaissance of urban spirit, particularly as an advocate of quality mental health care. Our societies are the logical organizers for our energies to help improve our communities and the quality of life for our fellow citizens.