What is psychoanalysis? What do psychoanalysts do? These questions attest to some of the challenges and problems within psychoanalysis today. These challenges and problems are reflected in the current debate on certification.
The evolution of certification in the American Psychoanalytic Association reflects the evolution of psychoanalysis itself. I will discuss the evolving process, why I believe that certification should be maintained, and why I think we also need recertification.
One of the problems in psychoanalysis since Freud's early papers is that the predominant language in psychoanalysis is that of nineteenth-century science: forces, entities, and the relationship between them, described in a one-person model. Yet the source of most of psychoanalytic data is personal: two subjects or two “I”s interacting with one another. In the development of psychoanalysis one can follow the strains of both of these perspectives.
The clash of these perspectives has also affected the evolution of certification in the American Psychoanalytic Association. Until the 1970s, the prerequisites for certification in the APsaA, and the membership status that followed, included a written description of the applicant's supervised analyses. The descriptions that were considered acceptable were similar to many of the clinical descriptions that appeared in the psychoanalytic literature at the time. They used the language of nineteenth-century science. Entities and their relationship with one another — superego, ego, id, defense, conflict, compromise formation, resistance, and therapeutic alliance — were described principally from a one-person perspective.
In the early 1970s, however, applicants were asked to write about their supervised analyses from the viewpoint of a process. The members of the Committee on Certification wanted to see a greater emphasis on the personal, experiential, and subjective, written from a two-person perspective. This change in the approach to certification reflected the beginning of changes in psychoanalytic thinking that included a movement from the language of nineteenth-century science to a more personal language.
Applicants for certification and the institutes that trained them were not fully prepared for the change. Applicants whose summaries were reviewed by their institute's faculty were told by the committee that their case summaries were incomplete and their certification had been delayed, which contributed to the hurt feelings, confusion, and rage that followed.
The Committee on Certification initiated an educational program through consultation, memos, and workshops. By the time the applicants entered the second phase of the application, many of the applicants were certified. The educational program continues to improve.
The difficulties with certification are related to another characteristic of psychoanalysis. Psychoanalysis is based on a process of exposure for the patient and the analyst. In the clinical situation, the principal affect that must be dealt with by the analyst and patient is humiliation. Establishing an atmosphere of safety is a major task for the analyst.
The analyst writer must be able to communicate a process of overcoming the threat of humiliation in the analytic situation by overcoming the threat of humiliation in the writing itself. But to be able to convey the personal details of an analytic process, the writer must feel a degree of safety with the readers that until recently has not been evident within the APsaA's certification process. During the last two decades, the lag in the creation of a more personal psychoanalytic language and the insufficient atmosphere of safety for writers of clinical material that have characterized the history of psychoanalysis are evolving for the better.
This brings me to the basis of my argument. Growth, evolution, and change are intrinsic to the psychoanalytic process. In the clinical situation, psychoanalysts demonstrate a mode of living that follows psychoanalytic principles. The values and ideals of love, courage, and honesty guide this mode of living.
The American Psychoanalytic Association has institutionalized the values and ideals of psychoanalysis through the oversight of training and the granting of certification. To remove certification would weaken the implementation of psychoanalytic values. I believe this would hurt psychoanalysis. In addition to maintaining certification, I believe we should develop a policy of recertification. Certification upholds the ideals and values of psychoanalysis. Recertification is necessary to maintain those ideals and to address evolutionary changes.
Much has been written on the Open Line of the lack of validation of the work of the Committee on Certification. I think it is possible to develop a consensus among the members of the committee about the important components in case descriptions. that could be validated by an independent group of observers to implement the evolution of our certification procedures.
Melvin Bornstein, M.D., is a training and supervisory analyst at the Michigan Psychoanalytic Institute. He is a councilor-at-large and editor of Psychoanalytic Inquiry.