Like many of us, I looked forward to the evening of December 31, 1999, with a mixture of anticipation and anxiety. However, our feelings notwithstanding, the millennium arrived right on schedule. As I watched the march of time westward from the international dateline, across the Pacific, Europe, the Atlantic, and to the United States, it gradually became clear that the apocalyptic visions of Y2K and international terrorism were not occurring.
As television coverage proceeded from country to country, each ceremony was beautiful and moving, reflecting the customs and traditions of each people. Gradually we realized with relief that the Eiffel Tower was still standing and Times Square was intact. In fact, for a few hours the whole world seemed united in one joyous celebration. It struck me that there was much for which to be thankful. It also struck me that in this time of endings and beginnings, it is appropriate that we pause for a moment as an association to take stock of where we have come from, where we now stand, and where we must go.
As we enter the new millennium, psychoanalysis is also entering its second hundred years. Last November 4, we celebrated the 100th anniversary of the publication of Sigmund Freud's landmark work, The Interpretation of Dreams. The event received an enormous amount of attention in the media. In addition to a number of newspaper articles, there was widespread coverage on radio and TV. On October 29, Leon Hoffman was interviewed on National Public Radio's “Science Friday,” hosted by Ira Flatow. Also in recognition of the anniversary, I appeared on “The Connection” on NPR, the “Discovery Channel,” and “The News Hour with Jim Lehrer.” A wonderful event, “Dreams 1900–2000, Science, Art, and the Unconscious Mind,” was assembled by Lynn Gamwell and funded by the Lucy Daniels Foundation. On the anniversary date, both the traveling museum exhibit and the impressive book were introduced by a gala evening at the New York Academy of Science to an overflow audience.
These are only a few examples of the extensive media attention received by psychoanalysis and our Association over the last few years. Consider, for example, the extensive article written by Erica Goode for the New York Times about the changing nature of our Association as manifest in the December 1998 meeting. In the article she described the new image of the American as “hip, humble, and ready for a fight.” The article also appeared in the International Herald Tribune and the London Times. Never has there been such an article or such widespread publicity for psychoanalysis.
There are two important points to be made about this. The first is that this kind of publicity in itself represents a dramatic departure from our past — or, more accurately, a return to our origins. Although the psychoanalytic pioneers were in fact very active in explaining psychoanalysis to the public, later traditional and theoretical considerations caused such efforts to lapse into disfavor. For many generations, psychoanalysis withdrew into “splendid isolation,” and it has cost us dearly.
The second point is that such coverage does not occur by itself but must be cultivated and sought out. Our Public Information Committee, under the able leadership of Leon Hoffman and with the help of consultant Dottie Jeffries, has developed an ever-increasing network of contacts in all aspects of the media. We are now in a position both to respond to misinformation about psychoanalysis and also to initiate proactive articles and media appearances.
We have come far, but we must go farther. At our May meeting in Washington, we arranged for a media consultant to train our members in the art of talking to the press and TV. A number of members participated, but we must train more. The ability to talk to the press should be part of the job description for every officer of our Association, societies, and institutes. Ideally, every member should consider this an essential for a psychoanalyst of the twenty-first century. I assure you that we are better at this than you might think, and it actually can be enjoyable as well as satisfying. We will continue to make this opportunity for training available. I urge you to participate.
Our public forums have been a tremendous success, in terms of attendance of members and nonmembers as well as in achieving media attention. The December 1998 panel “Homophobia, Analysis of a ‘Permissible’ Prejudice” was virtually standing room only and was widely reported. The May 1999 breakfast on Capitol Hill, “Preserving Privacy, Cornerstone of Quality Health Care,” featuring Reps. Edward Markey (D-Mass.) and Ted Strickland (D-Ohio), drew hundreds of our members and many congressional aides, and significantly raised the profile of our Association in Congress. The December 1999 presentation “Sports and Development: Helping Children Field Their Dreams” precipitated a large follow-up article in the New York Times. Our Chicago meeting will feature a panel on “Youth and Violence: A Town Meeting,” which has already drawn significant media inquiry.
The importance of presentations such as these is not only, nor even primarily, that they benefit psychoanalysis and our Association, though they certainly do that. The importance is that it allows us to bring psychoanalytic thinking to bear on important social issues. In so doing, we carry out Freud's dream for psychoanalysis to become a force for social good. Freud recognized that psychoanalysis would always be a treatment available only to a limited number. It was his belief that the deeper service psychoanalysis could bring to society would come when psychoanalytic ideas were thoroughly integrated into child-rearing, education, and public policy. Much has been achieved in the first two areas. We stand on the threshold of the third.
In previous columns, I have described our political efforts, which continue to expand, in terms of both effectiveness and magnitude. In my last column, I described the positive developments in both the Health and Human Services regulations and the report of the Surgeon General. Here I want to focus on a particular aspect of the privacy struggle. If you are like me, it will have been a long time since you have read the Oath of Hippocrates. Hippocrates lived from 460 to 377 B.C. These are the last two paragraphs of the oath:
Whatever I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.
While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times, but should I trespass and violate this oath, may the reverse be my lot.
Remarkably, the oath contains not only a pledge of confidentiality but also a punishment, a curse, should the oath be broken. In a time when such things were deadly serious, the consequence of failure to keep this oath was be to be driven from the profession and publicly humiliated.
The implicit assumption upon which the oath rests is that the doctor-patient relationship is at the center of the healing process and must be protected at all costs. In order to fully appreciate the magnitude of change that has taken place in the last few years, it is necessary to reflect that for the first time in more than 2,000 years, the relationship between healer and patient is considered less relevant than the need for corporate profit and data collection. Never before in the history of healing has the primacy of the doctor/therapist-patient relationship been threatened.
In the past, psychoanalytic organizations and psychoanalysts prided themselves on being apolitical. The traditional role of the healer is that of a noncombatant. Even in war, armies do not generally fire on hospitals or medics. However, this is no ordinary time. For the first time, corporations and governmental agencies have taken direct aim at both patients and health professionals. For the first time, we have had to fight back to protect our patients and our profession.
We have done well. We have come to take a leading role in the battle to protect the patient's right to private independent treatment. We have established an effective political organization and network. We have developed many important contacts and allies. That is the good news. The rest of the story is that the struggle over privacy is only the beginning, the tip of the iceberg, of corporate and governmental incursions into individual liberties. Consider, for example, the high-stakes conflict that has already begun over the control of genetic information.
In a very real sense, what we have accomplished so far has been a warm-up, a rehearsal, for the even more pivotal struggles ahead. When I ran for this office, I said in my position statement that it was my vision and hope that every member of our Association, every member of every society and institute, would become a vital force in this critical battle to protect the rights of the individual. I meant it then, and I mean it now.
More than anything else, what psychoanalysis is about is individual freedom. I believe it is our responsibility and our mission to play a vital role in protecting the rights and freedom of the individual in the struggle to come in the areas of health information and the ethics of biological research. However, it is not enough to act in these specific areas of our special concerns. We must also be prepared to strike at the root causes of the systemic problems that allow corporate special interests to take precedence over the welfare of citizens. In the health care arena, this will mean working to eliminate employer-sponsored health plans and the ERISA (Employee Retirement Income Security Act) laws that protect HMOs from lawsuits. Most of all, we must help return Congress to the people by championing campaign finance reform. As long as Congress is in a position to be bought by corporate campaign contributions, we will always be playing “catch-up” as one special interest bill after another is introduced and has to be responded to. Managed care itself is in fact the product of such special interest legislation, as are the plethora of so-called privacy bills we have been battling for the last five years.
In practical terms, this means we have to further strengthen our capacity to act quickly and with maximum effect to influence legislation at both federal and state levels. The network between our Association and our societies and institutes must become stronger and more responsive. We must support our political efforts with our actions and our dollars. Our last fundraising appeal was successful in that 220 members contributed a total of $31,000. Imagine what we could accomplish if all 3,400 of our members participated!
For some, it is difficult to believe that a small organization such as ours, with relatively few members, could make a significant difference. We have, and we will.
Some believe there is nothing one man or one woman can do against the enormous array of the world's ills. …
Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring, those ripples build a current that can sweep down the mightiest walls of oppression and resistance. …
Our future may lie beyond our vision, but it is not completely beyond our control. It is the shaping impulse of America that neither fate nor nature nor the irresistible tides of history, but the work of our own hands, matched to reason and principle, that will determine our destiny.
With these words, on June 8, 1968, a grief-stricken Sen. Ted Kennedy paid tribute to his fallen older brother, Robert F. Kennedy, at St. Patrick's Cathedral in New York City. Three days before, Robert Kennedy had been fatally wounded after winning the California primary in his race for the presidency.
Margaret Mead may have put it best: “Never doubt that a small group of thoughtful committed people can change the world. Indeed it is the only thing that ever has.”
It seems clear that our Association is healthy, vigorous, and growing. Our membership numbers are increasing, attendance at our meetings not only is up but now includes a wide range of mental health professionals and younger people, and our scientific programs are both broad and deep, thanks to the leadership of Owen Renik and Glen Gabbard. We have one of the finest analytic journals in the world, and it has been greatly improved both in terms of quality and circulation by the efforts of Arnie Richards and his staff. Financially, we are solidly in the black, and our income is increasing. We have strengthened our affiliations with other analytic and mental health groups and are working closely with them on matters of mutual interest.
Matters of internal governance deserve special mention. After such a move was recommended by both the Davis-Pyles task force and the Montgomery-Kaminer committee, due mostly to the efforts of Dick Fox, our seventy-plus Council committees have been organized into six groups, each with a section chair. These six will constitute the Steering Committee, which will meet to advise the Executive Committee at the March and October administrative meetings. The larger group will continue to meet in May and December in what is now called the Meeting of Council and Joint Committee Chairs. The new arrangement allows for much more effective functioning of council committees and also creates the opportunity for past presidents to continue programs in which they have a special interest and expertise by acting as section chairs.
Under the category of business pending, the Task Force on Education and Membership is due to make a final report at this meeting. I greatly hope the proposal for full voting rights for all members and for full de-linkage will be ready for vote at that time or shortly thereafter. Both are long overdue.
I would also like to add a personal note and a personal opinion about another matter. I deeply appreciate the efforts to improve the certification process. However, because of transferential and organizational issues, it is unlikely that any improvement will be sufficient to spare BOPS and the Association the negative fallout from this process as long as it is in-house. I feel the ultimate answer to the problem is external certification, hopefully sooner rather than later. I deeply hope that a joint Board-Council committee will be established to study this issue.
This continuing evolution of our governmental structures to better serve our current needs and the new vision of our mission is entirely healthy and appropriate. Jefferson observed that “laws and institutions must go hand in hand with the progress of the human mind. … As new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must also advance to keep pace with the times.”
Our organization is unusual among professional associations in that we serve our members both in the more traditional membership functions and in the educational and training area. Some have argued that these dual functions are inherently incompatible and inevitably in conflict. To the contrary, I feel that membership and education are natural partners, each of which strengthens the other. Upon these two pillars rest the strength and uniqueness of our Association. The challenge to us is to find the organizational structures that will allow us to maximize the strengths of both. If any “fault line” exists, it is not one between education and membership, but one between our past and our future.
The one area in which we have not kept pace has been that of working to welcome independent groups. It is my hope that the separate Board and Council committees now in place will be combined in one coordinated effort to deal with this issue in an expeditious manner. I do believe that we have an historic opportunity, which will exist only briefly, to heal past hurts and to accomplish a “coming together” that will be of critical importance to the future of psychoanalysis. This goal can only be accomplished if we can rise above our tendency to establish unilateral procedures and instead meet with each group to explore whether a mutually respectful path can be established.
At this writing, discussions with the Psychoanalytic Consortium to establish an external credentialing body and to establish a national floor for psychoanalytic training standards are proceeding much more slowly than anyone would like. I believe the timely establishment of such a body and of nationally recognized minimum standards (not our standards, but minimum acceptable standards) is our best protection against those groups who are attempting repeatedly, and sometimes successfully, to create licensing and credentialing bodies. At this point, I believe that the Consortium is the only group with a psychoanalytic constituency broad enough to be creditable as a national credentialing body. I hope that these negotiations can be brought to a rapid and successful conclusion.
Finally, as this is my last TAP column, I would like to say that it has been my great honor and privilege to work with you as your president for these past two years. Together, I feel we have accomplished a great deal for psychoanalysis and for the Association. We have been able to build on the achievements of the previous administrations of Mike Allison, Judy Schachter, Bernie Pacella, and Marvin Margolis. We are exceedingly fortunate in the new leadership team of Dick Fox as president; Newell Fischer, president-elect; Allan Compton, treasurer; Ralph Engle and Calvern Narcisi, chair and secretary of BOPS; and Jon Meyer continuing as secretary. The transition will be smooth, and I have every confidence that this group will work cooperatively and effectively to lead our Association into the new millenium and psychoanalysis into our second hundred years.
For me also, this is not only an end, but a beginning. Dick Fox has asked me to chair the Committee on Governmental Relations and Insurance, a post I look forward to with great anticipation. Thank you ever so much for your help and support, and I look forward to working with you in this new capacity.