Thoughts on the Psychoanalytic Consortium

Are We the Ghost of Christmas Past?

by Etta Gluckstein Saxe, Ph.D.

(A letter written to the newsletter of the Division of Psychoanalysis and published therein Vol. XX #3)

The Psychoanalytic Consortium consists of: the Division of Psychoanalysis of the American Psychological Association (39); the American Psychoanalytic Association: the American Academy of Psychoanalysis; the National Membership Committee on Psychoanalysis in Clinical Social Work.  The Consortium has been meeting to develop standards for accreditation of educational and training programs in psychoanalysis to be submitted to the Council for Higher Education , a quasi governmental organization, which has as its purpose the recognition of national accrediting bodies for the professions. The hope is that the Consortium and its standards will be accepted as the standards for accreditation of instructional programs in psychoanalysis.  Recently the Consortium also drafted a document to be sent to State legislatures for their use in drafting legislation for the regulation and licensing of the practice of Psychoanalysis.

There has been a good deal of discussion and controversy within the Division of Psychoanalysis about the standards and about participation in the Consortium. A draft of the very detailed standards was published in the newsletter of this organization and the president asked for member comment.  This letter was written as part of these discussions.

TO THE EDITOR
Psychologist-Psychoanalyst

I am writing this letter in response to my attendance at the panel about the consortium at the division meetings in San Francisco. I believe that the information revealed at the panel needs to be known by all members so that an informed discussion about the effects of the accreditation process can take place.

I am the "one" referred to in the Dr. Wagner's column in the "Psychologist -Psychoanalyst" Winter 2000, the "one" of a small handful of individuals who wrote to Dr. Orfanus about the Consortium as he requested.  In that communication I raised the same issue which I raised during the panel.

I was able to inquire during of the panel about the point I made in my original letter referenced by Dr. Wagner.  It is my understanding that should the standards be agreed upon and turned over to the federal government regulators for administration, that when they are implemented the name "psychoanalyst" will become regulated.  Only those who acquire their education through institutes accredited by the regulators will be able to call themselves psychoanalysts.  That is to say, the name psychoanalyst will be regulated and restricted in its usage to those who take part in Institute education and training and only in those Institutes which follow the very detailed guidelines and get themselves accredited.  People who choose self-directed education or who choose to pursue education within non-guideline directed organized settings will not be able to call themselves psychoanalysts or their work with people, psychoanalysis.

While some on the panel and Dr. Wagner in her column offered the argument that I was confused between accreditation and credentialing, Dr. Robert Wallerstein indicated that I was indeed entirely correct in my understanding.  Furthermore, while I do understand that accreditation relates to organizations and credentialing to individuals this is not the essence of this matter.

Regardless of an individual's credentials, that is regardless of whether one is successful in achieving ABPP credentialing, one will not be able to call oneself a psychoanalyst unless one completes an accredited Institute program.  One will be able to offer the ABPP as a statement of one's credentials /qualifications but one will not be able to use the name psychoanalyst.  In effect only graduates of accredited Institutes will be able to call themselves psychoanalysts and only such graduates will be able to bill for a service called psychoanalysis.  The connection to payment while is being played down by those who are in favor of the consortium, is part of the package, as is the restriction on who eventually will be able to call themselves a psychoanalysts.  This entire discussion can be found on the tapes from the meetings.  Colleagues, is this not a familiar dream of Christmas past?

This was the point that I was trying to make in my original letter to Dr. Orfanus.   The point became clear to me as I read the new brochure from Section I , which happened to arrive as I was considering his request for feedback.  In these materials Section I continued its long time commitment to alternative routes to fulfilling the membership requirements for this section.  It honored equivalence as it always has.   Although section I is a membership organization and does not credential, the spirit of the membership qualifications, however controversial and limiting some felt them to be, reflects the original spirit of Division 39 about diversity in psychoanalysis and in my opinion, is in the best interest of the discipline and profession of psychoanalysis. This diversity is also in the best interest of the "public", contrary to the assertions of the panel members.

If the consortium continues in the direction in which it is going the acceptance of the standards for Institute's will once again narrow the scope of who is a psychoanalyst to those who find it most desirable acquire their education in an Institute setting. While Dr. Wallerstein assured me that this would serve to keep "anyone"" from calling themselves psychoanalysts, I think we need to remember that it was not long ago that the Dr. Wallersteins of the world considered many of our group to be such "anyones".

If after consultation with its membership, Division 39 continues to wish to follow this path, which I consider to be contrary to the best interests of psychoanalysis as a discipline and profession, then we should go ahead and do so.  However, this should not take place without considerable discussion and open debate.  I would think we would want to avail ourselves of all the information about the effect of the plan's implementation.  It would be a great shame to pretend to not know what we can know ahead of time, that one of the effects will be to limit the nature of the education to Institute only training experiences if one wants to call oneself a psychoanalyst and be paid for one's work as psychoanalysis and then be sorry later.  I strongly urge that the discussion of continued participation in the Consortium include an open debate and then some form of democratic decision by the membership of the Division.

Psychoanalysis teaches us that decision-making is best undertaken without suppression or repression of complicating or unpleasant ideas.  The attempts to keep this aspect of the decision making off the table is disloyal to the psychoanalytic perspective and doing so is already contrary to the best interests of an alive, vibrant psychoanalysis.