Dr. Winer (TAP 30/2) makes no mention of The American's previous grapplings with the issue of the functionally impaired training analyst. Prompted by Lewin & Ross in 1960, The American recommended the following guidelines (1961): 1. No training analysts who have reached age sixty-eight should start a training analysis. 2. Training and teaching analysts who have reached age seventy-two should usually be relieved of administrative, supervisory, and additional responsibilities. 3. Participation in educational and administrative activities after age seventy-two may continue by mutual consent agreement but without vote. Most institutes adopted the guidelines, but with vitiating loopholes: An analyst in good physical and mental health could continue practice regardless of age. Not specified were who and how that was decided. The 1974 COPER Preparatory Commission on Age and the Psychoanalytic Career, concluding that any exception rendered the 1961 guidelines unworkable, recommended their elimination (Ticho 1974, Goodman 1977).
At present, Winer's COPE study group's point of departure, institutes still lack systematic policies for analysts' retirement, illness, or death (Panel 1993, p. 192). He states that “[n]o well-defined approach to the problem is readily available.” Rather, none of the several devised by Cath, Gray, and Segel were accepted by their respective institutes and societies.
Weiss, Kaplan, and Flanagan's 1996 plan is modeled on the annual renewal procedure for physician's hospital privileges. The renewal form comprises a series of signed declarations: that the applicant has had an annual medical examination, suffers from no impairment of professional functioning, has no convictions for infractions of ethics or law, and is not a substance abuser.
We recommend a comparable policy of annual institutes appointments contingent upon review of a renewal application. The appointment committee would be empowered to request medical reports and additional examinations. The appeal procedure for those denied reappointment requires deliberation, discretion, and compassion.
I wish Winer's committee success in its charge, collecting and sharing institute experiences with the functionally impaired analysts. I wish also for their eventual evolution into a consultative, administrative, and collaborative resources of The American for institutes and societies.
Eugene H. Kaplan
References available on request.