In March 2019, Lee Jaffe asked me to chair the Task Force on Controversial Educational Issues, mandated by the Board (then the Executive Council). The main controversial issue, which had plagued the organization for years (or really decades), was the appointment of supervisors (SA's) and training analysts (TA's), which used to be overseen by the Board on Professional Standards (BOPS). Executive Council wanted to know what the membership thought about appointment procedures: Should they be retained, changed, or eliminated? The arguments for the traditional system we maintained for decades centered on the intention to maintain standards and ensure excellence; the arguments against emphasized the lack of valid or reliable data for assessing the quality of analyses by those appointed, to say nothing of the history of some egregious ethical violations by some who had been appointed to these positions in the past.
My own trajectory in the organization began with having to receive a waiver of the requirement that one be a physician to be trained in an APsaA institute (this was in 1986). The waiver process was burdensome and painful, and I decided, at that time, that I would never apply to the national organization for certification, which was a requirement for appointment as a TA/SA. Fast forward 25 years, and my institute (then the Washington Psychoanalytic Institute), in keeping with Local Option that is now in place with APsaA's new Standards of Education, decided to put in place procedures for appointment of TA's, SA's and TA/SA's that do not require national certification. I applied and became a TA at the Washington (now the Washington Baltimore)
The task force, now called the Task Force on the TA/SA Survey, consisted of Holly Crisp, Ralph Fishkin, Catherine Kimble, Alan Sugarman, and me. Working with this group was one of the great pleasures of my time in APsaA. We are very different people, who managed to complement each other (and occasionally compliment each other) in our task of designing and analyzing a survey of member values. None of us being expert at survey construction or administration, we hired a consulting firm, the TDC group, which had helped the Boston Psychoanalytic Society and Institute conduct a member survey a few years back. Lowell Aplebaum, then working on the APsaA staff to assist with strategic initiatives, was also a key member of our team.
… standards are useful and meaningful only if they have buy-in from the membership, especially absent clear-cut evidence to validate them.
The terms “TA” and “SA” have become loaded in organized psychoanalysis, as they are associated with power and prestige. In the old days, up until somewhere between a decade and two decades ago, most APsaA institutes were administratively organized according to a “TA system,” whereby TA's had the complete authority for running institutes, including their educational programs. Over the past 10 to 20 years, it became increasingly obvious that such a system was antiquated. Consequently, in most contemporary institutes, educational programs are run by analysts with an interest in and a skill for educating candidates. TA's are not necessarily in charge of these activities because such administration requires a different skill set than being able to analyze effectively. That is, being an outstanding clinician does not necessarily correlate with teaching or administrative excellence; therefore, today more attention is paid to assigning functions to those with demonstrated capacity for those specific functions.
Consequently, our task force decided to be clear, in constructing our survey, that our interest was in the function of analyzing and supervising candidates, not in titles or status that might accrue to those who perform those functions. In other words, we wanted to focus on function, not on the “TA system” which, for the most part, no longer exists. (Although, as I was completing this article, it was brought to my attention that the traditional organization version where TA's retain power still exists in some institutes). We set out to survey, in as thoroughgoing a manner as possible, the membership about their sense of what our educational standards should be in regard to these functions. Alan Sugarman, then head of the DPE, reminded us that standards are useful and meaningful only if they have buy-in from the membership, especially absent clear-cut evidence to validate them.
The survey, once released in the summer of 2020 (following a Covid-19-related delay), stirred reactions on the APsaA listserv, most pointedly claiming that we were biased and invested in a pre-determined outcome. I was surprised and disappointed by this reaction, as we were careful to make the survey as free of bias as possible. To this day I do not know what any of my colleagues on the task force would say is their
David Cooper, Ph.D., is the Board member from the Washington Baltimore Center for Psychoanalysis and serves on the Executive Committee of the APsaA Board. He chaired the APsaA Task Force on the TA/SA Survey, which completed its work in 2020.
preference as to standards for TA and SA functions. Everyone seemed truly invested in the task of studying membership attitudes, not in advocating for a particular position. Our planning meetings unfolded by inviting a redesign of psychoanalytic training in one's imagination: Should a candidate be required to have an analysis? If so, why? If not, why not? If so, should there be criteria as to who performs that analysis? If so, why? If not, why not? If so, what should those criteria be, and who should decide if someone meets the criteria? And so on. While the issue of supervision has been less controversial, we asked the same questions in that arena. Our survey consultants suggested a use of “skip logic,” whereby those who do not believe there should be criteria for who analyzes candidates, for example, would not be asked what those criteria should be. This precluded opportunities to answer certain questions, but it also spared the respondent from answering questions that previous responses suggested were not relevant.
Going into this project, Council and the task force agreed that a robust response rate to the survey was necessary to make the findings meaningful. With repeated requests/reminders we got a 51.4% response rate. Our consultants found this to be excellent for such a survey, and we thought it to be a strong response, given our membership's previous response rates to other solicitations of their input, including past elections. We certainly cannot say that we have a representative sample from a scientific perspective. Respondents are a self-selected group. But there were enough responses for us to say comfortably that the results reflect the beliefs of a significant segment of our membership. It is our hope the results will stimulate further discussions of these issues at both local and national levels.
In response to the question of whether candidates should be required to have their own concurrent analysis, 96% of respondents believed they should. Yet approximately 30% of these respondents thought some exceptions could be made when a candidate had an extensive prior analysis. In addition, many acknowledged that requiring analysis does introduce complications to analyses despite its overall desirability. Approximately two-thirds (68%) of respondents believe analysts of candidates should meet some specific criteria, while less than one-third (29% believe any trained analyst “in good standing” can be the analyst for a candidate. When we looked at respondents by different groups, non-faculty graduate analysts supported the need for specific criteria by a smaller margin than the whole group (56% to 43%), but even in this group, the majority supported the idea that analysts of candidates should meet some specific criteria. As to what those criteria should be, the strongest support was for objective criteria, such as years' post-graduation and number of cases (62%).
…the results reflect the beliefs of a significant segment of our membership. Our hope is the results will stimulate further discussions of these issues at both local and national levels.
Qualitative evaluation received less support (44%). Within this type of assessment, the strongest support was for discussions with colleagues from one's own institute (47%) or from other institutes (44%). Only 27% supported some form of certification exam by an independent entity. There was strong support for decisions about appointment and appointment criteria being left with the local groups (73% supported this example of Local Option, the current stance of APsaA).
One final piece of data stood out: the absence of majority support for restricting any educational function other than analyzing candidates (including participation on education committees, membership in or chairing subcommittees of the education committees, and being director or chair of an institute) to analysts approved to analyze candidates (TA's or the equivalent). Whatever becomes of the designation of those who are authorized to analyze candidates, it appears a majority of our membership thinks the “TA system” should be relegated to the past.
Where do we go from here? The Institute Requirements and Review Committee (IRRC) is responsible for suggesting changes in educational standards to the Board. This is done in consultation with the DPE. Should we change our standards regarding who is eligible to analyze and supervise candidates? From the survey, it is not clear how many members actually know the procedures their own group is using, even fewer are aware of the different approaches being used elsewhere. Local Option is alive and well, as very different procedures are employed across the country, with some groups requiring certification of some sort, some having a “developmental path” focusing on seminars and collegial discussions, and some screening applicants according to mostly objective criteria.
However institutes choose analysts and supervisors for their candidates, there are important questions about whether we need to address the difference between function and status. Should we drop the designation, “training analyst,” and only identify analysts approved to conduct the analysis of candidates? Might we recognize that the TA designation is essentially meaningless outside of psychoanalytic organizations? Is this an argument for keeping or ridding ourselves of the title? Separating out the status and power issues which have accrued in the past to the positions of TA and SA, the questions of who should be authorized to do what within psychoanalytic training centers can be approached from a reasoned perspective, leaving powerful transference-induced fantasies and struggles behind. I hope we will make such reasoned discussions a reality.