We are all being asked to vote on a new set of bylaws for the Association, known as the Plan to Renew the American. If you have not yet voted, please vote now and vote in favor of the plan. We need these new bylaws. They represent our best opportunity for a more adaptive system of governance. We face profound challenges to our profession. The new bylaws establish more flexible governing structures for our Association and will enable us to continue our commitment to future generations of our profession.
How much do our bylaws really matter in shaping the future of our profession? Tremendously. Although bylaws are only a vehicle, after 60 years of organizational conflict, we desperately need a new vehicle. Our organizational model is 60 years old, an antique, ill suited to 21st century realities. Our current bylaws are far too detailed. They attempt to govern, rather than create structures for governance. A more flexible and adaptable governance structure will enable us to take the Association in new and exciting directions, such as advancing psychoanalytic research and scholarship. The Renew Plan's bylaws formalize a structure for research and scholarship.
In order to increase our visibility and relevance, we need to commit ourselves to solid research into the process and outcomes of our treatments, as well as our concepts of the mind. One of the most important features of the Renew Plan's bylaws is the creation of the Council for Research and Scholarship. This should put the leaders of our Association in a position to steer our course toward greater relevance in our society by helping advance our traditional health-care disciplines of psychiatry, psychology, and social work. It should also enable us to be contributors to future developments in cognitive neuroscience while also applying our knowledge to all humanistic disciplines, literature, history, art, political science, economics, religious studies, and jurisprudence—to name just a few. As we commit ourselves to such efforts, we need to think critically about our ideas, our concepts, and our practices. We must not be afraid to change when cherished beliefs prove wrong. We must not cling to the fantasy that we are somehow a special science, above providing evidence to a skeptical world. We need to move beyond our theoretical controversies into the realm of data. If we are to thrive, we need to commit ourselves to science and critical thinking. The alternative is to be only a system of belief.
A more flexible and adaptable governance structure will enable us to take the Association in new and exciting directions, such as advancing psychoanalytic research and scholarship.
We need to provide evidence of the value of our efforts to understand and heal the human psyche. There will always be suffering individuals who want to understand themselves and their motives. They will find their ways to our doors. Psychoanalysis as a clinical practice is likely to survive in some way, shape, or form as long as human beings are troubled by their own thoughts, feelings, and actions. Our profession should be concerned with the general public's access to psychoanalytic care. Invoking our authority as the most highly trained mental health practitioners is unlikely to get us very far with policymakers. Convincing skeptical public and private policymakers of the value of our work is a major challenge. It requires systematic studies demonstrating the value of particular interventions for specific clinical situations. In this era of evidence-based health care, outcome research must be part of our future; the public's access to care increasingly depends on it. We will either provide the data, or we will survive solely as an increasingly small part of the privately funded health-care sector.
Can we demonstrate the value of our interventions? Can we show that frequency makes a difference? Is frequency a false issue, and the relevant factor in efficacy the dose, the total number of hours of treatment? If we can make such determinations and demonstrate relevant factors, controversies about training standards should evaporate. The problem with our current situation is the lack of data to guide us. We need to generate data. Without it, our discourse is dominated by authority and opinion.
The problems in our field boil down to this: Are we going to provide evidence? Unfortunately, some of us still feel that such efforts are of dubious value. We have existed for over 100 years, and we have generated valuable insight into the human mind, human culture, and the therapeutic process. We have many interesting hypotheses, but we have too little systematic data. We have been content to rely on anecdote. Some say this is the nature of our field; we are not like other sciences, we deal in human subjectivity and need to utilize the methods of hermeneutics, not science. Like Robert Stoller, I believe that psychoanalysis is the subjective study of subjectivity, striving to be the objective study of subjectivity. It follows that we must become more objective in our study of subjectivity. To do this, we need to employ the methods of modern empirical research. We need to demonstrate the value of what we do, settle controversies, create new ones, and advance our knowledge of the human psyche in all of its individual, group, and cultural forms.
Eric J. Nuetzel, M.D., is chair of the Board on Professional Standards.
We need new structures within the Association to accomplish all this. Thinking honestly and critically about all aspects of psychoanalytic thought and practice and putting them to the test will not be easy, but it is our best hope for our future. An adaptable American Psychoanalytic Association, committed to advancing research and scholarship, can lead the way.