The arrival of the yearly APsaA membership dues notice, the prospect of applying for certification, and questions from colleagues about whether or not I will be attending an upcoming meeting of the American all remind me of my lack of identification with the American and its activities. Although some of the reasons for this lack of identification are undoubtedly personal, I have come to believe that historical factors also contribute in important ways to my sense of alienation.
Specifically, I feel as though participation in the American at this point in history separates me in a divisive and destructive way from those members of my discipline who were excluded in the past from psychoanalytic training at APsaA-affiliated institutes. I am writing because I believe that I may not be alone in my alienation from the American and because I have some thoughts about what might rectify the situation.
Some background must first be established to provide context for my suggestions. I entered the Denver Institute for Psychoanalysis for psychoanalytic training under the auspices of the Gaskill Amendment to the APsaA by-laws in 1988; I graduated in 1992. Prior to entering the Denver Institute, I was involved in the early stages of establishing the Colorado Center for Psychoanalytic Studies. The Colorado Center was founded in 1984 primarily through the inspiration of Charles Spezzano, with some help from Division 39 (the Division of Psychoanalysis of the American Psychological Association) and a few extremely talented psychologist-psychoanalysts from New York City and elsewhere.
The Colorado Center, like many other institutes founded in the 1980s and earlier, was established to provide an opportunity for formal psychoanalytic training to psychologists who had been and continued to be excluded from psychoanalytic training by the American. For those of us who were clear that we wanted to practice psychoanalysis, the research waiver that was available at the time was a demeaning option.
My decision to transfer to the Denver Institute was a personally complicated and painful one. At the time I saw it as something that I had to do. I still see that way, but I am now better able to see what is regrettable about my needing to have made that choice. Having been an alienated adolescent during the 1960s, I had struggled for much of my life with feeling compelled to embrace outsider status, eschewing participation in more traditional groups. Predictably a yearning for some kind of home base and for participation in a historical tradition grew stronger as I grew older. Involvement with an institute sponsored by the American seemed to hold the possibility of participating in a multi-generational endeavor with deep historical roots. In contrast, the institute where I had been training, although full of creative, committed, and talented people, seemed devoid of the tradition that I longed for.
My impression is that other psychologists who have opted to train at an APsaA-affiliated institute rather than at a psychologist-run institute (if one was available or becoming available) are acquainted with some of the guilt that I experienced at making such a choice. Some years back, an analyst whom I respect a great deal jokingly (?) called me a “Judas.” In fact, I have come to realize that many psychologist-psychoanalysts who have trained outside the American feel precisely this way about those of us who chose differently (or who had a choice where they did not). So while I now have the opportunity to participate in the American if I so choose, to do so feels bad, knowing that there are many psychologist-psychoanalysts no less committed and capable than I who have been excluded.
I go into this personal history not because it is particularly interesting but because I believe that the tensions associated with my psychoanalytic training may be quite generic and therefore familiar to other non-medical psychoanalysts who sought training during the past fifteen to twenty years. Overall, I have not regretted my decision. I feel good about my psychoanalytic training and have become part of a well-established psychoanalytic community. The Denver Institute and the individuals involved have always seemed open to my contributions both as a candidate and as a faculty and committee member.
What I do regret is that in Denver and in other communities around the country (outside New York City), the American's opening up of training opportunities for non-medical professionals has, ironically, left a generation of psychologist-psychoanalysts partially marginalized at the local level and has dealt a blow to fledgling psychologist-run institutes. In Denver and elsewhere, psychologist-run institutes were barely congealing as ongoing entities at the time that the American opened its doors. Prospective candidates had the choice of participating in institutes with little or no history or of entering APsaA institutes that often had long histories within a given community offering access to national and international organizations of long standing. To go to the younger institute in town in certain cities could mean limiting one's local psychoanalytic colleagues to a handful; going to the established American-affiliated institute would mean joining a community. In addition, many prospective candidates were presumably in therapy or analysis with training analysts from the local APsaA institute. This is tough competition if you have legitimate, historically based reasons to get a new institute going.
In cities like New York, where non-American institutes had long established traditions, the playing field may not have tipped as dramatically in favor of the APsaA institutes when they opened their doors. If one lives in New York and chooses to go to the White Institute, there is a tradition and a large community of psychoanalysts within which one can participate. In many cities, such alternative traditions have not been established — in large measure because of the effectiveness of the American's training policies.
How this history translates in terms of people is that in places like Denver and elsewhere, there are handfuls of analysts who persisted in training at non-APsaA institutes who are now professionally isolated from
David Stevens, Ph.D., is a psychologist and psychoanalyst in private practice in Denver. He is on the teaching faculty of the Denver Institute for Psychoanalysis and is also on the clinical faculty of the University of Colorado Health Sciences Center.
many of their psychologist-psychoanalyst colleagues who opted to train at an APsaA institute. There are many such committed and creative psychologist/psychoanalysts around the country who remain marginalized within their own psychoanalytic communities directly as a result of policies pursued for so many years by the American. In addition, there are fewer avenues open for participation in national and international organizations for these marginalized analysts. In communities where there are few analysts to begin with, such schisms and divisions can only sap energy and lead to divisive ill will at a time when it seems obvious that we need to pull together to tackle the considerable obstacles that confront us all.
I have noticed that medical analysts with long-standing affiliations with the American are often surprised that psychologists could continue to hold resentment toward the Association. These medical analysts point out that psychologists now make up a significant percentage of the candidates in training and have full membership privileges in the American. I have been graciously told to notice how far the American has come, in what a short period of time these changes have occurred, and so on. What these analysts have difficulty appreciating is that what they experience as evidence of a certain institutional largesse does nothing to erase the fact that the American steadfastly excluded psychologists (and qualified others) from psychoanalytic training, as well as from participation in the International Psychoanalytical Association, for a number of decades. Outsiders believe — correctly, I think — that the American's “largesse” emerged only under the duress of the lawsuit. To these outsiders the APsaA institutes are sometimes perceived as psychoanalytic carpetbaggers, skimming off valuable resources (psychologist candidates) without particular concern as to the effect on Division 39 psychologist-led institutes.
So what to do? I think it would be a meaningful, reparative, and forward-looking move for the American to give serious consideration to the possibility of grandfathering psychologist-psychoanalysts who were forced by virtue of the American's training policies to acquire psychoanalytic training however they could. There should be a period of two to three years during which psychologist-psychoanalysts (and perhaps other mental health professionals) be allowed to apply for full membership in the American.
Grandfathering does not need to imply an abandonment of standards. Grandfathering is more about acknowledging historical realities and accepting that some individuals may have needed to acquire and succeeded in acquiring psychoanalytic competency in theory and practice through non-traditional routes. There is a long history of grandfathering in various professions, including medicine.
Such a move would have a number of consequences. First and foremost, it would signal the American's commitment to achieving a true professional pluralism the American needs to clarify what it wants to achieve and whom it is for. Can it truly embrace professional pluralism, or does it hope to maintain its essentially medical identity? To many (myself included), the American appears to remain strongly identified with medicine, unwilling to make additional moves that might be construed as a further dis-identification with medicine. Yet if the American's goals include becoming the primary national organization for committed and well trained psychoanalysts while fostering clinical practice through advocacy efforts and research, professional pluralism must be embraced, not merely accommodated. But if the American seeks to maintain its medical identity and an associated self-concept of being the sole protector of psychoanalytic standards and purity, then it will alienate its emerging constituency. Most nonmedical analysts care about standards and are going to be looking for participation in national groups that truly want and value them as members. Already there are rumblings of such groups forming.
Grandfathering would also offer an opportunity for marginalized psychoanalysts to have access to a larger community of psychoanalytic colleagues. This could have an invigorating and reparative effect at both the local and national level.
Finally, grandfathering would demonstrate the American's good faith in relation to nonmedical mental health professionals in a way that would be helpful to those of us who may be members of the American but have conflicts about it. I have no problem if otherwise qualified psychologist-psychoanalysts don't want to belong to the American, so long as they have been offered the opportunity to join.
It has recently been suggested to me that some in Division 39 might construe a period of grandfathering by the American as yet another instance of unfair competition. This would be a dark and disturbingly cynical interpretation of such a move. Why would Division 39 prefer continued exclusion of qualified individuals from membership in the American? No one benefits from the maintenance of the current unhealthy status quo.