Maybe it was never easy for psychoanalysis. Maybe all the talk of the “golden years” is just that, talk. Maybe we always struggled against the current. If so, and I believe it is, we can take some solace from the fact that we have weathered prior challenges.
We have recently finished our 2012 National Meeting in New York and I am pleased to report on very positive events for our field occurring within the context of some of the most combative times for our profession. What is hard to know is whether we are doing these things because we actually sense the scope of the current forces allied against us and we are taking charge, a true example of reform, or whether we do it more from an effort just to react to all of these daily stresses we face and to which we must respond. I am an optimist and I will opt for the former. Indeed, reform has been a major theme in APsaA for several years now and our Strategic Plan is a major step towards addressing the challenges confronting us both internally and externally in a proactive manner.
An astonishing 97 percent of our respondents answered that they were either satisfied or very satisfied with their professional work with patients.
Before discussing the meeting, I would like to highlight a few of the findings of our practice survey. For the first time, we included in this version detailed questions about income. The results are very informative, albeit disappointing in some ways and disturbing in others. Median income for psychoanalysts is about $160,000, a figure that does not compare favorably with those of many other very specialized highly trained professionals. A closer look, however, suggests major income disparities within APsaA. A full quarter of respondents earned below $100,000, while the top quarter earned over $234,000, which is more competitive with other similar, trained professionals. Looking further, we see that physicians averaged $219,000 and that training analysts averaged over $239,000. This is a cautionary sign for us, pointing to the possibilities of fault lines and morale problems, and a definite need to take steps to deal with this. A commitment to serious reform means a commitment to acknowledging and grappling with these disparities. Members of an organization with these kinds of divisions in income may not be able to effectively work together to solve our many other challenges. Fortunately, there is also a proverbial silver lining in the practice survey data that I will save for my closing comments.
Turning to the events of our recent meeting, the most exciting in my view is the invitation, approved by BOPS, to the William Alanson White Institute to join APsaA as an “approved institute.” For many of us, this is the culmination of more than a decade's worth of effort. It is particularly a landmark since the White's standards are not identical to APsaA's and this demonstrates APsaA's newly found willingness to entertain the concept of “substantial equivalence” rather than “identical.” This is historic. There are still a few potential potholes and wrinkles, so don't break out the champagne yet. And the William Alanson White must vote on whether or not to accept our offer.
The second event is that BOPS made a recommendation to investigate the externalization of the process of certification. While I had long been among those who believed that it was to our organizational advantage to include educational/evaluation components as well as membership concerns within APsaA, I have found myself in recent years increasingly disturbed and upset by these ever-intensifying fault lines and the contentiousness that are absolutely corroding the possibilities for amity and comity within APsaA. I think the only way we can continue to serve these dual and conflicting, functions is to place the certifying component outside of APsaA. Our recent involvement with the Accreditation Council for Psychoanalytic Education (ACPE) may offer us a way to manage this.
A third event is that the Pyles-Perlman-Procci proposal (P-P-P) for a major shift towards strictly objective criteria for selecting TA's took an official step forward. The framers, I among them, had suggested that BOPS take charge of this proposal. Although initially not on its agenda for the January meeting, BOPS did consider this during the new business portion of its meeting. The BOPS leadership requested formal submission of the P-P-P proposal to them by Robert Pyles. At the Executive Council meeting the following day, the Council approved a small task force, to be chaired by Pyles, to present the proposal to the Board on Professional Standards for consideration at the June 2012 meeting.
These are salutary signs of an organization actively seeking to find new ways and solutions to deal with issues that are weights around our necks—issues that are leading to
Warren R. Procci, M.D., is president of the American Psychoanalytic Association.
our decline in membership and enrollment and to problems with making our professional income match the complexity and sophistication of our training. We are taking the reins in dealing with these problems. We are showing the courage to embrace the new and to surrender some old, outdated “certainties.”
I will close my comments on an uplifting tone. The practice survey also asks about the level of satisfaction with one's professional work. An astonishing 97 percent of our respondents answered that they were either satisfied or very satisfied with their professional work with patients. I cannot imagine many other occupations that would yield similar results or results even close. Despite all of our current obstacles, we have a great and very satisfying professional pursuit. Let's continue working together to keep it that way.