It is an unusual opportunity to step back and to review from a distance what the IPA president does, as I have been asked to do. I will begin first in general terms and then continue in a more personal way.
The tasks, of course, depend on the definition of the overall mission and responsibilities that each IPA president devises for him- or herself in formulating the presidential role. I began with the realization that powerful external forces in the scientific, professional, cultural, and financial realms were challenging psychoanalysis. I saw it as an objective of my administration to determine to what extent these challenges were similar or dissimilar throughout our international community and to what extent they were being met successfully in our component societies. Most importantly, we needed (1) to devise ways that all of us could learn from the successes and failures of our individual societies in dealing with these challenges and (2) to decide what common measures could be adopted to help psychoanalysis at large. I saw the IPA's role as both to facilitate information-sharing and to develop initiatives in response to these challenges and to promote psychoanalysis.
It quickly became evident to me that if we were to strengthen psychoanalysis as a profession, we would have to pay increasing attention to our academic, intellectual, political, and cultural environment. However, I also saw that by increasing respect for psychoanalysis as a science we would contribute, more than anything else, to strengthening its role in the health delivery systems, in medicine, and particularly in psychiatry — but also in psychology, the humanities, and the social sciences at large. This solid recognition would assure our professional future and further development of our science and its applications.
From these realizations, the plans of this administration evolved in the following ways:
To strengthen psychoanalytic research by facilitating research projects, training of researchers, and cooperative efforts of the international psychoanalytic community.
To strengthen our relationship to society by means of the many activities of the newly developed Committee on Psychoanalysis and Society and by its cultivation of our relations to psychiatry, to health delivery systems, to government and funding agencies, and to the media.
To develop another new initiative, the Inter-Regional Conferences, geared to brief and intensive meetings in local areas, aimed at strengthening the relationship between local psychoanalytic societies and their academic and cultural environments.
Finally, of great importance, to foster the development of psychoanalytic science by our psychoanalytic institutes as an addition to their fundamental task of transmitting psychoanalytic knowledge at a high level of professional expertise.
These, then, were the general missions and related tasks with which I defined my own activities. We developed the administrative structures to facilitate carrying out these tasks, which meant intense work for the Executive Committee and the Executive Council. It also involved reorganizing our committee structure and implementing an active dialogue among the House of Delegates, Executive Council, and the relevant committees.
I also decided to explore personally the reality of the problems psychoanalysis was facing in various parts of the world by making focused visits to some leading psychoanalytic societies, as well as to some others with acute problems that seemed symptomatic of the challenges psychoanalysis faces today. In light of the information I was gathering, I decided to put some of my developing viewpoints into the form of position statements in an effort to draw attention to urgent problems facing the psychoanalytic community.
How does all of this look in terms of my daily work? First of all, every evening I am on the telephone somewhere between half an hour and an hour, discussing plans, conflicts, and administrative matters, appointments and schedules, with IPA secretary Robert Tyson. He is my closest co-worker and has a tactful and diplomatic talent for strategic planning. In addition, I am on the phone with committee chairpersons, presidents of component societies, and IPA members from around the world who call because of particular difficulties, questions, and suggestions.
A second, major part of my IPA work consists of direct meetings with society presidents, members of component societies, and regional organizations. I participate actively in meetings of the American Psychoanalytic Association, meeting with the Executive Committee, the Executive Council, the Board on Professional Standards, affiliate society presidents, and various IPA committees. I have similar meetings with Latin American presidents, particularly at the FEPAL conferences, which combine scientific and administrative meetings. I meet with European presidents at the times of the meetings of the European Psychoanalytic Federation, and I try to attend the scientific congresses in Europe that center, respectively, around the French-language, German-language, and English-language psychoanalytic societies.
I also have had more focused meetings with some societies experiencing particular problems. My aims are to help resolve the problems without resorting to an ad hoc bureaucratic structure and to learn more from these experiences about the general challenges to psychoanalytic organizations. Thus, for example, I have been involved intensively with a situation in Brazil that particularly affects one of the three Rio de Janeiro societies. I have been engaged in Germany with the possibility that the Deutsche Psychoanalytische Gesellschaft, a non-IPA psychoanalytic society, may come to affiliate with the IPA. I have consulted with the Swiss Psychoanalytic Society regarding internal administrative issues, and I have involved myself with educational, professional, legal, and financial issues affecting other IPA societies.
A major concern that emerged during my visits to component societies in Europe and Latin America is the strong development of psychotherapy organizations. These groups often appear to be in competition with psychoanalytic societies. Questions about the boundaries between psychoanalysis and psychotherapy and their overlapping conceptual and clinical backgrounds contribute to the political tension.
Otto F. Kernberg, M.D., is a training and supervising analyst for the Center for Psychoanalytic Training and Research of Columbia University; a professor of psychiatry at the Weill College of Medicine, Cornell University; and director of the Personality Disorders Institute at Cornell's Department of Psychiatry.
This concern has drawn my attention to the way that French psychoanalysis deals with the boundaries of psychoanalysis and psychotherapy — a very different approach from those dominant in Great Britain and the United States. On several occasions I have met with French psychoanalysts to discuss this problem, and it has motivated me to write a position statement.
Another major area of concern in many places is the relationship between psychoanalytic institutes and their corresponding psychoanalytic societies, and the vicissitudes of training that have precipitated conflicts between them. After a number of consultations on these issues, I wrote a position statement on this subject too, and both of these position statements — on psychotherapy and on psychoanalytic education — have been submitted for publication in the International Journal of Psycho-Analysis.
How does this affect my practical life situation? I attempt to travel over the weekends and usually spend two out of four weekends traveling to Europe and Latin America. I usually leave Thursday evening or Friday evening and return on Sunday evening to New York, which permits intense involvement over two or so days in the countries I visit. I travel more extensively to participate in scientific meetings or regional and inter-regional conferences, approximately one week per month. This puts significant strain on my clinical practice and my research work. I have compensated for this by increasing the frequency of sessions for my patients in psychoanalysis and psychotherapy at the times when 1 can see them. This has permitted me to carry out my ordinary clinical functions, albeit at the cost of a seventy-hour-plus work week. I hope it is not immodest to mention that I receive no personal compensation from the IPA, although I understand there has been some idea to the contrary. My administrative budget allows only for official administrative IPA meetings, plus one meeting a year with European, and one with Latin American presidents. When not compensated by a conference or lecture, I believe that subsidizing my own travel is a price worth paying for the ability to carry out this “hands-on” approach to the tasks of IPA president.
I have been acutely involved with two major administrative tasks. One has been the International Congress in Santiago, Chile, this past July. The second is an effort to radically simplify the administrative structure of the IPA in order to achieve a more functional and effective, democratic and transparent, leaner and less expensive administrative structure. As you may know, I appointed a Task Force on Structure and Mission (SAM) to achieve this goal. The SAM Task Force has presented a major proposal that should reduce the administrative IPA costs by approximately $200,000 a year and increase the importance of the regions — and of all the affiliate societies of the American. A copy of this report has been sent to the presidents of all the affiliate societies of the American as well as those of all IPA constituent organizations. I hope you will read this report, give it your attention, and convey your views to the American representatives to the IPA House of Delegates. I have been very encouraged by the work of the SAM Task Force, and I am actively engaged in pulling together reactions to it as part of the process to move a simpler, more effective, less expensive, more representative, and more democratic IPA into the new millennium.
The personal experiences of others that I have been able to learn about and learn from have kept me from falling into the isolation that anyone in a leadership position may experience. A significant part of this is the resulting sense of what our needs are and a concrete feeling of what is going on in the psychoanalytic world. I have been trying to reduce the distance between the IPA's Executive Committee and the membership at large, as well as between the IPA's Executive Committee and the leadership of our component societies. In this regard, I have been very pleased to accept all invitations that I have received from the affiliate societies of the American, with a clear consciousness of my function as IPA president from the North American Region. (The IPA rotates the presidency among the North American, Latin American, and European regions.)
It has been a great help that under the inspired leadership of Marvin Margolis and now of Bob Pyles, the American has opened its doors to a more direct relationship between the IPA and the affiliate societies of the American. It has encouraged me, as well as the IPA Executive Committee in general, to provide APsaA members with relevant and detailed information about what is going on in the rest of the world, how it influences us, and how we influence it. This column is an illustration of this increased interchange, and I am grateful for this opportunity to share my experiences.