When we were selected to lead the Board on Professional Standards, the most frequent congratulatory message was, “The American is really changing.” Behind the words was a fact: Since the psychologists' lawsuit in 1986 and the Gaskill proposal fifteen years ago, there has been enormous change in our organization. Most significantly, we have become less exclusive and more inclusive in our selection of candidates for training.
Now the focus of change is on building relationships. Several years ago, when he was president of the American, Marvin Margolis wrote a column for TAP about beginning efforts to welcome freestanding, existing societies and institutes into the Association. At that time, APsaA officers and representatives were talking with the officers of these institutes about the nature of our organizations and getting to know each other in a number of ways.
We began to work together on committees and as speakers on each other's institutes' scientific programs. A frequent concern of institutes with which we have been talking about affiliation is that they will be swallowed up by our organization and lose their highly valued uniqueness and individuality. In fact, within the American, we explore and accept many psychoanalytic theories. We are increasingly open about technique and increasingly candid about what we do in psychoanalysis.
Many of the visions of the recent past have become realities. Last year the Committee on Accreditation of Freestanding Institutes (CAFI) came into being. This year we held discussions with the four IPS societies (the Institute for Psychoanalytic Training and Research and the Freudian Society in New York, and Los Angeles Institute and Society for Psychoanalytic Studies and the Psychoanalytic Center of California in Los Angeles), the Karen Horney Institute, the William Alanson White Institute, and the Southwest Psychoanalytic Center. They all share an open, healthy suspicion about our motives and interest in them. There is still a sense that the American is an exclusive organization composed almost entirely of physicians. Since the lawsuit, the American is open and welcoming to psychologists and social workers, but our image has not changed as much as we think.
What we are doing in these preliminary discussions precedes the formal process mandated by BOPS. Individual negotiations will be required to fit the specific circumstances of each affiliating process. As Don Rosenblitt wrote in TAP earlier this year, “It is possible to create structures that will help independent groups develop toward integration into the American,” and we must “be prepared to flexibly develop [a] mutually acceptable process for achieving accreditation.”
As a first step for institutes that have been organized for many years, an enabling committee (similar to the sponsoring committees set up for the Minnesota and Berkshire groups) would maintain close contact with the institute, familiarize themselves with every aspect of the institute's involvement with the American, advise on steps toward accreditation, and report back to CAFI on progress toward full accreditation. After review of procedures used in appointing faculty and training analysts, the American would “grandparent” the institute's faculty and training analysts if the review showed administrative integrity and if the analysts agreed to conduct analyses and supervision according to APsaA standards. Upon completion of these steps, an institute would become an allied institute of the American. While there are additional steps in the process of accreditation, these first ones are crucial.
Several other approaches would be helpful in the affiliation process. First, since the CAFI process is slanted toward the American's getting to know the freestanding institutes, it is essential that they continue to get to know us. The workings of BOPS and its committees are mysterious to all of these groups. Their members are sitting on APsaA committees and workshops, but this trend needs to increase from the beginning of the affiliation process, in addition to welcoming them to BOPS and Executive Council meetings.
We have discovered that our certification process seems threatening and foreign to all of these groups. As certification is central to the work of enfolding freestanding institutes, some ongoing meetings will be necessary to communicate the importance of certification as well as explaining how the process works.
A universal fear of these groups is that they will be changed and diminished in the process of affiliation. Those unfamiliar with the American need to know that we actually function as a group of affiliated, unique institutes. While our institutes share the same standards and principles of education and ethics, there is no cloning of institutes. Each has its own strengths, culture, and traditions, a fact that is not generally acknowledged, either inside the American or outside. Attending a COI or CNTF meeting could be quite helpful in demonstrating this. The guidance of the enabling committees should be complemented with direct experience with other parts of our organization. Certainly this would be a test of our openness toward new people and new groups.
As we look back at the lawsuit and the Gaskill proposal, we can remember fears that the lawsuit would cripple us or be the end of us, or that opening up the American would be the end of high educational standards. If the past fifteen years can be our guide, we will entertain the same fears as we actively open the American to other groups whose members have been trained and are training candidates in ways with which we are not familiar.
However, our experience with diversity has shown that training a wider group of candidates leads to richer, more exciting psychoanalytic training. We can fairly say that our organization has profited from the risks we took years ago. We are stronger from our experiences, examining new questions and juxtaposing them with more familiar ones. Now we again attempt to integrate necessary change without losing the best of our earliest traditions.
In addition to CAFI, there is a complementary council group: the Task Force on Independent Societies, chaired by Glen Gabbard, who is also a member of CAFI. The two work together closely, sharing information and arranging meetings and telephone conferences with the independent societies and institutes.
The process of affiliation may take a unique path for each society or institute. For instance, the Southwest Psychoanalytic Society was accepted as a society of the American in May 1997. Then in May 2000, the organization applied as the Southwest Psychoanalytic Center to become an affiliate institute through the CAFI procedures after years of liaison with BOPS through CNTF, which served a preliminary enabling function.
Ralph P. Engle is chair of BOPS. Calvern E. Narcisi is BOPS' secretary.
Why CAFI rather than CNTF? After consultation, it seemed to both committees that the fit with CAFI might be more comfortable for the Southwest Center, as it was already functioning as an autonomous institute. An enabling committee, much like a sponsoring committee or institute in the CNTF model, will provide the necessary support and organization needed in bringing the Southwest Center along toward accreditation.
What will come of our discussions with the seven freestanding institutes? We expect to learn more about BOPS, about psychoanalytic education, and about the persistent influence of our past in our efforts to shape our future. We hope that the experience of the past fifteen years will be valued as careful, well-thought-out changes warranted by our changing profession.