No one doubts that during a large portion of our lives we are inundated by the omnipresent influence of the marketing orientation of contemporary American culture. To many of us, the concept of “marketing” is synonymous with the manipulative use of unconscious and/or transferential messages for the financial benefit of (or the political domination by) the few at the expense of the many. Many of us believe that such a marketing orientation runs counter to the value placed by psychoanalysis and psychoanalysts on the central importance of each human being as a unique autonomous person, ideally making conscious rational decisions as to how to live his or her life.
If we, as an organization, develop an effective marketing plan, will we be proceeding counter to this most important value? On the other hand, without an effective marketing orientation, can we compete successfully in the marketplace of ideas, given that we live in a pluralistic diverse culture where authoritative pronouncements do not carry the valence that they carried in previous generations? A central goal for the American in 2001 is to implement an effective ethical marketing plan, more than a decade after the groundbreaking work of the Task Force on Research and Information, which released its report “Marketing Psychoanalysis” in 1990.
That committee, chaired by Norman Clemens and including Arthur Farley and Paul Mosher, stated:
Psychoanalysis is often depicted in the public mind as something mysterious and convoluted, or fusty and arcane. The facts are otherwise. The message is simple. Psychoanalysis is:
listening to patients and allowing them to express themselves in their own way;
a rock solid commitment to confidentiality, high ethical standards, and attentiveness to the therapeutic relationship;
a flexible and comprehensive model of mental functioning with multiple perspectives, on which rests
highly individualized treatment for a range of difficulties, which is designed to reach a definitive conclusion;
an established and influential part of American medicine, psychiatry, psychology, [social work] and culture;
a rich source of knowledge about children and families and concern for their healthy development and welfare; and
quality control on both the national and local level far beyond that of any other school of psychotherapy, supported by the requirement of a personal analysis for every psychoanalyst and extensive training after standard professional education.
How did we get to the state where the repute of psychoanalysis had sunk to a nadir in the public eye and in the scientific community at large? Three factors jump to mind in response to that question.
As a result of its great popularity in the post-war years, psychoanalysis promised more than it could deliver.
As a result of its immense successes, organized psychoanalysis insulated itself from the rest of the scientific and medical community as well as from the ever-growing cadre of psychoanalysts who were not part of the American Psychoanalytic Association.
To its peril, organized psychoanalysis closed its eyes to the profound change that was occurring in American psychiatry. This was as a result of, first, the development of successive editions of The Diagnostic and Statistical Manual of Mental Disorders (DSM), published and successfully marketed by the American Psychiatric Association, and second, the explosive development and sophisticated marketing of psychotropic drugs.
These factors contributed to an underlying attitude among the psychoanalytic establishment: “We know best. Those who do not listen to us or come to us (almost by accident) should be ignored.” Predictably, psychoanalysis itself came to be ignored, while competing ideas took center stage, particularly in the mental health delivery system. “If we build it, they will come” simply did not work. Without knowing that psychoanalysis existed, few came to us.
In the current climate at the beginning of the twenty-first century, in a world of managed care and “a pill for every ill,” psychoanalysts have an unprecedented opportunity to communicate to the public that these attitudes are destructive for everyone in the community. We need to communicate intelligently and effectively that, in fact, “talking therapies” are very much needed by the public. Psychoanalysts have to show that the talking therapies are alive and well, providing a unique form of treatment. By promoting the value of psychoanalysis and the derivative talking therapies, we will counter the negative prevailing attitudes.
As a result of our public information success, the visibility of psychoanalysis, the American Psychoanalytic Association, and its members have dramatically increased during the last several years. With this new visibility comes an opportunity and responsibility to combine modern marketing knowledge with our understanding of current psychoanalytic theory and practice to create effective messages for the press, the government, and the public. For the first time, we have the opportunity to affect the state of psychoanalytic practice through our public relations efforts. Using marketing expertise, we can design messages that are more likely to result in increased patients in psychoanalytic practices.
Of course, as we actively encourage public identification of psychoanalysts and psychoanalysis and become involved in marketing projects, we have to realize that there may be unintended negative consequences of this public communication of psychoanalytic ideas. For example, the transference issues of our own patients may become more complicated, and we may have to understand and address the individual ramifications for our patients of our public appearances. Such concerns have prevented psychoanalysts from having an unambivalent commitment to public communications
Leon Hoffman, M.D., is co-director of the New York Psychoanalytic Society's Parent-Child Center and chair of the American's Subcommittee on Marketing Issues and Committee on Public Information.
and marketing, which would do wonders to spread the word in an ethical way — who we are, what we do, and how we do it.
It is possible to develop ethical market-informed messages and market-educated ways of thinking that would inform all of our publicity materials, our style of interacting with the press and public, and our style of interacting with other organizations. This material would be used to train our members to give psychoanalysis a face in their local press and communities. The ultimate goal is to build upon the dramatic increase in our public information effectiveness during the past several years. In this way we will educate the general community on how to take advantage of our knowledge and skills. The psychoanalytic profession will continue to have influence, ensuring that the public hears the message of the unique value of a psychoanalytic perspective.