Our New Ecumenism and the "Medical Model"

Dear Colleagues,

A new ecumenism has swept into our field, not quite while we were sleeping, and in a way that presses inexorably for change. Yes, we are all psychoanalysts but our diversity is also our strength. The training of psychologists, social workers, and psychiatrists is each very different and distinguished, and these differences are contributing in bold and subtle ways to the energy of our enterprise together. However, our medical legacy, both for good and ill, cannot be ignored.

Because our organization was founded by physicians, and for many years refused Freud’s call to educate “lay” analysts, our Association has always been a “medical” organization. I can well remember the early days of our new inclusivity when we still used the term “non-medical applicants” to refer generically to our newly eligible colleagues (even by the 80s in America, the descriptor ‘non-white’ had become a pejorative).

We are still struggling , very diligently, to accommodate the diversity of professions which now constitute our organization, and not just in terms of such things as equal voting or equal opportunity to hold office. We still have miles to go to become the fully ecumenical umbrella for psychoanalysts of all backgrounds that we aspire to be.

Here is just one of many areas where there are very serious differences among our distinctive disciplines. When the number of analytic patients diminishes, psychiatrists are often still able to pull in much more substantial fees by prescribing medications, or admitting patients into hospitals, or performing expert evaluations in Worker’s Compensation cases to name but a few. Of course many psychoanalysts do not engage in such activities, but they could. Psychologists and social workers have fewer remunerative alternatives so the survival of their practices is more vulnerable.

If we are all to be helpful to each other in coping with less verdant practice environments, we will need to develop new strategies, new ways of thinking. Insurance, for example, with its ever more stringent limitations on providing services cannot be relied upon as a central source of income, yet insurance is also a pathway for so many people who need our help. There’s no easy solution to these problems, but in establishing broader partnerships with our allies in the psychiatric APA, the psychological APA, particularly Division 39, and the social work NMCOP, we will have the opportunity for creative thinking beyond the so-called ‘medical model.’

More importantly for us all, we need to look thoughtfully at the differences within our organization: differences in training, differences in worldview, and differences in opportunity. We must look, but not as a means for erecting arbitrary distinctions or perpetuating ongoing splits. We must look because the creativity and experience that lies within our differences is also a source of strength and a guidepost for our evolution.

Of course, differences in training and opportunity are among many significant issues that our organization must recognize and appreciate. But we have not been swift to do so. Nor have we thoroughly grappled with the impact of our exclusionary legacy and its impact on our many other mental health colleagues.

In this context, I hope only to raise the issues and offer some general ideas about meaningful change. But, as always, I would be very happy to hear your own thinking and work together to make our organization as robust, creative, inclusive, and thriving as possible (call me at 626-793-7957, email me at wrprocci@sbcglobal.net or visit my webpage at www.wrprocci.org or http://warrenprocci.blogspot.com)

Best regards, and Happy Thanksgiving,
Warren R. Procci, Candidate for President-Elect, APsaA