Newsweek magazine predicted in January that psychoanalysis won't survive this century. How can we prevent this dire forecast from coming true? We analysts understand how past and present interact, helping us aid our analysands to lessen past burdens and to enlighten and enliven the present, though we claim no special expertise about the future. However, we may sell ourselves short with this disclaimer; many of us retain Freud's modestly realistic view that one may learn from the past and thereby influence the future beneficially.
As analysts, we can and must work together to save the life of psychoanalysis as a science, as a therapy, and as a humane psychology. We must strive to enable it to long outlast the present century and to remain a permanent aspect of civilized life. My view is that psychoanalysis is a global enterprise that cannot be limited any more by the many parochialities that pervade our partisan politics, divide our loyalties, and prevent us from achieving our shared goals. Cultural and intellectual diversity should be treasured, but cultural and intellectual isolationism in psychoanalysis will bring Gresham's Law to bear on our field — It will drive out the immensely valuable richness of psychoanalytic knowledge and insights, leaving only isolated fragments of what might have been. It need not be so.
Some disturbing signs suggest an increased partisanship. To help see the whole matter in perspective, a brief review of some points of recent history is necessary.
I learned about the IPA relatively late. Like my colleagues, I was well protected from outside influences in my analytic training during the 1960s, which was the heyday of ego psychology and insurance support for analysis. Attending my first IPA Congress in Rome in 1969 was a confusing experience. Although many people said they were analysts, I couldn't understand most of them. What was the IPA and what was it for, I wondered?
Living and working in London as an analyst for the next seven years was a remarkable educational experience. I began to understand that psychoanalysis was more than I had been taught, and that the organizational conflicts that had wracked and almost wrecked my American institute came in many flavors and on many levels.
Returning to the States in 1977, I reflected on what the IPA was all about from an American's point of view. I had seen what it could mean in Europe and in Latin America. However, the APsaA seemed to serve the needs of psychoanalysts and psychoanalysis adequately in this country. I also saw evidence that strands of analytic thought from abroad were emerging and growing here. Furthermore, the American was beginning to encounter difficulties in several dimensions. Slowly I realized the IPA wasn't doing anything specific for American members, except for those who participated directly in IPA activities and were involved in analytic endeavors beyond our borders. But the organization seemed unfocused even there.
The IPA, founded by Freud in 1908, has grown into a global organization with more than 10,000 members and sixty-four societies in thirty-three countries. Freud's aims for the IPA involved ideas of protection, promotion, and transmission. Hierarchical and bureaucratic concerns inevitably arose, especially as institutes for psychoanalytic training were set up. In the late 1930s the American particularly objected to the IPAs establishing required training standards. This objection was based on the fear that the Europeans' policy of admitting non-medical professionals would' be detrimental to the status of psychoanalysis in the United States. (Robert S. Wallerstein documented this well in 1999 in his book Lay Analysis: Life Inside the Controversy.)
World War II intervened. A solution devised before the war was implemented afterward: The American would be established as a regional association with responsibility for its own admission and training policies; the IPA would interact with the American only through the APsaA's elected officers and their central office; and the American's affiliate societies would have no direct relationship with the IPA. These conditions were Incorporated into the IPA's constitution and by-laws, and the organization has developed over the past sixty years with this agreement at its core.
Although there were some desirable results from the relative isolation of North American psychoanalysis, this agreement brought with it certain unintended and unanticipated consequences:
Photo by Mervin S. Stewart
The cultivation of a distinctly American ego psychological approach, which informed and exclusively dominated the literature and training that prevailed for decades in the United States but was poorly understood internationally.
The emergence of a parallel parochialism that eschewed the teaching of any “alternative schools of thought.”
The disappointment of growing numbers of non-medical clinicians who sought but were excluded from the excellent training offered by the American's institutes.
As the numbers of disaffected non-medical clinicians increased, other training centers were established; some members of the American cooperated in teaching, supervising, and analyzing candidates in these centers according to standards similar to those of the American. Ultimately this disaffection fueled a lawsuit by a group of psychologists against both the American and the IPA for restraint of trade. The IPA was a party to the suit because of its decades-long agreement with the American granting it the exclusive right to authorize new psychoanalytic training centers in the United States, with only its graduates becoming IPA members.
After extensive and expensive negotiations, the 1989 settlement agreement required the American to provide access to psychoanalytic education and clinical training for non-medical clinicians, accelerating moves in this direction that had been under way for some years. The settlement also mandated the IPA to consider any group that wished to affiliate with it and to abolish the agreement giving the American exclusive right to authorize and oversee all psychoanalytic training centers in the United
Robert L. Tyson, M.D., F.A.P.A., F.R.C.Psych., is a training and supervising analyst (adult and child) for the San Diego Psychoanalytic Society and Institute. He is also a geographic child supervisor for Denver Psychoanalytic Institute; a clinical professor of psychiatry at the University of California, San Diego; and secretary of the International Psychoanalytical Association.
States. This led four non-American institutes to join the IPA, and it opened the door to other interested groups affiliating directly with the IPA. These changes eventually began to relax the stringent insulation of communication between the American and the IPA, established decades ago, and efforts to reestablish lines of communication — like this series of TAP articles — are under way.
How do these events affect the current relationship between the American and the IPA? This question faces us as we enter the third millennium. The lawsuit settlement required the IPA to provide a route for direct affiliation with the PA for any established group that desired it. As a consequence, the American no longer holds hegemony over analysis in this country. As new groups consider whether to affiliate with the American or directly with the IPA, some members of the American have interpreted this to mean that the IPA is in competition with them for such groups. The IPA holds a different view: Since the members of all groups become IPA members, whether the group affiliates through the American or directly with the IPA is of little consequence to the IPA, although it has consequences for the American.
I believe the time is more than ripe for the IPA and the American to work together toward strengthening psychoanalysis worldwide. Were the IPA and the American to work cooperatively, not only would this augment the strength of analysis globally but it would also enhance the image of psychoanalysis in the “outside” world.
Furthermore, it would be a positive and far-sighted contribution to the enrichment of American psychoanalysis were the American to facilitate its members' interactive participation with all other IPA members, instead of maintaining or amplifying barriers. For example, as more views of American psychoanalysts are being debated internationally, additional room could be provided in APsaA meetings for presentations and interchanges with colleagues from other parts of the psychoanalytic world. This is already beginning to happen in the pages of JAPA. The importance of being part of and contributing to an organization that supports psychoanalysis worldwide as a patently worthy and worthwhile cause would have immediate practical results in the building of bridges between the two organizations. In the long term, it would lead to a growing coherence and solidity of psychoanalysis.
The paradox is that as the American is opening up, it appears at times to be moving away rather than toward the IPA and a long-term world view of psychoanalysis. As in the 1930s, local parochial concerns, rather than the global interests of psychoanalysis, are driving the agenda.
An example of such a concern is in the area of finance. For instance, if the American were to withdraw from the IPA, it could anticipate a strengthened financial position. This would give an immediate positive boost to the finances of the American, which would undoubtedly use it to subsidize its own activities in research and its own committee activities, for just two examples. This would correspondingly decrease the IPA's ability to support worldwide research and its Summer Research Training School and would seriously affect many other cooperative efforts worldwide.
The alternative, of course, would be for the two organizations to collaborate in areas of common interest, such as in research, child analysis, women and psychoanalysis, ethics, the impaired analyst, attempts to address prejudice and promote racial and ethnic diversity (which led the IPA to be recognized by the United Nations as a non-governmental organization with special consultative status). These are the sorts of things we could address more effectively cooperatively, as colleagues, rather than competitively or in isolation. Without mutual cooperation, it is questionable that comprehensive research on psychoanalysis or concerted and combined efforts to support psychoanalysis will be possible in any single region.
To repeat, if ties with the IPA are threatened or severed, the risks include not only a renewed isolation but also the jeopardizing of many current cooperative efforts including the maintenance of training standards around the world. There would be serious risks to research efforts now supported by the IPA, of which the United States (not simply the American) is a major beneficiary. A number of activities in other parts of the world that aim to strengthen psychoanalysis to the benefit of us all would also be endangered.
The current IPA administration, with an American president and American secretary (both with long histories of contributions to and committed participation in American activities) and excellent support in the IPA Executive Council, has been seeking areas of increased collaboration with all its component societies and with the American. It is exactly because this administration came to office in 1997 with the same questions now being asked by some of our colleagues on the American Executive Committee that we have invested our energies in reorganizing the IPA at many levels to become an effective agent of global psychoanalysis.
As the umbrella psychoanalytic organization, the IPA has provided major support for psychoanalytic research, establishing a network of psychoanalytic researchers and publishing the Open Door Review of Outcome Studies in Psychoanalysis. In addition, it has undertaken the following (and there are still other goals):
To increase scientific and professional community engagement, providing well-known IPA authors and financial support for conferences based on local preferences involving psychoanalysts, mental health clinicians and universities (e.g., the recent conference on Women and Power held in Atlanta, jointly sponsored by the IPA, the American, and Emory University).
To expand our relationship with society at large and to support the clinical practice of psychoanalysis by sharing successful strategies among the societies, learning much from the American's achievements in this area.
To clarify the role of dynamic psychotherapy in its many facets, including its relationship to psychoanalytic training — issues that vary widely among countries.
To bring into clearer focus, and to address, the many problems in psychoanalytic education that exist among our societies, including the methodology and content of teaching, and to evaluate the impact on practice of the different modes of psychoanalytic education being employed today.
To facilitate the development of psychoanalysis in new countries and regions — for example, in countries formerly behind the Iron Curtain — and to provide expertise in developing new groups.
To increase the transmission of psychoanalytic knowledge and information by supporting translations of important works.
To pursue this ambitious program effectively requires a competent organizational structure, competently run. A much-needed transition in the IPA's legal and financial structure has been completed recently under the Committee on Organizational Transition. The Task Force on Structure and Mission (SAM) is dedicated to producing the best possible solutions to the problems of governance, financial management, conference and International Congress management, and committee organization and oversight, with the highest attainable degrees of democratic representation, accountability, and functionality. SAM's second report to council, including the accompanying minority report, has been widely discussed among the societies, and the task force is working to fashion a proposal for still wider distribution based on the many suggestions received. An upgrading of the IPA's central office to meet the increased demands for support, financial and congress management, budgeting and legal expertise, etc., has begun. We provide more services now to more members more directly than ever before, accomplished without increasing dues in the last ten years by increasing overall efficiency and reducing non-productive activities to the minimum.
The scope of the IPA's objectives demonstrates that as the psychoanalytic umbrella organization, it is positioned to pursue and integrate activities globally for the benefit of our patients, of psychoanalysis, and of psychoanalysts. We look forward hopefully to an era of increasing collaboration with and collegial responsiveness from our regional association, the American Psychoanalytic Association and its affiliate societies.
This is a time of increasing awareness of the interdependence of social, intellectual, and cultural change around the world. The conclusion seems inescapable that the future of psychoanalysis lies in fruitful collaboration among all psychoanalysts and psychoanalytic organizations. The United States' contribution is vital to the vigor and creativity of a worldwide approach to understanding the human mind and promoting its healthy development and restoration. The IPA has been devoted to these goals during its eighty-year history; they are more urgent today than ever before.