In the past eight years I have served the American, first as Chair of the Board on Professional Standards and then as president of our association. It has been one of the greatest challenges of my life. In these years a new generation has come into leadership at both the local and national levels. Together we have set in motion a quickened process of change, true to our values but creatively adaptive to our times.
The evolving plan has been successful. Our membership is growing. We have 3,192 members. Our candidates are increasing in number (960). We have new institutes, societies, foundations, and allied psychotherapy and student associate groups. We have become a younger organization that is multidisciplinary, more democratic, and more open to theoretical diversity. We are not blandly uncritical; issues are sharply debated in our vibrant scientific meetings. Scholarship is flourishing. Our alliances with our fellow psychoanalytic groups as well as with our parent mental health organizations are stronger. We are no longer viewed as a rigid, closed, hierarchical organization. We are gaining a reputation as one of the most open, inclusive, and welcoming psychoanalytic organizations in the world.
We can be especially proud of the enhanced democratization of our organization. However, the further empowerment of our societies, candidates, institute faculties, and even the Board and Council must be continued. As long as we continue a system of checks and balances, a more democratic organization will serve us well. To further democratization, perhaps we might now begin to consider limiting terms for Councilors and Fellows, as well as granting candidates voting privileges in local and national affairs.
Our membership has become more diverse in terms of professional background, sex, ethnicity, race, and sexual orientation, thus mirroring the increasing diversity of the American population. While more than tokenism, it is only a beginning effort. We need to accelerate these developments.
Our lively scientific programs are open to all streams of psychoanalytic thought. We feature more programs than ever before related to applying psychoanalysis to social issues and the humanities, as well as to education issues in psychoanalytic training. Our public forums at national meetings welcome the general public and are media events of national and local interest. It is no wonder that attendance is rising at our meetings. Subscriptions to our journal (JAPA) and our quarterly newsletter (TAP) are rising as these house organs serve as a window on the lively diversity of our association and on that of psychoanalysis worldwide in both scholarship and outreach.
The fears that psychotherapy training programs and psychotherapy affiliate organizations would have a negative impact on our core mission of training psychoanalysts and on the development of psychoanalytic practice have not been realized. The same concern was voiced in the past when we began our foundation movement and the multiple community liaison programs now so common in our local organizations. On the contrary, growing psychoanalytic practice and influence is associated with our becoming involved with local communities. Our members' wish to help their communities arises from the same idealistic impulse that initially led them to seek psychoanalytic training to treat deeply troubled patients. We are becoming an important partner in the successful effort to redevelop a civil society that cares about its families, its children, its homeless, its school systems, and the arts. We are rightfully part of the movement to renew our urban centers.
“We are becoming an important partner in the successful effort to redevelop a civil society that cares about its families, its children, its homeless, its school systems, and the arts.”
Our ever-increasing national committees (now 72 in number) are a growing resource that can now be accessed by our local societies, institutes, and candidate organizations as well as by our foundations and allied student and psychotherapists' associations. Our committees tap the creativity and talent of candidates, students, and non-member psychoanalysts as well as allied professionals and foundation board members. A merit system governs appointments. Our association is unique in
offering so wide an array of resources to aid the internal and external activities of our psychoanalytic communities or centers.
Together with our Psychoanalytic Consortium partners, our parent mental health professions, and consumer alliances, we have become a potent force to fight for the rights of our fellow citizens who require psychotherapy and psychoanalysis. This effort especially includes protecting confidentiality and the right to contract privately for mental health care.
In many areas our efforts are too new and/or underfunded to have the impact that is necessary for fulfilling our mission. To name but a few: expanding psychoanalytic research; increasing the availability of analytic treatment for children, while reaching out directly to parents and teachers in the K–12 educational systems; and again becoming a respected and generative force in academic life.
It becomes increasingly clear that the fragmentation of our analytic world in the United States needs to be confronted. I addressed this issue in my last column. I must confess that I feared that this topic of closer alliances with our fellow psychoanalysts, even progressing toward unification, while eminently practical, might run into substantial negative reactions resulting from our earlier history of denying psychoanalytic training to psychologists and social workers. This did not happen. For the most part, in our initial exploratory meetings Bob Pyles, Don Rosenblitt, and I met with interest, good will, and an understandable reserve lest once again an interest in working together, even joining together, would lead to eventual rejection by the American.
Younger colleagues who did not go through those psychoanalytic wars, as well as many thoughtful senior leaders in many of our societies and the independent psychoanalytic groups outside the American, have welcomed our initiatives. Of course there are a significant number of colleagues inside our association who are concerned that these initiatives will interfere with maintaining educational standards. There are many outside the American who are equally concerned that their unique history, traditions, and educational standards will be unappreciated by us and are consequently cautious in beginning such discussions. We all need to remain patient and open-minded in these early stages of exploration and negotiation. Premature closure, particularly by nay-sayers, does not allow for a careful consideration of the potential for strengthening psychoanalysis.
Many are willing to consider beginning a careful, deliberate discussion about the merits of increasing joint efforts now and, should these succeed, possibly working toward unification in the future. I sometimes wonder if I am dreaming that the interest in cooperation and unification is so strong. In many centers I have been astonished at the already existing development of local collaborative efforts in scientific programming and educational outreach. The Boston Psychoanalytic Society and Institute, the Psychoanalytic Institute of New England, and the Massachusetts Institute for Psychoanalysis (a Division 39 associated institute) have a very successful joint program for medical students, residents, and psychology and social work graduate students. In New York, the recent “Seduction Hypothesis” conference co-sponsored and organized by the American, the Independent Psychoanalytic Societies (IPS), William Alanson White, and the Institute for Psycho-Analysis (London) drew more than 600 attendees and was a landmark scientific and collegial success. Los Angeles programs sponsored by the Federation of International Psychoanalytical Association Societies (FIPAS), a coalition of two American and two IPS societies, have drawn large crowds; many attendees are not members of any of the four societies.
Psychoanalysis is demonstrating that we can attract the interest of large numbers of people. In Seattle I discovered that the candidates of our Seattle institute and two non-American institutes (the Center for Object Relations and the Northwest Center for Psychoanalysis) meet monthly to hear clinical presentations by the training analysts of each of the three groups. The walls are coming down, a respectful dialogue develops, and we begin to appreciate the value of different points of view. True, there are differences that for many are unacceptable, but they need not keep us so isolated from each other as occurred in the past.
We have reached a point in our exploratory discussions with the IPS where a proposal has been jointly created: that the two organizations consider an initial cooperative effort in scientific programming, public information, and health care legislation which would be monitored by a group of six APsaA and six IPS colleagues. If the experiment succeeds, the coordination group could then suggest additional steps to their respective organizations' governing bodies. This process could be continued up to the point of unification or stopped by mutual consent at any point. This proposal will be brought to the Board of the IPS in the near future and the American's Board and Council in Toronto. I hope that we will all have the courage to attempt this experiment.
“Psychoanalysis is under siege. We need to be united in order to effectively pool our talent, numbers, and institutional strengths to promote psychoanalysis in our country.”
While both organizations belong to the IPA, admittedly we have developed somewhat differently. We can learn from each other and gain from such efforts. If we went all the way to unification, it would mean that we would have to exhibit some degree of flexibility that need not compromise educational standards; we should not expect that all differences be obliterated. Actually, considerable differences already exist among our own institutes and societies. We have never been a totally monolithic organization. This flexibility has been one of our strengths.
A slow, carefully monitored process would be necessary to give both organizations an opportunity to become better known to each other. In New York and Los Angeles, this process has already begun and most colleagues have experienced it as useful and comfortable. A significant number of colleagues in the IPS and the APsaA already enjoy joint membership. If we were ever to proceed to unification with the IPS, it would be expected that the IPS continue to maintain its separate organizational structure, as well as its present relationship to the IPA.
Similar steps might be attempted with independent institutes and societies that are associated with other entities, e.g., Division 39, the American Academy of Psychoanalysis, or the National Membership Committee on Psychoanalysis in Clinical Social Work. These organizations need not be affected by such unification, as they fulfill a vital role for psychoanalysis within their respective professional organizations. In fact, many of our members are also members of the aforementioned groups. More should join, and we need to strengthen such intra-professional efforts.
Some might wonder what role remains for the Psychoanalytic Consortium should unification become a major successful effort. I believe that the Consortium will still be able to serve as an umbrella psychoanalytic organization that establishes a floor for standards for psychoanalytic training through joint external accreditation efforts. It will also continue to serve as a locus for joint efforts in health care reform, public information, and ethics. All psychoanalytic groups will not choose to join the American at this time. The Consortium has served us well as an opportunity to demonstrate that we can work together and has actually been the inspiration for unification efforts.
Psychoanalysis is under siege. We need to be united in order to effectively pool our talent, numbers, and institutional strengths to promote psychoanalysis in our country. In my view we do not need to create three federations. The IPS may shortly create such a federation. Division 39 may not be far behind. Perhaps the American could serve as a home to all? Increasingly we read the same journals, the same books, and we are all multidisciplinary.
Finally, we have discovered that there are a number of free-standing institutes that may be ready to accept our IPA-mandated standards. One of these is the Southwest Center for Psychoanalytic Studies in Arizona. Many of the faculty are either IPA members or members of the American or both. This institute wants to join the American, and it is already in the process of implementing our standards. At present we do not have procedures to allow such societies and institutes to join our association. To facilitate such a development, we will need to devise procedures to grandfather in the existing faculty and candidates and consider how to phase in the IPA/American standards for post-agreement candidates and faculty. The American graduates on the faculty of this freestanding institute support such an approach.
Do we want to further the Balkanization of the psychoanalytic movement in this country?
Many of us would support the creation of a joint Board and Council committee to begin studying how to best approach such an opportunity. These issues affect both Board prerogatives (e.g., educational standards) and Council prerogatives (e.g., membership and alliances). Therefore, a joint committee would serve us best.
There are many worthy free-standing institutes in this country that would make major contributions to the American were we to find a pathway for their inclusion. Foremost among them is the William Alanson White Institute. This is one of the major generative groups in American psychoanalysis. Its leadership is similar to ours in vision and values. Its scholars are among our most creative contributors to psychoanalysis in this country. We like each other and comfortably pursue many joint projects. However, the institutes educational traditions are somewhat at variance with those of the American, although similar to those of the Paris Psychoanalytic Society, one of the most prestigious psychoanalytic groups in the IPA.
What compromises on both sides would be required to allow a successful marriage? Many of the White Institutes traditions merit our interest. For instance, they require four analytic cases for training; we require three. We require a minimum of four-times-weekly sessions for training experiences; they require three. While I prefer five times a week, I know that a mutative analytic experience primarily requires a deep interactive immersion in the cauldron of the dark — and creative — living forces in the human personality. Numbers do not guarantee this, although in most instances they can facilitate the process. William Alanson White is proud of its traditions; we are proud of ours. I believe we could find a way to join together. This would be part of the work of a joint Board and Council committee.
The major danger to standards today resides in the lack of adequate educational and clinical prematriculation experiences for our candidates and declining private practice opportunities. We have strategies to correct those problems. They should be augmented by fellowships and loans for candidates. These problems are common to all institutes inside and outside the American. Standards will decline unless we pursue solutions. Again, we could do it best through unified efforts.
I would like to address one final issue that involves alliances. We are almost all members of parent mental health associations (psychiatry, psychology, and social work). For too long we have been isolated from our basic mental health disciplines. Some of this has been due to our arrogance and elitism, and certainly some of this has been due to those organizations' disdainful attitude toward psychoanalysis.
Faced with the common enemy of managed care, we have begun to work more closely with the leadership of the American Psychiatric Association. We are being appointed in growing numbers to APA committees. We must prevent the issuance of diagnostic guidelines that are inimical to psychotherapy and psychoanalysis. We wish to have a greater access to training of residents. The present leadership of the American and the APA now recognize that we need each other. Does this argument begin to sound familiar?
Our psychologist and social work colleagues also need to re-involve themselves in the organizational and educational activities of their parent organizations. To stand aside as an alleged independent profession is suicidal. Psychoanalytic education should be regarded primarily as sub-specialty training in the major mental health professions of psychiatry, psychology, and social work.
“To stand aside as an alleged independent profession is suicidal. Psychoanalytic education should he regarded primarily as sub-specialty training in the major mental health professions of psychiatry psychology, and social work.”
This is the last time that I have the privilege of writing this column. I thank you for your confidence in electing me to the presidency of one of the most respected psychoanalytic organizations in the world. I have tried to do my best to carry out my responsibilities. I have attempted to be fair to all points of view and to be everyone's president. Yet I have not been reluctant to take stands that I have felt were good for our organization and psychoanalysis even if they were not yet consensual.
I could never have been effective without the extraordinary dedication and talent of our elected leaders, our committee chairs, and our candidates and graduate analysts. Ellen Fertig, our administrative director, is a national treasure, and she and her staff have been indispensable to our growth and development. My wife, Tami, has been my chief support and critic and has devotedly stood by my side throughout the many difficult moments that are a necessary part of working for the American. I thank her for her help as well as for her independent contributions as a member of the Board of the American Psychoanalytic Foundation.
We have been blessed with officers who carried out their duties in an exemplary way and merit our gratitude for their innovative and dedicated work: Don Rosenblitt (BOPS chair), Bob Cummings (BOPS secretary), Bob Pyles (President-elect), Newell Fischer (treasurer), and Jon Meyer and David Hurst (secretaries). I would like to speak personally about each officer's effort and special gifts. I will reserve that for another occasion, although I must acknowledge that owing to the rising amount of Executive Committee work, each has assumed a larger range of responsibilities that would in earlier years have constituted the total workload of a president of the American. I would like to mention the names of all of our committee chairs, but this is not practical. They all should be honored for the endless hours of devoted and valuable service that they render us day in and day out.
When I first assumed office we were a much more divided organization. I hope that I have contributed to greater unity, higher morale, and a useful vision of our organization's future. I am particularly proud of having supported the current revision of our ethics procedures under the direction of Ralph Engle. The revision is vital for our organization's integrity as well as our patients' protection.
Bob Pyles, our president-elect, has been of enormous help in achieving these results. On the basis of many years of working very closely with him, I can say that the American is now going to be led by a man of integrity, enormous experience, and talent. He is a consensus-builder and has exceptional knowledge about the strategic effort that is needed to protect psychoanalysis in our political world. He promises to be one of the greatest presidents that the American has ever seen. We have shared this job and worked as a team, a tradition that I am certain he will continue with Dick Fox, our new President-elect. I know that Bob and I are both pleased that Don Rosenblitt is chair of the Board on Professional Standards at this time. His concern for maintaining standards while carrying out his responsibilities with wisdom and flexibility is critical for our survival. The American is in exceptionally good hands.
Finally, it is no secret that the deep friendships that develop for all of us in the course of performing our duties are as important as the jobs themselves. I know that these friendships will endure. Psychoanalysis will more than endure; I believe it will flourish in coming years. We can be very hopeful about our future. Thank you for allowing me the privilege of serving as your president.