A number of years ago, a fairly well-known analyst wrote, One topic is … so important, so rich in hopes for the future, perhaps the most important of all the activities of analysis. [It] is the application of psychoanalysis to education, to the upbringing of the next generation. … I am certain that if you remain loyal to your interests in psychoanalysis you will be able to learn much that is new and valuable on these subjects.
This analyst recognized that our knowledge of early childhood development is critical when considering the well-being of our children. That knowledge becomes even more critical when considering the following statistics from the Children's Defense Fund, about our country, the wealthiest nation in the world:
Every 17 seconds, a child is arrested.
Every 40 seconds, a baby is born into poverty.
Every 56 seconds, a baby is born without health insurance.
Every minute, a baby is born to a teen mother.
Every 4 minutes, a baby is born to a mother with no prenatal care.
Every 19 minutes, a baby dies.
Every 41 minutes, a child under 20 dies from an accident.
Every 2 hours, a child under 20 is killed by a firearm or is a homicide victim.
Should analysts be concerned about these statistics, or about U.S. Surgeon General David Satcher's recent statement that one in ten children has a mental illness and fewer than one in five of those ever receives treatment?
Only one in four African Americans is insured, and Alvin Poussaint of Harvard points out that many African Americans, understandably suspicious, believe “there are only two people who can lock you up — a cop and a psychiatrist.”
The New York Times reported that in 1998 on the upper east side of Manhattan, among the wealthiest areas in the city, 8 percent of new mothers were on Medicaid and the infant mortality rate was 1.6 per 1,000. Only a few blocks north, in Harlem, 74 percent of the new mothers were on Medicaid and the infant mortality rate was 11.8 per 1,000. In Connecticut, a state with the highest per capita income in the nation, poor people are becoming poorer and wealthy people wealthier. From the 1980s to the present, the annual income of the poorest 20 percent of Connecticut residents dropped 26 percent, to $17,615. It rose 18 percent to $174,149 for the wealthiest 20 percent during that same period.
We would all agree that the individual citizen has a social responsibility. Would we all agree that awareness and activism is a part of being a psychoanalyst, as important as understanding, for example, transference and the unconscious? Should we be teaching our candidates how to apply psychoanalytic knowledge in the community, making it part of our normal professional activity?
These questions emerge each time our Committee on Social Issues meets, but these issues are also raised by numerous committees, including the committees on School Consultations, Psychoanalysis and the Community, Foundations, Vulnerable Children, Government Relations, Public Information, and Marketing.
The American Psychoanalytic Association has become a successful political action group. President Bush's signing of the medical privacy rule of the Health Insurance Portability and Accountability Act, and our responses to recent attempts to undermine this important bill, reflect our impact and success. Remember how many of us showed up on Capitol Hill to lobby in that effort two years ago? Are we willing to do for our children what we did for our patients?
The Committee on Social Issues believes that social issues do challenge us to voice our concern and commitment, especially to our children. For example, President Bush, as of this writing, would like to eliminate $20 million of the federal budget, which supports preschool programs. A recent longitudinal study at the University of Wisconsin showed how much better students were doing by the time they were in high school if they and their parents had a preschool educational experience like Head Start, which included parental involvement, compared to those who began school without a preschool program.
What can be done? If we are committed to the well-being of children, and those fellow citizens marginalized and isolated by race, gender, sexual orientation, and lack of economic means and opportunity, then we have a professional responsibility to act on their behalf.
During a recent consultation at a large mental health agency on the south side of Chicago, three analysts sat and talked with social workers who were working with struggling children and families. This staff is committed to their work and to self knowledge in that work, but most importantly, to the mission of their agency, “Saving Lives — Making a Difference,” as it says on the baseball caps that the director gave the three consulting analysts. The Community Mental Health Council is about saving lives and making a difference. What is our mission as psychoanalysts?
The Committee on Social Issues recommends the following for the APsaA:
That we issue to the media regular position statements (like the recent one on violence) created by all committees involved in social issues.
That the Council recommend and the Board of Professional Standards require all institutes' curriculums to include classes on applying psychoanalytic knowledge, principles, and concerns to the greater community.
That committees already addressing social issues consider political lobbying efforts and plans on behalf of children.
That we continue our contact with the media through interviews, letters to the editor, feature stories, and availability to reporters at programs and meetings.
I would like to thank the members of the Committee on Social Issues for their hard work and commitment to these issues and for all they have taught me: Leslie Brown (co-chair), Irma Bland, Alex Burland, Phyllis Cath, Stanley Cath, Ted Cohen, Hussein Etezady, Kim Leary, and Ray Raskin (former chair).
And finally, that “fairly well known analyst” mentioned above? Sigmund Freud.
Mark D. Smaller, Ph.D., chairs the Committee on Social Issues.