Sunday, August 14, 2011

Highlights of the Division Board Meeting

Transitions
The Board of Directors met last week during the APA Annual Convention to discuss, debate, and decide a range of issues facing our organization and psychoanalytic psychology in general. The August Meeting is always a time of transition; and next year’s board will be very different in composition. With the election results in, we will soon be greeting new board members in January, with Frank Summers as President-elect, Lu Steinberg as Treasurer, Norm Abeles, Laura Barbanel, and David Downing as Council Representatives, and Jaine Darwin, Diana Diamond, and Ernesto Mujico as Members-at-Large. In addition, Usha Tummala-Narra was elected by the board to complete the one year remaining on Frank Summers term as Member-at-Large.

While these new (and returning) board members will have our welcome and support, we are losing a number of members who have had years of service on our board, including Judie Alpert, Al Brok, Bart Magee, Dolores Morris, Marsha McCary, and Nina Thomas. It is good to know they will not go far. All of them will continue as committee members, although this loss of experience on the board will be keenly felt. I want to extend my heartfelt appreciation for their contributions to the Division. Finally, we are actually losing another important member, with Larry Zelnick stepping down from the Public Relations Committee after what must be well over ten years in various board and committee positions. Thanks to Larry, who will continue as a member of APA’s Committee on Division and APA Relations (CODAPAR).

APA Elections

One of the more important discussions we have at this meeting every year is to decide whether or not to endorse a candidate for APA President. This year we were faced with a number of candidates whom we know and have worked with over the years, and who asked to attend the board meeting to request our support. We found there were strong reasons to support two of the candidates for president and decide to endorse both. Here is the announcement, which you have probably already seen posted on our e-mail list:

The Board of Directors of the Division of Psychoanalysis has endorsed the candidacies of Douglas Haldeman and Steven Reisner for APA President. The board encourages its members to vote for both candidates as first or second choice on their ballots. (As a reminder, under the Hare System of voting, members are asked to rank order their choices.) Information about Steven Reisner can be found at reisnerforpresident.com; Doug Haldeman’s campaign information is available at http://president.drdoughaldeman.com/

Vote 10 for Division 39

You will be hearing about the above endorsement again when our board members call each of you in a few months requesting your support in the APA apportionment ballot. We very much want your renewed support in our “Vote 10” campaign and we certainly want to win back our 7th Council seat that we barely lost last year. Although we often are not able to talk to you personally, we on the board very much want not only your support but also your feedback about the Division, its programs and services. If we don’t get to talk to you, please write to let us know how we are doing.

Progress on the Fund for Psychoanalysis

Marsha McCary has been spearheading an important initiative for the Division for over a year: the Fund for Psychoanalysis. She reported that we collected a significant amount of money during our Spring Meeting, our first experience with a fund drive in our history. The Fund has collected in pledges or cash over $88,000. In order to get the Fund operating, we need to have $100,000; and so the board voted to contribute $12,500 to “top out” the Fund.

What this means is that we can now proceed to form a committee that will oversee not only future fundraising but also develop a board to disburse grants from the Fund to support psychoanalytic psychology. As an aside, Marsha reports that in several meetings with APA staff and members over the weekend, the Division was recognized for its success in getting this project off the ground and running fewer than 16 months after its inception. Many other Divisions still struggle to get their funds past the $100,000 “hump” that allows them to actually get started providing grants. Although many have contributed to its success, it has been Marsha’s tireless effort that has gotten us this far. We are already planning another more ambitious fundraiser at the Spring Meeting in Santa Fe, so bring your checkbook!

Support for Early Career Professionals (ECPs)

During the debate last year on the proposed bylaws changes, one of the arguments advanced by those supporting the change was the difficulty many members, especially early career members, face in joining APA. At the Spring Meeting, Jonathan Slavin introduced a number of measures designed to help shore up Division funds and support psychologist’s continued membership in APA. I formed a task force to address these ideas, with Jaine Darwin as chair and Jonathan and Johanna Malone as members. At this meeting, a number of proposals were introduced with the goal of 1) increasing fees for Life Status members, 2) decreasing fees for ECPs attending the Spring Meeting, 3) increased information, support and encouragement for graduate students and ECPs to belong to APA, and 4) establishing a mechanism to provide rebates to ECP members who join APA.

To a great extent, the ideas and proposals developed by the task force have been overtaken by events at the APA level. As it turns out, APA is proposing to its members that APA raise the age when a member may claim Life Member status. In addition, APA has “evened out” the graduated membership fees to ECPs, resulting in a reduction in fees for many ECPs. As a result there will be a need to await the result of the APA bylaws change before changing our Life Member publications fees (our only means of increasing charges to our Life Members, unless we do away with Life Member status altogether, a change that would be possible but certainly feel like a “take away” from our senior members). If the APA bylaws pass, it will be our APA membership that has decided to limit Life Member status to those 69 or older.

The board did agree to reduce ECP fees for attendance at the Spring Meeting. They will now be the same as Graduate Student fees. We agreed that the president will charge the Graduate Student and ECP Committees to develop improved ways to encourage APA membership. The proposal to provide a mechanism for a rebate on APA dues was not supported, however, partly for the reasons described above.

In addition, there was a general consensus that our efforts should go in to finding ways to support ECP attendance at our Spring Meetings. While dissemination of cheaper accommodations, scholarships and other ways to reduce costs are important, one vital way to enhance ECP attendance is to have ECPs represented on panels and discussions, as well as on our board and committees. The ECP Committee has started a mentorship campaign to assist ECPs in writing proposals for the Spring Meeting, which should help increase presence of ECPs on panels. Although we currently have good representation of ECPs on our committees, they continue to fail to win election to the board, despite the fact that many recent candidates had served for years on Division committees. I have asked the Nominations and Elections Committee if we can look at having a separate slate for ECP (and other diversity candidates) with (or preferably without) a bylaws change.

Membership

The news here is short and sweet. Our membership numbers are up, way up, and over 3,000 for the first time in a few years. One caveat to this is that this may be the result of better numbers from APA, as Ruth Helein and Marsha McCary have done yeoman’s service in prodding loose from APA the various ways it accounts (or does not account) for our members. Still we can savor the relatively good news.

Also good news is that one new member of the Membership Committee, Cristiano Santostefano, developed a membership survey that should be in operation in the next month or so. The first survey is an “exit” survey, seeking to learn why some members have failed to renew (and hoping they simply forgot and the survey will serve as a reminder). Once in place, this should give us a way to regularly poll various constituencies of the Division to improve our services and members benefits and to develop a better database of member interests and willingness to work on various committees and projects.

While on the subject, there is an error in the current membership brochure that members should note. In revising the old membership brochure to be sure to include the rebate of Division dues to members joining through APA, somewhere along the way International Affiliates inadvertently were lumped in with Affiliates. While the information on the web site is now correct and the International Affiliates fee is $65, our recent brochure states the charge is $95. Of course anyone who is eligible to join as a Member may do so and pay the full freight, even someone outside the country. This particularly includes our Canadian members who are eligible for full privileges.

Accreditation Council for Psychoanalytic Education (ACPE)

The board had another discussion of ACPE and its budget and progress. Concerning its progress, ACPE continues to accredit psychoanalytic institutes across the country and continues to do so without charge. There has been significant progress since the Spring Meeting in that a number of institutes are now “in the pipeline” applying for accreditation. Since the primary goal of ACPE, however, is to have its standards and procedures recognized by the Department of Education, there is no indication that this will happen within the timeframe set up by ACPE, that is, by the end of this year or soon thereafter. There appear to be increasing bureaucratic roadblocks that may or may not be overcome in time.

The ACPE budget situation is clearer. Our board, along with the three other psychoanalytic organizations that make up the Psychoanalytic Consortium (Academy of Psychoanalysis and Dynamic Psychiatry, American Association for Psychoanalysis in Clinical Social Work, and American Psychoanalytic Association), have provided $100,000 payable over 18 months. The Division has contributed $20,000 for 2011 and is obligated to pay the remaining $20,000 in 2012. (Incidentally, the assessment of $40,000 for the Division is based upon our membership numbers, since the Division and the American Psychoanalytic have many more members than the other two groups.) The ACPE budget for 2013 and beyond anticipates two things: 1) ACPE is recognized by the Department of Education as an accrediting body, and 2) institutes applying for accreditation will pay for this service. As a result, there is no anticipation that ACPE will ask the Psychoanalytic Consortium for more funds (although they may ask our members or institutes graduates to donate funds).

What happens if ACPE fails to gain recognition from the government? I don’t know. It could cease or suspend operations and return unspent funds to the Consortium groups. It could carry on as an accrediting body and begin to charge for its services. Since ACPE is autonomous, its decisions will be based on whether it can survive financially and still provide a service to psychoanalysis.

One of the important questions raised during our discussion was the possible benefit of ACPE to our members. The Division has supported the ACPE process for many years and has contributed regularly to keep it in operation. The documents that make up the ACPE standards were largely the result of Division 39 members of the Consortium and it is fair to say that the Division has taken the lead in forging consensus on the Consortium. So in many ways our continued support for ACPE is the result of many years of decisions by our board.

The question of benefit to our members, as opposed to our philosophical commitment, remains important. After all, most of our members are not institute graduates; many of our members are even opposed to the regulation of psychoanalysis implied in institute training and certainly in having government oversight. At the same time, ACPE, if it succeeds, will establish psychoanalysis as a mental health discipline that has clear standards and empirical and institutional support that should benefit all of our members who work from a psychoanalytic perspective, regardless of whether they call themselves psychoanalysts or not. This should help us in defining psychoanalysis to our state legislators who have not have national standards to rely upon in determining whether or not to license psychoanalysis as a separate discipline. It should also help define psychoanalysis as a treatment that typically requires length of time and frequency of contact for optimal benefit against the accusations, frequently advanced, that anything other than super short term treatments are unnecessary, if not unethical.

APA Task Force on Clinical Treatment Guidelines

Last year APA established this task force and many of us, especially Mary Beth Cresci, worked long hours finding nominees for this group and lobbying the Practice Directorate to accept one or more of these nominees, all in the space of a month or so. I think it is a fair characterization to note that when the Practice Directorate wants our help, they are quick to call, but when we ask to be included, suddenly we are small fry indeed. In any event, none of our nominees were selected and the only practitioner selected was Jeffrey Magnavita (and for that we are quite grateful).

Lest we rest upon our indignation, some facts, however unpleasant, need to be considered. It is certainly true that our members and, I suspect, most practicing psychotherapists across the theoretical spectrum, find the idea of specific guidelines for specific disorders to be ill conceived, if not ludicrous. It is not only psychoanalysts who recognize that the person in distress is not an Anxiety Disorder or a Bipolar Disorder, but also someone whose life and being must be addressed in order to alleviate emotional trouble. Knowing this, however, does not stop the juggernaut of managed care and insurance companies who are only too eager to supply their own guidelines. And psychiatry and Big Pharma are only too glad to add their idea that psychotherapy, if needed at all, should only address medication compliance. So our practitioner colleagues, for good or ill, support the idea of having some sort of weapon to defend against assaults on their practice.

The second major issue to keep in mind is that this task force is not charged with writing guidelines but with developing guidelines for the guidelines. Before MEGO sets in just keep in mind that any guidelines will be a long time in coming and there will be ample time for our members to comment and object to the specifics. While the bureaucracy of APA can feel stifling at times, it does mean that the guidelines that result will be sufficiently general as to accommodate psychoanalytic and other forms of treatment. Who knows? Perhaps by then APA will have come to recognize that psychoanalysis is as evidence based and empirically valid (or whatever new phrase comes along in the meantime) as CBT, EFT, or LSMFT.

CODAPAR Grants

Time for another lesson learned about APA: CODAPAR is an acronym for Committee on Division and APA Relations. This group has limited funds to support interdivisional grants that typically initiate some sort of change process in APA policy or governance. This year Shara Sand, co-chair of Sexualities and Gender Identities Committee helped spearhead a grant, with Division 44 and other sponsoring Divisions to form a task force on treatment of transgendered individuals. This is an important way for our Division to build up areas of trust and collaboration with other Divisions. The group was awarded $6650 to complete its task in 2014

Committee on International Relations in Psychoanalytic Psychology (CIRPP)

Marilyn Jacobs requested and the board approved forming a new standing committee that will have as its mission increase in international presence at our Spring Meetings, in our publications and in our membership, as well as liaison with APA’s Committee on International Relations in Psychology. This committee has also applied for a CODAPAR grant in collaboration with Division 45 (Ethnic Minority Issues) and Division 52 (International Psychology) to address need for increased diversity within psychoanalysis.

New Committee Chairs and Members

The following members have been appointed (or will be appointed for 2012) to various committees:
  • Membership: We have a new co-chair, Johanna Malone and new members, Daphny Ainslie, Cristiano Santostefano, Anthony Tasso.
  • Nominations and Elections: Nancy McWilliams and Tamara McClintock Greenberg are reappointed for another year with Mary Beth Cresci continuing as chair.
  • Awards: Mary-Joan Gerson is the new chair. Jill Bresler, David Lichtenstein and Elliot Jurist are new members. Thanks to Maureen who will serve as a member for one more year.
  • Candidate: Ricardo Rieppi is the new co-chair of this committee.
  • Continuing Education: Colin Ennis is the new chair for this Committee; thanks to Laura Porter who will remain on the committee to assist Colin during this transition.
  • Early Career Professional: Heather-Ayn Indelicato is the new co-chair with thanks to Winnie Eng who will remain a member. Joining the committee is Daphny Ainslie, Colin Ennis. Karen Dias, Corry Gerritson, and Almas Merchant.
  • Education and Training: Almas Merchant and Emily Jones are new student members.
  • Graduate Students: Jonathan and Tanya Cotler are stepping down from this committee. New Co-chair is Brian Brown. New members are Emily Loscalzo and Jenna Rosen.
  • Public Relations: Ankhesenamun Ball is the new co-chair; Joseph Reynoso is a new member. Larry Zelnick is stepping down.
  • Research: Sherwood Waldron is the new chair, with Diana Diamond, Bill Gottdiener (Liaison, Section VI), Jim Hansell. Peter Haugen (ECP), Johanna Malone (Student), Cheri Marmoresh, Karl Stukenberg and Paul Wachtel
  • Sexualities and Gender Identities: Shara Sand is the new co-chair. Scott Maguire is stepping down. New members are Brian Brown (Student), Karen Dias, and Rhonda Factor.
  • International Relations: Marilyn Jacobs and Ken Reich co-chair, with Neil Altman, Richard Ruth, Marilyn Metzl, Rukhsana M. Chaudhry, Jenny Heller, Anurag Mishra, and Andrew Samuels.

Conclusion
That’s about it for a summary of our meeting. The Council Representatives will provide you with a more detailed report on the working of APA Council at the Convention. I will take a few more minutes of your time to describe a panel I attended at the Convention. It was the scheduled for 12 Noon on Sunday, not a “prime time” for sessions, but before the session began the room was packed with numerous standees. The panel was chaired by Jeffrey Magnavita and the presenters were Lorna Benjamin, Laura Brown and Nancy McWilliams, with a discussion by Nadine Kaslow. The presenters’ task was to show a short video clip of clinical work and to discuss their theoretical and clinical assumptions that guide their work, especially in reference to the video vignette.

As a “plug,” this was the first opportunity to view even a small part of the video that APA has recently published with Nancy McWilliams, Les Greenberg and Judith Beck interviewing two separate clients over two sessions. (Shorthand description: The “Gloria” tapes redone, this time with a psychoanalyst) And Nancy’s video clip was a vivid demonstration of both empathy and critical distance in allowing the client to express and experience walled-off grief over his father’s death. I highly recommend the videos: Three Approaches to Psychotherapy With a Female Client and its companion, Three Approaches to Psychotherapy With a Male Client.

But back to the panel. I found my self impressed overall with the work presented and the coherence of their theoretical approach and rationale for the interventions offered. I could but choose not to resist that the theoretical stances offered were largely completely compatible with psychoanalytic perspective. Jeffrey Magnavita emphasized the intergenerational transmission of abuse in working with a woman concerned about being too hard on her child only to “open up” to explore her own history of abuse. Lorna Benjamin emphasized the “positive” side of self-destructive behavior and the need for clients to understand that their seemingly irrational actions were in one sense a “gift of love” to a parent who both abused and in some ways seduced the child, so that reaching out to new and healthy relationships and patterns of behaving are actually threatening. Laura Brown addressed the issue of empowerment, and how women fail to recognize and claim their own power, and this in working with a client who explicitly disclaimed any interest in being powerful and instead wanted the therapist to “tell her what to do.”

As I partly described above, Nancy’s client gradually began to link his increased anxiety over the past months with concerns about his daughter’s immanent departure for college. This in turn allowed him to explore the impact of his father’s death when he was just a boy and how walled off he has been from his feelings all his life. Finally, Nancy made an observation that his “caretaking” and need to please as a way of warding off pain extended into the session and his readiness to help her feel like the “good therapist.” During his short emotional breakdown as his felt the grief of his father’s loss, Nancy sat more or less in attentive silence and ended with a construction of the events during the session that paid attention not only to his evident pain, but also his characterological stance (and strength) of transforming pain into reflection and intellectualization.

So here is my point, obviously a biased one, but with each of the other therapists I felt the heavy hand of theory guiding and directing the clients in far more overt ways than I saw in Nancy’s work. It seemed to me that each had a clear (and certainly useful) lens through which they saw the client. My conclusion is that in some ways good psychoanalytic therapy is actually less theory-driven, less focused on tying up loose ends, than the other approaches I observed. All the presenters offered up a version of themselves, in their theory, in their openness to the clients, and in their understanding of change and health. All of these attributes, the attributes of good therapy, are obscured by the tiresome battle of “evidence based” treatments and the hoops various therapists go through to demonstrate that their work is scientific. I am pleased that Jeffrey Magnavita is on the APA Task Force for Treatment Guidelines, but I despair for our field until and unless research meets clinical practice (and vice-versa) to have a real conversation about how to help real patients with real problems.

And Beyond

I want to read your comments and suggestions. I very much want you to attend our next meeting in Santa Fe. Register early and often for excellent savings and come to Santa Fe to participate not only in learning but in discussing our craft, our future, and our need for connection.

1 comment:

  1. Bill,

    Your summary of the Division's activities at the convention is extremely valuable to the membership. Thanks for taking the time to put this together.

    ReplyDelete