ES: Important things first. What would you rather be running, The American or the marathon?
BP: The marathon. Its a whole lot easier and not nearly as painful. I've run 40 marathons, but I've never been president before.
ES: I know you do sports consulting, but what other sports do you do?
BP: Tennis and squash, but running is the main thing — and sailing.
ES: And you have a large family.
BP: I have five children ranging in age from 16 to 33.
ES: And you play the guitar.
BP: I just picked it up again after many years. I bought a beautiful guitar at the IPA meetings in Barcelona.
ES: And you also sell guitars?
BP: My youngest boy, who's quite a musician, and I have a little business selling guitars called Doc's Custom Guitars.
ES: Your office shows yet other sides of you: an enormous amount of scrimshaw, huge pieces of whalebone with wonderful carvings, many, many whale oil lamps, behind your desk a triple row of running medals, other memorabilia all around. So, in your spare time from practice, political work, sports consulting, running, guitar shop, rebuilding your house, etc., etc. —you are going to run The American? What do you least look forward to?
BP: I think that we [in The American] are uniquely skilled at fighting with and misunderstanding each other and attributing malevolent motives and bad diagnoses to each other. This distracts us from the important work we have to do. I hope we can learn to hold our fire and actually talk with each other. I've done organizational and group consulting. Every group fights to some degree, but analytic groups are especially gifted in this respect. I was president of the Candidates' Council at the time of the PINE-BPSI split and got interested in this problem. So many people were behaving so badly that I felt either analysis didn't work or something else was going on.
Something about the nature of our work causes this problem: We are so isolated, and most of us have had little experience functioning as a team. During a discussion of guidelines for selecting training analysts, I suggested that TA's need extensive experience in team sports.
ES: — Says this man who is a runner.
BP: True, but when you function as a team member, you have to put aside your own agenda for the good of the group.
Analysts are so individualistic that we don't do that well. Also, we tend to view ourselves as experts on everything. That doesn't help. We've debated the possibility of using outside organizational consultants, but somebody always says, “Well, after all, we know more about this than anyone else.”
ES: I think we practice enormous restraint in our work with patients and that massive amounts of aggression come out in our organizational work.
BP: That's right. I'd like to see us direct some of that aggression toward our outside enemies — of which there are plenty. I think our internal fighting is a kind of defense, the result of our fear of and sense of hopelessness about the forces menacing us from outside. There's a cultural piece too. When there's a problem, my natural inclination is to tear the thing up, throw it in the air, and see what comes down. I've noticed that many colleagues have a “circle the wagons” mentality. We have different cultural heritages. My roots are Scottish and Celtic. Nobody ever said we were smart, but the first thing we do is charge rather than adopt a defensive posture.
ES: Were your people from a border region?
BP: Yes — of Scotland. When the Scots raided the English, my ancestors helped them and skimmed off a few cattle. And then when the English retaliated, they helped them and skimmed off some more.
ES: True border people. They never knew on which side their bread was going to be buttered, they just hoped there'd be some butter.
BP: I think I have a certain cultural disposition for negotiating and trying to work the borders.
ES: What are you most looking forward to during your presidency?
BP: Right now, there is a really historic opportunity for influencing legislation and the quality of health care delivery. The main reason I decided to run for president was my belief that, if a small group like CPR [Coalition for Patients' Rights] could have the effect it did and still does, then just imagine what would happen if a group the size of The American did similar work at the federal and state levels. Although many analysts don't think we can have much of an impact, we need to learn that we can.
ES: How would you go about convincing or teaching them otherwise?
BP: First, I'd stress the importance of the mission. The luxury of squabbling with each other is no longer available. We won't survive if we don't begin to protect our profession, our patients and ourselves. These ideas should be conveyed at our meetings, in TAP, and so forth, but specifically we should develop groups in each society that will mobilize activities in this arena. We just proposed a council of presidents in the hope that, if the presidents are more involved, the societies will be too. I think its vitally important for analysts to become point people.
ES: Activists.
BP: Activists, yes. Scholar-activist is the word I like. When I became politically active here in Massachusetts, I got several awards; one was from the Massachusetts Psychiatric Society. They thought it was wonderful that psychoanalysts were coming back into the professional community. In the past we isolated ourselves dramatically from professional organizations and from the public. Now there's a real opportunity to turn that around.
ES: What are your plans for getting local groups organized and functioning?
BP: I've been going around the county delivering the message and acquainting our members with what has been done and what needs to be done. There are a number of committees and groups that can be instrumental in this: CGRI [Committee on Governmental Relations and Insurance], Public Information, Barbara Rosenfeld's Liaison Committee, and the COS [Committee on Societies]. We must encourage our members to join (or rejoin) and become active in the professional organizations of their parent disciplines. The Panic Guideline is a case in point. The APA did not mention psychotherapy
as a treatment for panic in the guideline, an extraordinarily important omission. Our members must make their views known to the APA leadership. The APA is worried about its declining membership. Because so many of us have dropped out, our tremendous power is going to waste.
ES: Recently, we've taken various initiatives to increase membership by adding new membership categories.
BP: My feelings differ with regard to the different categories. I hope we find ways to have closer relationships with the four IPS groups, the W. A. White and the Horney groups. We do get into the problem of membership versus training issues since these groups have their own traditions and culture. We need to establish a dialogue so we can work together on public education and in the political arena. In general, the bigger the group, the greater the clout. The organizations I just mentioned have at least 1,000 members. Just undoing some of the old rivalries and bitterness would be a great thing. The question is, can we enlarge the group and still maintain our and their core identities?
I have great faith in the democratic political process. Most analysts have a picture or bust of Freud on their desks,-1 have a bust of Jefferson on mine. Jefferson said that democracy flourishes best with an educated people. We need to educate ourselves about each other. For example, with the Consortium, passions were heated, but I think we have been able to create a process where everyone feels they have their say and are heard. That's vital! Unfortunately, I think some of our governance structures were set up more to protect ideology than to encourage real process.
ES: It seems to me that the president can either increase the membership's belief that they aren't being heard or give them the feeling that a real consensus has been arrived at as a result of discussion. That is clearly not what happened in Council with the COPAP [Committee on Preparedness and Progress] report and the proposed by-law amendment about accepting MSWs. People felt they weren't heard.
BP: I was on CNMCT [Committee on Non-Medical Clinical Training], which became COPAP. In fact, I became active in The American because of the lawsuit. We needed to change law firms. Ours encouraged us to fight to the death. I believed we were on the wrong side of the issue and it was costing us a ton of money. When it was settled, since I wanted to be on the cutting edge of change, Dick Simons appointed me to the CNMCT. I think that master's-level people who have sufficient training are equivalent in terms of preparation to psychiatrists, particularly with the current state of psychiatric residencies. I took part in the development of the proposal about master's-level
“Most analysts have a picture or bust of Freud on their desks; I have a bust of Jefferson on mine.”
people — though I hasten to add, master's-level with additional training. This was the group COPAP studied, and they have done very well in their institute training.
ES: The issue of voting on Board issues won't come up because certification is necessary for that — though with the COPAP issue it has become apparent that it is unclear what is a Board issue and what is a Council issue.
BP: I think that a clear distinction between Board and Council functions can't be made in many cases. One of the things we've tried to do
is to create a forum where Board-Council tensions can be addressed directly. The inauguration of Board-Council joint meetings should help prevent polarization. Debating whether Board or Council is more important is like wondering which of your two legs is more important. Membership and education are twin pillars of our organization. Historically, we've been a kind of discussion group because there's been no need to be a really functioning organization. Fellows of the Board have to be training analysts, historically the position of greatest prestige. During the PINE-BPSI split I asked one of the dissidents why he didn't want to do things in the society. He said, “Who wants to be a member of a group of ex-patients?”
ES: When I was young, we thought of societies, the Council, and even the Presidency as ladies' auxiliaries.
BP: In the past, Chairman of the Board was far and away the most prestigious position, as was being a Fellow versus being a Councilor. Recently, there's been a huge shift because the functions of societies and Council are now critical.
ES: What do you think about the psychotherapy associates?
BP: I think having affiliated groups is a good idea because it creates friends for psychoanalysis and a vehicle for people to learn about it. This is a step in the direction of transforming ourselves from a club into a functioning organization. Mechanisms are needed to enhance this kind of change. When a new president of the APA comes in, he often fires some committee chairs. Of course, we don't do that.
ES: In line with that, I have two quite disparate questions. I think e-mail has the potential for really changing how we function. Why hasn't anyone said that committee chairs have to have e-mail?
BP: Actually, the day before yesterday, I asked Ellen Fertig to put that on the Steering Committee agenda, and we stressed it at the administrators' meeting and at the meeting of members.
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ES: What is The American going to do about money?
BP: I think you came up with part of the answer: One of the things you do is to raise money.
ES: I hear that the Fellowship is getting out of the fundraising business and giving up the road race. That was such a lovely thing; all these analysts out in the fresh air getting sweaty together and doing your favorite avocation.
BP: The Fellowship is the perfect vehicle for inspiring fund giving. We also need to figure out how to make our operations and committee structure more efficient.
ES: But we need more money, even if we stop being so baroque in our organizational structure.
BP: We certainly need more money for political work. If The American could raise another $75,000 a year for political work, we would have a tremendous impact in Washington.
ES: We don't even have a line for contributions to a PAC in the dues statement.
BP: No we don't. I've been working with Sam Rubin and Warren Procci to send out informational letters at least four times a year about the political situation. When that gets going, I'd like to send a fundraising envelope with it. We did that with CPR. The first letter we sent out raised about $75,000. We need money for other things too, like research.
ES: People are also concerned about the dates and the locations of the meetings and about child care. I think if changes were made, more people would attend.
BP: I think those things are at least as important as impressive brochures.
ES: Do you have any new initiatives planned?
BP: I don't think we need new initiatives. We've got plenty of initiatives! We need to use the ones we have more efficiently. I want to see our political work, our work with the media, and public education really take off. We should establish or reestablish our place at the universities. I've never thought institutes should be free-standing. Tilings like psychoanalytic studies are very important. We also need to pay attention to our own house and the efficiency and effectiveness of our internal structure. That's what I have in mind.
ES: What about our relations with the IPA?
BP: Our relations with the IPA are strained mainly, I think, because of competition for new groups. There is a real danger that there will be competitive psychoanalytic associations: Division 39, the IPS groups, and so on. There are so few of us that it won't be good for psychoanalysis in this country to have competing groups. I'm not sure of the best way to avoid that possibility. This is a very recent phenomenon.
ES: I've noticed that after someone who is very vigorous speaks at a society, there's a flurry of activity, but then it quickly dies down. How will you encourage ongoing efforts?
BP: I think you're absolutely right. We need very active ongoing liaison with societies. Characterologically, analysts are shy people.
ES: That's why we sit behind couches.
BP: Encouraging activism should be part of the education of candidates. When you and I were coming along, if you did anything other than pure clinical analysis …
ES: … something was wrong with you.
BP: Exactly. It was seen as a resistance to being a real analyst.
ES: You mentioned a variety of committees that should he in contact with societies. I think our committee structure is very redundant.
BP: We do have an enormous number of committees — many working in slightly different areas but doing similar things. There's no time for all of them to report to the Council or the Steering Committee. We are trying to group and coordinate committees with similar functions.
ES: But as I understand the proposal we voted on, it opens training to people who are without additional training.
BP: Unfortunately, the amendment as written did not really represent the intention of the COPAP proposal. The goal of the COPAP proposal is to raise standards. We reviewed hundreds of applications. It showed us that we can no longer rely on degree alone (but we do have to remember that the rest of the world does look at degree.) In a revolutionary paradigm shift, we set out clinical and didactic prerequisites for all applicants. The Gaskill Process spells out steps for training new categories of people, ultimately leading to their acceptance without waivers through a by-law change. Proposed by-laws go to Board, to Council, and then to certified members. The wording of the by-law that was passed didn't provide an escape clause for institutes that don't want to train master's-level people, and it could be interpreted as obligating them to do so. At the Toronto meeting, we asked Council to rescind the by-law amendment. It will be rewritten. Certainly the Council didn't have a chance to discuss it adequately.
ES: I think the issue of master's-level people raises a number of questions. What will it do to our relationship with Division 39, both those who are members of The American and those who aren't? I think some Ph.D.s are upset about our accepting MSWs because they've been fighting for years against master's-levels psychologists being considered the equals of Ph.D.-level psychologists. What will it do to our position in the Consortium? And what will it do to our already strained relationship with the American Psychiatric, particularly given our concern that the APA back our view that psychiatrists (though not psychiatrists alone) should be doing psychotherapy?
BP: The amendment will have to be very, very carefully written. The amendment as written did not capture the full specificity and strength of the COPAP proposal. I believe that a new, carefully written by-law, together with the full COPAP report, will make it clear to other groups and to legislators that our aim is to protect high standards in a more realistic and profound manner.
ES: Even if there is an escape clause, there still might be lawsuits against individual institutes. It is really problematic.
BP: This is a huge change, not a small step.
ES: Much bigger than accepting psychologists who are, after all, doctoral-level people and have a tradition within psychoanalysis. Or the academics we train, who are doctoral-level people and continue in their work as professors and scholars. What about the other ways of increasing membership, like student membership?
BP: I like the idea of student affiliation. It's similar to the Fellowship.
ES: Another important question concerns candidate members and the vote.
BP: I'm all for it. After all, candidates are adults. The vote and activity in The American are ways of solidifying one's identity as an analyst.
BP: We do need to push that, though I think e-mail is a mixed blessing. For instance, recently we couldn't get a notice out quickly because some committee chairs didn't have e-mail. On the other hand, there were several issues within the Executive Committee that required frank exchanges of views. Some people hid behind their e-mail rather than saying, “Here's what I think. What do you think?”
ES: I think as we get more used to the medium, things will be better.
BP: Maybe Paul Mosher could put up a notice saying, “Before using the members' list, make sure brain is engaged.”
ES: I think one reason is that groups can now go directly into the IPA.
BP: The IPA has a much shorter route for establishing training programs than we do. The IPA sponsors new groups directly, sending in a team that works with the new group for a period of years. Some of our efforts, with established institutes sponsoring new ones, have taken a very long time. We are talking with the Board about developing a more direct sponsorship of new institutes by The American, and we are about to follow that route with Minnesota.
ES: If we are going to develop new institutes, that would level the playing field and also give the Board a whole new job. Maybe that would help — an unexpected dividend — to diffuse Board-Council problems.
BP: I think that's right. The Board is concerned that its functions are being taken away from it. I do think that if they could take on this new initiative, it would be a good thing. One way we are trying to reduce the strains between us and the IPA is to have the presidents of our societies meet with the presidents of European and South American societies. Their presidents have always been invited to IPA meetings, and our presidents haven't. Now the IPA has agreed to invite our presidents too.
ES: Thank you for giving me so much of your time and especially for your candor and openness. If you can achieve even a small part of what you are setting out to do, psychoanalysis and psychoanalysts will be in a much better place two years from now.
BP: Thank you. I am certainly going to try.