I trace many of the contentious structural and policy issues within the APsaA — like the current debate over the certification process and its linkage to training analyst status — to a particular history. For almost a century, the controversy over the legitimacy of non-medical psychoanalysts (so-called lay analysts) bedeviled the relationship between the IPA and its American components. In my 1998 book Lay Analysis I trace this controversy in full detail from its origins as far back as 1910 until its final resolution in the 1988 settlement of the Sherman Antitrust Act lawsuit against the APsaA for its restrictive policies concerning training and membership (and only secondarily against the IPA for allowing its American component to maintain its training policies).
From the very start, the controversy centered on the unwillingness of the (then nascent) APsaA to acknowledge the authority of the IPA's International Training Commission (ITC) concerning criteria and conditions of training and membership. The Americans insisted from the beginning on maintaining exclusive jurisdiction over these issues, independent of the policies of the IPA and its ITC, which monitored adherence to their policies in all the other IPA component organizations.
The central dispute was over the wishes of the Americans to restrict training and membership to qualified physicians. In contrast, the IPA's component organizations almost universally adhered to Freud's position that training and membership should be open to all suitable aspirants, regardless of prior professional or academic training.
These issues came to a head at the fifteenth IPA congress in Paris in 1938 when, on the eve of World War II, the APsaA — by then 40 percent of the IPA's worldwide membership — threatened to secede from the IPA unless the ITC were dissolved and its authority over training and membership issues eliminated. This bitter struggle could not be resolved at that congress and was deferred for final vote until the next scheduled congress in 1940.
However, the war intervened, and the next IPA congress (the sixteenth) did not take place until 1949 in Zurich. In order to bring the APsaA securely back within the IPA fold, the Zurich congress — after lengthy negotiations between the officers of the IPA and the APsaA — undertook to ratify de jure what the APsaA had established de facto in 1938: the total autonomy of the APsaA in matters of training and membership criteria as well as an “exclusive franchise” regarding access to the IPA within the United States.
“The central dispute was over the wishes of the Americans to restrict training and membership to qualified physicians.”
All this was codified within the IPA's rewritten constitution and by-laws in 1963, which established the APsaA in a unique status as a regional association, with its separate two rights accorded to no other IPA component organization: its autonomy in training and membership issues and its “exclusive franchise” on IPA access. As a corollary to this, the APsaA was the IPA component in the United States, and all its members held IPA membership only through the APsaA.
As a direct consequence of these institutional relationships, major training and membership authority and responsibility was centralized within the APsaA as a national organization. Its accredited institutes did not have this authority and responsibility. No other IPA component organization has ever been accorded regional association status. Nor would the IPA have ever been willing to do so for others. The APsaA acquired its special status within unique historical circumstance, to avert an otherwise seemingly irreconcilable split within worldwide psychoanalytic organizations.
This series of events has had its consequences for administrative structures and operations within the APsaA. One central result was the establishment of the Board on Professional Standards, which created and oversaw the training conditions and standards to which all accredited societies of the APsaA have had to adhere.
In accord with this position, the APsaA, almost from the start, had its own membership criteria (only modified very recently). The certification process also (and exclusively) conferred membership in the IPA. It naturally followed that membership certification by the APsaA would be required for training analyst status, since such status controlled by the APsaA would be a major avenue to maintaining the mandated training standards within its institutes.
Now all of this has become a source of contention among the institutes of the APsaA. Should the APsaA cede full authority and responsibility over training and membership activities to its institutes (within the general framework of the constitutions and by-laws of the APsaA and the IPA, to be sure), as is true of all the other component institutes of the IPA? Or should the APsaA maintain centralized aspects of its executive and supervisory functions in regard to training and membership issues? I.e., is such an arrangement better for the health and well-being of American psychoanalysis, or not?
The issue here is whether graduation and membership locally within an institute should convey unrestricted national membership and all rights (such as training analyst and BOPS Fellow status), or whether it serves psychoanalysis better to retain national certification and national eligibility criteria for these responsibilities.
This concern with certification as the road to eligibility for election to training analyst status and designation to BOPS membership is the real subject of the certification discussion.
Robert S. Wallerstein, M.D., is an emeritus training and supervising analyst with the San Francisco Psychoanalytic Institute and an emeritus professor and former chair of the Department of Psychiatry at the University of California-San Francisco School of Medicine.