Division 39 and the Psychoanalytic Consortium

 During the recent debate concerning the proposed bylaws amendments, the focus of the discussion centered on the Division’s relationship with psychology and the American Psychological Association. It is true that our bylaws strongly address our Division’s unique focus on psychoanalysis as a vital and legitimate area of psychological study and practice. It is important that our organization remain committed to psychoanalytic research, scholarship and practice as an important part of our identity as a psychological organization.

At the same time, our organization is committed to psychoanalytic teaching and education and has taken its place among the major psychoanalytic organizations in this country. For18 years the Division of Psychoanalysis has been part of the Psychoanalytic Consortium made up of the American Psychoanalytic Association (APsaA), the American Academy of Psychoanalysis and Dynamic Psychiatry (AAPDP), and the National Membership Committee on Psychoanalysis in Clinical Social Work (now renamed, American Association for Psychoanalysis in Clinical Social Work [AAPCSW]) in addition to the Division.

Accreditation and Psychoanalytic Institutes

It may come as a surprise that psychoanalytic institutes in this country have never had a recognized set of standards or a means to accredit institutes as being able to adequately teach psychoanalytic practice. Further reflection may easily suggest why. Institutes in this country were often formed by those breaking away from other institutes in order to teach their view of psychoanalysis and psychoanalytic practice. Although APsaA has maintained some control over its separate institutes, this has been entirely an “in house” matter. During the early years, especially with the dominance of medical psychoanalysis, there was little thought that institutes might need to demonstrate the value or validity of their teaching.

This admittedly anarchic approach to accrediting institutes began to shift as psychoanalytic institutes and organizations faced the declining prestige of psychoanalytic training, the increased challenges to psychoanalytic treatment, and the embarrassing diversity of psychoanalytic training and practice. In response to these perceived challenges APsaA initiated an effort to seek recognition as the only organization able to accredit institutes. The National Association for the Advancement of Psychoanalysis (NAAP) countered with similar efforts to establish training standards that would be recognized by the Department of Education (DoE). One outcome of both NAAP’s and APsaA’s efforts led to the formation of the Consortium and the attempt to develop a common set of standards among the four constituent organizations of the Consortium.

Emergence of Accreditation Council for Psychoanalytic Education

The Consortium was able to develop a set of common standards and to enlist the agreement of the major organizations that this document could become a common standard for psychoanalytic education in 2001. At that point, a new organization was formed, the Accreditation Council for Psychoanalytic Education (ACPE), which was empowered to seek approval of the DoE and to accredit any institutes that applied. For 10 years, ACPE has continued to refine the standards and the accreditation process, prepare for application to the DoE, and to accredit institutes.

The bland recital of the emerging consensus among the major psychoanalytic organization disguises the wrenching struggles both within the Consortium and our Division Board. It particularly overlooks the role many of our members played in forging a consensus and at times bringing other groups dragging and screaming onto agreement. Although many members served on the Consortium, certainly Nat Stockhamer, Lew Aron, Jonathan Slavin, and Laurie Wagner stand out not only among our own members, but also of the Consortium members. It is fair to assert that while these and other Division members actively attended to the value and importance of psychoanalytic psychology and the issues particular to “our” institutes, their contributions in many ways “saved” Consortium members from shortsighted and preemptive attempts at protecting their “turf” to the detriment of a wider concern for psychoanalytic education and training.

 

Whither ACPE?

The Consortium has largely continued to function in support of the ACPE. ACPE has been largely dependent upon Consortium members to fund its operations. It has also been highly dependent upon volunteer efforts of the ACPE officers who have devoted countless unpaid hours in advancing the goal of establishing ACPE as an accrediting organization. Over the years, the requests for funds have been relatively modest and our Division has typically provided $5,000 a year to support operating expenses. The problem is that until ACPE is recognized as an accrediting body by the Department of Education, it cannot in good conscience charge institutes that apply for accreditation. Also, ACPE cannot apply for recognition by the DoE unless it is able to translate its standards and procedures into “bureaucratese.” Hence they have needed to employ a bureaucrat sympathetic to psychoanalysis (such people evidently do exist) as a consultant. Finally, even a well-crafted application to the DoE needs to be accompanied by two things: a demonstration that there is an actual need for this service, and financial resources to keep ACPE going.

So this is where we come down to the current year. In order to make the final push to seek DoE approval, ACPE must have vastly increased financial resources and a significant number of current and future applicants for accreditation. While the Consortium organizations created and sustained ACPE for ten years, only institutes can make ACPE a going concern. The Consortium has been asked to bankroll the application and to provide sufficient funds to convince DoE that it is a viable organization. Division 39’s share of this request comes to $40,000 payable over the next 18 months. If these funds are not forthcoming, the process is likely to grind to a halt if not fail altogether. If these funds are provided and ACPE still fails to gain DoE approval, some of the funds will be returned to the Division. Finally, money or no, DoE approval or no, ACPE needs institutes applying for accreditation.

Whither Institutes?

ACPE offers a process whereby institutes may obtain external accreditation for their programs. One problem with this is that many institutes do not necessarily see the value of external accreditation. As noted above, APsaA institutes must seek and maintain internal accreditation and may feel that this is sufficient. NAAP is an accrediting body for many psychoanalytic training programs and many of these programs might not be able to meet ACPE standards even if they desired to do so. Other institutes may simply not see the benefit of accreditation. Although there are certain benefits accruing to recognition by DoE, these may not be compelling to institutes struggling to stay “above water” in an increasingly difficulty time for training programs.

Why is this important to Division of Psychoanalysis

As noted above, not only has the Division been a participant, but also it has been the linchpin of this process and has consistently been supported by the Division Board. That in itself cannot answer the question as to the value ACPE has for the Division. We believe that external accreditation of psychoanalytic education is certainly an important part of our mission to improve psychoanalytic education generally and psychoanalytic training generally. External accreditation is likely to lead institutes to become more pluralistic and rigorous in their approach to teaching and increasing fair and transparent in identifying candidate “milestones” and evaluating candidate progress. This is certainly a reflection of our values as a psychoanalytic psychology organization.

It is a fair question to ask whether the current request for funding accurately reflects the needs of our members, many of whom are not institute graduates or candidates, many of whom have serious concerns about defining psychoanalysis solely through institute training. This is an important objection. I believe there has been an insufficient attempt to mobilize institutes and institute leaders and graduates to make separate contributions to a project that will mainly benefit institute training. I am encourages that ACPE officers have acknowledge this “gap” in seeking funding and plan to make this effort in the future.

I believe that this last request, as substantial as it is, reflects an important contribution to seeing through an 18-year project that has been vitally important to many of our members.  The fact remains that the hefty request would not have seemed so hefty had ACPE had a crystal ball and foreseen what it would take to complete the process. Instead it has had a “low ball” approach to budgeting based on paying current bills and “making do.” I hope that our Division Board and our members will continue to support this final push to get ACPE functioning independently.

The Division of Psychoanalysis and the American Psychological Association-Part I

In the last few weeks a great deal has been written by our members on the Bylaws Discussion Forum concerning the Division’s relationship with APA. Many of those opposed to the bylaws changes frame their concerns in terms of our need to remain connected to APA, its governance and policy making. Their concerns can be summarized a follows:

• If psychologists are allowed to be full members of the Division, many current members will resign from APA, thereby weakening our ability to sustain our current number of representatives to APA Council and thereby reducing our influence within APA.
• If psychologists and nonpsychologists who are not members of APA are allowed to serve in the offices of secretary, treasurer and president, our ability to represent psychoanalytic psychology within APA will be reduced as these officers would have no credibility in their dealings with APA.
• If psychologists who are not APA members are allowed into the Division, and they, along with nonpsychologists are allowed to hold key offices, our organization will become a "generic" psychoanalytic association rather than a force to promote and defend the science, practice and teaching of psychoanalysis in psychology.

These reasons for opposing the bylaws changes rest on a number of assumptions that I do not find credible, at least partly due to history of previous changes. For four years, nonpsychologist members of the Division have been eligible to vote in our elections and run for the office of section representative and member-at-large. There has been no great influx of nonpsychologists into the division and no one has competed for an office at the board level in that time. Also, although always true, in the last three years, we have realized that psychologists who are not APA members are able to join the Division as Affiliate Members, without voting or office holding rights. (The Division board had always assumed differently until we asked APA attorney to review our bylaws. The finding was that the Affiliate category, while not intended for psychologists, could not exclude them.) Still, few have chosen to do so. This was the history we relied upon in developing the bylaws proposals regarding membership and membership rights.

Obviously I do not share the dire predictions listed above. More importantly, I actually do share the concerns of members concerning our need to involvement in the governance and policymaking of APA. This is a challenge that will continue regardless of the outcome of the bylaws vote. More on that in Part II.

Did You Hear the One About the Forty Psychoanalysts Who Walked Into a Meeting?

Well, I am afraid the punch line to this story is not very funny (see below). At the same time, there was some humor and a great deal of relief when the Board of Directors (BoD) Meeting was held in January. First on the agenda was a discussion and vote on the proposed bylaws changes that had been passed by the BoD in August 2011. As you know (if you have read the earlier blog), the membership vote to approve the changes was suspended after it became clear that many members were not only opposed to the changes, but also felt there had been insufficient time to discuss and debate the changes. The BoD first offered a discussion forum for members to post questions and propose alternative wording for the measures; but this process proved cumbersome and few members participated in the discussions. The BoD then decided to revise the bylaws and present them again for approval of the new BoD in January. This is where the story of the forty psychoanalysts begins.

As president of the Division, my primary function is to move the agenda forward and facilitate resolutions and board decisions. As the board assembled, we were also greeted by about eight members of the Division who arrived for the discussion of the bylaws changes: all of them opposed to most of the proposed changes. Now I have attended BoD meetings as a guest and officer for about twelve years and have watched (and participated) in some lively and passionate debates; but this was the first time that the BoD was essentially confronted with a group of members solidly opposed to what the BoD had unanimously endorsed only months before. What a great day to assume the job of being residing officer!

Well, to get to the end of my story, we spent the morning discussing and debating the bylaws changes, far more than the hour allotted out of a busy agenda. I admit I felt increasingly anxious that the debating would fill up the entire day and no actual work would be completed. Knowing that the BoD would again endorse the bylaws changes once allowed to vote, I was concerned about the impact that would have on our colleagues. I was relieved to have our parliamentarian, Laurie Wagner, by my side, not so much for her rulings, as for her ability to help me contain my anxiety.

And the result? After the discussion the BoD voted to approve the bylaw changes with one exception and one amendment. The membership and rights and privileges changes were passed without change, as was the change in the responsibilities of the Publication Committee. We decided to “pull” the proposed name change, even though there appeared to be an emerging understanding of the purpose of the change, and refer the issue of changing our name to a new committee. Finally, the proposed change to allow electronic voting for bylaws changes was amended to make it clear that members could choose to vote either electronically or by post.

So what happened? While strong feelings were expressed for and against the proposed changes, we ended the discussion with positive feelings on all sides and the recognition that all those present wanted the best for the Division and for psychoanalytic psychology. So what is the joke’s punch line? “They had a respectful and reasonable discussion.” It will never make it into the Joke Hall of Fame, but I think we were all relieved and pleased with the outcome.

We are now in the next phase of our discussion and debate about the proposed changes and Division members are encouraged to participate in the Bylaws Discussion Forum that will last until late February. If you are not subscribed to the forum, please contact Ruth Helein (div39@namgmt.com). Once debate closes, pro and con statements will be added to the bylaws ballot and should be send out to members for their vote in mid-to late March. We will know the results one month later.

Winter of Our Discontent

The Lame Duck Board of Directors

As we awaited the results of our “lame duck” Congress, the Division Board of Directors (BOD) had its own lame duck session of sorts, voting, once again, on the issue of the proposed bylaws changes. The BOD agreed to completely suspend voting on the new bylaws, to authorize a new Membership Task Force to prepare a revised ballot, and to ask the new BOD, which will meet on January 15, to approve, amend, or revise the bylaws changes that were approved unanimously in August. If the BOD once again approves the bylaws changes, the membership will be asked to participate in a discussion and debate on a newly devised interactive listserv before the ballots are mailed out for a final vote.

To recap the issues with which I hope everyone is now familiar, the BOD in August voted to approve several key bylaws changes. Two proposed changes apply to the criteria for membership and the rights of non-APA members of the Division. A third provision is to change the name of the Division to “The Society for Psychoanalysis and Psychoanalytic Psychotherapy: Division 39 of the American Psychological Association.” Since I will have the opportunity to write another column for the newsletter in February, I will hold off discussing the name change until then, as well as discussion of the other two changes.

What the Current Bylaws Allow (Or Not)

Before addressing the proposed changes in membership and membership rights contained in the new bylaws, I first want to emphasize what the current bylaws allow and do not allow. Our bylaws allow for two categories of Members: APA Members and non-APA Members. The first category is clear: APA members are eligible to join the Division if they agree to subscribe to the mission of the Division. If you are not an APA Member, however, you may still join the Division as a Member if you are 1) a mental health professional who is not a psychologist, or 2) a psychologist ineligible to join APA[1]. The only mental health professional ineligible to join the Division as a Member is a psychologist eligible to join APA who declines to do so.

Secondly, Members of the Division who are APA Members have full rights, that is, they are able to vote in all elections and to serve in any office in the Division. Non-APA Members of the Division have limited voting and office holding rights. They are able to vote for all Division offices except for the office of APA Council Representative. They are eligible to serve on the Division Board as Members-at-Large and Section Representatives (that is, they may not serve as President, Secretary, Treasurer, or APA Council Representative).

So the summary above describes how the Division currently operates (and has done so for about four years since the last bylaws change). To date, all officers on the BOD have been psychologists and non-APA Members make up a very small percentage of the overall membership. There has been a gradual increase in this category of member, although we have also speculated that the opportunity to subscribe to PEP-Web has been a more powerful incentive than the opportunity to serve on the Division Board!

The bylaws ballot sent in September generated opposition to the proposed changes, including criticism that the changes came as an unwelcome surprise to a number of our members, including several former presidents and officers of the Division. There will be time, if and when the bylaws ballot is approved by the BOD in January and posted to the membership, to debate the merits of the proposed changes. I hope there is now a sufficiently open and lengthy process to provide for this full debate of the merits (and demerits) of the proposed changes. I would like to take the rest of this column to reflect on the intensity of the response and its possible meaning, at least as it emerged for others and me on the Board over the last year.

Some History

I have been attending Division board meetings for over twelve years; and during that time witnessed the struggles and debates over membership questions. In retrospect, I should have thought more realistically about the impact the ballot would have, having witnessed storms of protest many years ago at the idea of allowing any non-APA Member join the Division (even, at that time, as Allied Professionals, without voting or office holding rights). It was a struggle to admit Allied Professionals into the Division (it lost the first time it went to the membership for approval); and it dragged on through successive board meetings until it finally passed. Some on the board were opposed, fearing the Division might be inundated with non-APA Members. The actual result was just the opposite and despite outreach efforts, notably by Section I (Psychologist Psychoanalyst Practitioners) and Section IV (Local Chapters), few Allied Professionals chose to join.

There was less of a struggle years later when the board agreed to revise the membership rights of non-APA members and to establish one level of membership, albeit with different rights for Members who were APA Members versus those who were not. At least one reason it was less of a struggle, I believe, was that after five years or so allowing non-psychologists to join as Allied Professionals, we were able to come to the conclusion that neither skies had darkened, nor had the Division been “overrun” with the unwashed. Instead, we had about 100 or so members (out of 3,000) who happened to be non-psychologists.

This takes the history down to the last few years when the greatest membership challenge we faced has been the resignations of many Division Members from APA due to objection to APA policy on psychologist involvement in interrogations of detainees and APA Ethics Committee’s failure to revise the Ethics Code to strength its position on psychologist ethical duty to protect basic human rights. For those of us on the Division board, it has been a real struggle, sympathizing with those who were attempting to protest APA policy through withholding their membership dues, yet concerned that by leaving APA they were diluting our ability to have an impact on APA through our Council Representative’s actions and other initiatives. I recall a particularly moving episode during a board meeting when a number of members spoke of their pain and ambivalence in coming to a moral decision whether to “stay and fight” or leave APA.  Although the 2008 Referendum (supported by many members of our Division) changed APA policy on interrogations and the Ethics Committee and APA Council (thanks partly due to efforts of Laurie Wagner and others) did get around to changing the Ethics Code in a way more satisfactory to many, many former APA Members cannot accept that APA policy and procedures have changed sufficiently to allow them to re-join, although they still wish to remain Division Members.

The 3^rd Membership Task Force and the Current Bylaws Proposals

It is in this context that the board took up the issue of membership and membership rights and for two years struggled with how to find a way to keep those members, who were committed to the mission of the Division, in our ranks, even as they felt they had to leave APA. As task force after task force addressed the issue, it also became clear that we could not simply address the needs of one “class” of member, that is, those members who resigned in opposition to APA’s policies, without considering all those psychologists who wanted to belong to the Division but who refused to join APA for any reason. It is important to note that our charge was primarily to address the possibility of providing membership status for psychologists who were not APA members. Our secondary charge, however, was to clarify the rights and privileges of non-APA Members, since the old bylaws were unclear on that subject.

It was in this spirit that a third task force appointed to address membership issues met over the spring and summer last year and came, surprisingly, to a quick consensus to open up the membership in the Division to as many as possible consistent with APA bylaws, and to open up membership rights to as many as possible, again consistent with APA bylaws. We consulted with APA about this, curiously just as APA was about to launch its own campaign to support Division membership. We learned that APA had taken the position that whatever strengthens a Division ultimately strengthens APA. The more APA members join Divisions, the more likely they are to remain in APA. The more non-APA member psychologists join Divisions, the more likely they will ultimately join APA. That, at least, is the position of APA Division Services.

As our Task Force quickly jelled around the issue of membership and membership rights, we found the same spirit characterized the reactions of those present at the August Board meeting. The board accepted the bylaws proposals unanimously and there was a palpable sense that we had finally put behind us a years-long troublesome and controversial struggle. Well, were we wrong!

At this point we know why some members are opposed, strongly opposed, to extending membership to non-APA member psychologists and/or extending membership rights beyond what are currently held by non-APA Members of the Division. In fact, some of the criticisms have seemed to be based on the belief that non-APA Members should not have voting or office holding rights. Again, to be clear, regardless of the outcome of the balloting, non-APA Members of the Division will retain the limited voting and office holding rights they currently have.

Membership from a Local Chapter Perspective

It has been easy for me to advocate for more open membership in the Division over the years, I suppose, since my “origin” in the Division is as a member of a local chapter, the Appalachian Psychoanalytic Society. Like all local chapters, we have had an open membership policy since inception, admitting any mental health professional that subscribes to our mission statement. Like most chapters, our organization has mainly elected officers who are psychologists and Division 39 Members, although many other professionals have served on our board. It has simply been a moot issue throughout our twenty years as an organization. I offer this by way of partial explanation for why I was blindsided by the criticism of the bylaws, especially from colleagues whom I thought shared my perspective.

Membership and Identity

It has become commonplace for us in the Division to reflect upon and sometimes bemoan our “divided” identity as psychologists and psychoanalysts, although the divisions we experience are not the same for everyone. From time to time, the conflicts over training and adherence to particular psychoanalytic theories have also posed problems within the Division. Many of our members are not psychoanalysts and are uncomfortable when that term is used to define what we do, while others are alarmed that psychoanalysis is diluted if we use any other term to describe our work.

As for the “psychologist” side of our identity, many of our members are disidentified with APA for a whole variety of reasons. Although the reason uppermost in many minds has been APA leadership’s support for psychologist involvement in interrogation of detainees, others have opposed APA’s position on prescriptive authority for psychologists, its timid stance in confronting managed care’s assault on psychotherapy and its refusal to challenge the government’s gutting of privacy protections in its implementation of HIPAA regulations.

As for where I stand, I “side” with neither the psychoanalyst nor the psychologist identity and think of myself, most of the time and in most circumstances, as a psychoanalytic psychotherapist. I value that I was trained as a psychologist and I believe that the kind of education I had was in many respects ideal in helping to forge this identity, in a clinical program that heavily emphasized clinical practice with highly troubled individuals. I actually missed out on a lot of what makes a person a “psychologist” and my program, however psychoanalytic, did not stress the need to attend an institute in order to do the work we did. We learned our craft through long (ongoing) years of consultation and supervision groups. And did I mention the educational effort of our local chapter? Over the years I have added to my sense of identity and increasingly value psychological research, the institutional structure offered by APA, the importance of formal psychoanalytic education and so on. I make no claims that my “identity” is the best one possible, only that it is mine. I believe regardless of the bylaws ballot outcome, we will remain a Division with many, many different definitions of what it means to be a “divided” member.

Going Forward

If the bylaws are passed as currently written, psychologists will be able to join the Division whether they choose to join APA or not. If the bylaws pass as currently written, non-APA Members of the Division will be able to serve in any office of the Division Board except APA Council Representative. Based upon the “track record” of four years eligibility, it does not appear likely that non-psychologists will join in great numbers or seek board office. In particular, it seems highly unlikely that expanded office holding rights will be an incentive for more non-psychologists to join.

There is no “track record,” of course, for psychologists who are not APA Members. It appears likely that many psychologists who recently resigned from APA may choose to join the Division; and some of those members who resign include members who have served as officers on the board or on Section boards in the past, so some may chose to stand for office in the future. As for the rest? It is truly unknown whether many non-APA member psychologists will join, or alternatively, whether current APA members will drop their membership and stay in the Division.

I know that some of the opposition to allowing non-APA member psychologists to join the Division is based on the concern that many will choose to do so (or that many current APA members will drop out of APA while retaining Division membership). The concern is that by doing so, we will become less connected to APA, eventually losing our connection to our parent organization and part of our identity as psychologists. My guess is that will not happen. I certainly would not want that to happen.

I respect the position of members who oppose allowing psychologists to belong to the Division without also being APA Members, or who would not want our organization to be led by a non-psychologist (keeping in mind, of course, that a non-psychologist who is also an APA Member is entitled stand for any Division office). I believe either possibility is very slight, while admitting I could be wrong, just as those who warned the Division would be “swamped” with Allied Professionals many years ago were wrong.

Our 2011 BOD will soon have the opportunity to vote on the bylaws and our members will be able to debate, discuss, and eventually vote the changes up or down. Write to you again next month.

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[1] There is a small group of psychologists who were trained in graduate schools that did not seek APA accreditation and, as a result, they are ineligible to belong to APA, although they are licensed as psychologists.