Certification first appeared as a concept in the Association in 1946 when new by-laws were created in connection with transforming the APsaA from a federation of local societies to a simple membership organization. Between 1932 and 1946, under the federation structure, all members of the member societies automatically became individual members of the Association.
The 1946 by-laws for the new membership organization contained a provision that the Board of Professional Standards would “receive applications for membership in the Association and certify the qualifications of applicants for membership in the Association” [emphasis added]. This provision began a process that has been fraught with controversy ever since.
By 1951, complaints were being heard that the Membership Committee of the Board was holding up membership applications. An investigation of the Board's activities found that of 219 applications received from 1947 to 1951, 66 had been deferred, mostly for “technical and administrative difficulties,” and most had been subsequently approved. The Investigating Committee recommended a mandatory review independent of the Membership Committee for all deferred applications, but the Executive Council rejected this suggestion.
In the 1950s, in order to achieve medical legitimacy for psychoanalysis, the Association considered applying to establish a Psychiatric Sub-specialty Board in Psychoanalysis, but this proposal was defeated by a membership vote of 166 to 481. Certification took on another meaning when the Association attempted to gain recognition for the profession through registration with the U.S. Office of Education as the sole accrediting body in the United States for psychoanalysis, but several of the APsaA's applications were turned down (the last in 1975) because the Association, with its multiple roles, was seen as having a conflict of interest.
In the 1970s, amid an atmosphere of some urgency about third-party coverage, the APsaA turned to internal certification. The two versions of certification became conflated in 1976, when the Membership Committee became the Committee on Certification. All current members were declared certified, and certification was made a primary requirement for membership.
In the following years, rapid growth of the APsaA masked the fact that the application process was deterring significant numbers of institute graduates from joining the Association. By 1976, of the 2,200 graduates of APsaA-approved institutes, only 1,400 belonged to the Association. Many of the other 800 had ill will (or worse) toward the Association, even though many actually belonged to our societies and were practicing psychoanalysts.
As growth began to level off, the APsaA perceived a membership crisis. A series of temporary changes in membership policy culminated in the final de-linkage of membership from certification in 1992, after which all graduates of approved institutes were eligible for membership. Certification became a qualification only for voting on by-laws amendments, eligibility for training analyst status, and eligibility to serve as an Executive Councilor. Finally, in 2001, the membership voted to eliminate the requirement for certification to be eligible to vote on by-laws amendments and to serve on the Executive Council or as an officer.
Probably as a result of the changes noted above and a decline in hopes for third-party coverage, the percentage of graduates of approved institutes who actually apply for certification has now dropped to between 30 percent and 40 percent. [Editor's note: Singer maintains that the number of members applying for certification is increasing, with a 28 percent increase between the four-year period 1992–96 and the four-year period 1997–2001. Singer and Mosher appear to disagree about the significance of these figures for graduates vs. members.] About 65 percent of applicants are certified on the first application, but ultimately about 90 percent of those applying are certified.
Overall, about 58 percent of our active members are certified, but obviously this percentage is steadily declining. (Among all licensed physicians in the United States, about 90 percent are certified by a major medical certifying board.). The average age of applicants for certification in psychoanalysis is fifty-three years.
At present, the only formal organizational significance of certification is limited to eligibility for training analyst status or to serve as a Fellow or an officer of the Board or on a Board committee. In practice, however, because officers of the APsaA have almost exclusively been training analysts despite their minority status (about 20 percent), and certification is required for eligibility to become a training analyst, certification is one of several hurdles to be crossed in order to play a major leadership role in the Association.
[Editor's note: Since certification was required for membership prior to 1992, by definition 100 percent of members who joined before 1992 were certified. As this older cohort leaves the organization, of necessity the percentage of certified members declines.]
Paul W. Mosher, M.D., a psychoanalyst in private practice in Albany, N.Y., is an councilor-at-large of the American Psychoanalytic Association and chairs the APsaA Task Force on Communication and Information.