Dear Colleagues,
Sunday’s very pertinent article about psychoanalysis in the New York Times
Week in Review section has led to several notes on our member’s list. All of these postings strongly suggest the need for us to be far more actively involved in very real world issues such as: demonstrating the validity of our ideas, validating the utility of our treatment, and working together with other colleagues in the academic, psychoanalytic and mental health communities. I completely agree with those sentiments and I have expressed that view any number of times in the past and during this campaign.
Unfortunately there has for many years now been a major impediment to our ability to turn our eyes towards these outside communities, namely the continuing divisiveness of our struggles over the current centrally mandated link between certification and TA status. I have consistently stated that we need to solve this dilemma so we can finally move on to deal with the kinds of crucial problems facing psychoanalysis as described in the NY Times article and the responses to it.
Since this will be one of the last times I will get to write to you prior to the mailing of ballots next Monday I’d like to reiterate my position on this issue. I believe that certification in its current form, at least as an absolute prerequisite for TA appointment, must be laid to rest. Period! It has caused too many hurt feelings, raised too many questions about reliability and validity, and has simply been the source of far too much organizational ill feeling and stasis to continue in this form. Attempts to rehabilitate or resurrect mandatory certification for TA appointment in some externalized facsimile or by means of “alternative” requirements which reproduce all the same problems under a new guise will only perpetuate our problems and lead to way too much additional organization demoralization, thus setting us back ever so much more.
Here are a few recent facts which support this. First, two years ago, in a record turnout, a strong majority of 57% of the members of APsaA voted against maintaining BOPS’s ability to require certification for TA appointments. Let me repeat this for emphasis, 57% voted against our current system. While this wasn’t a sufficient vote to enable the proposed bylaw amendment to pass anyone can see the organizational peril of attempting to maintain a very key procedure which is opposed by a robust majority of the membership.
Second, in a survey concerning certification conducted by the Association about five years ago there was already strong opposition expressed to any external certification process, and a mere 50%, consisting predominantly of those already certified, supported having any kind of a certification process within APsaA. Any of you who are interested can request a copy of the results of this survey. I recommend you do so.
Third, the current process must be considered a “market failure”. Our recent graduates are voting “with their feet” on the issue of certification and their feet are indicating a very decided “no” vote. It appears that only about 15-20% of these colleagues are choosing to pursue this process at all.
Should we continue to put so much organizational support behind a process that such a paltry fraction of our graduates now finds sufficiently meaningful to take seriously? I think not.
I have made clear my stance on this issue throughout this campaign and I have reiterated it here for all of you as we prepare to receive our ballots.
Warren Procci, Candidate for President-Elect of APsaA
Sunday, November 25, 2007
Tuesday, November 20, 2007
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
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
Monday, November 19, 2007
Our Politics of Old Are Inadequate for the 21st Century
Why APsaA should be an incubator for psychoanalysis, not a museum.
Dear Colleagues (known and not-known-yet):
Even if by now many of you are sick and tired of lengthy campaign mailings and emails; and especially if you are tired of politics (as usual or otherwise), please do me two favors: 1) cast your vote in the current election, if only out of civic virtue, and 2) read the next few paragraphs to see if any of this might actually matter to you. I hope it does. I promise to be as brief as I can.
It might not be easy for most of you to distinguish between the positions of the candidates running for the presidency of APsaA. BUT before you say “tweedledum or tweedledee”, here’s why I think this election is so important:
Our organization once confined itself to psychiatrists only; and for decades we have often confined ourselves largely to American ego psychology; and today we are still confining ourselves: via outdated processes of certification, via an exclusionary link between this procedure and TA status, and via outmoded institute “rules” that are frankly driving many excellent candidates to independent institutes.
In this environment it shouldn’t be radical to suggest that our certification process needs to garner the faith of both the public and the much broadened mental health community by being national and independent; nor is it radical to suggest that our local institutes need to have more autonomy in how they want to determine and qualify who is capable of training and analyzing candidates. On at least these two basic issues, my stance is longstanding, unequivocal, and distinctive.
As your Treasurer for the past five years, and as someone deeply involved in this organization, I have seen how we continue to hurt ourselves with endless debates that have too often been mere excuses for excluding very qualified people, and ideas, from our organization. Without losing our reputation for quality and depth, our organization should and must become a greater umbrella for the diversity of practice, theory, candidates and analysts that everywhere are part of the renewed vibrancy of psychoanalysis in America.
I apologize if these seem like niggling issues to some. But if indeed you want our organization to proceed thoughtfully in the direction of greater transparency, diversity, and democracy, without any diminution in its quality and value, then I humbly ask that you at least take the minimum step towards involvement and send in your ballot. I will do everything I can to be worthy of your vote. I am passionate about making our organization the best it can be, for all of us and that means embracing meaningful change rather than standing in place.
Warren
Dear Colleagues (known and not-known-yet):
Even if by now many of you are sick and tired of lengthy campaign mailings and emails; and especially if you are tired of politics (as usual or otherwise), please do me two favors: 1) cast your vote in the current election, if only out of civic virtue, and 2) read the next few paragraphs to see if any of this might actually matter to you. I hope it does. I promise to be as brief as I can.
It might not be easy for most of you to distinguish between the positions of the candidates running for the presidency of APsaA. BUT before you say “tweedledum or tweedledee”, here’s why I think this election is so important:
Our organization once confined itself to psychiatrists only; and for decades we have often confined ourselves largely to American ego psychology; and today we are still confining ourselves: via outdated processes of certification, via an exclusionary link between this procedure and TA status, and via outmoded institute “rules” that are frankly driving many excellent candidates to independent institutes.
In this environment it shouldn’t be radical to suggest that our certification process needs to garner the faith of both the public and the much broadened mental health community by being national and independent; nor is it radical to suggest that our local institutes need to have more autonomy in how they want to determine and qualify who is capable of training and analyzing candidates. On at least these two basic issues, my stance is longstanding, unequivocal, and distinctive.
As your Treasurer for the past five years, and as someone deeply involved in this organization, I have seen how we continue to hurt ourselves with endless debates that have too often been mere excuses for excluding very qualified people, and ideas, from our organization. Without losing our reputation for quality and depth, our organization should and must become a greater umbrella for the diversity of practice, theory, candidates and analysts that everywhere are part of the renewed vibrancy of psychoanalysis in America.
I apologize if these seem like niggling issues to some. But if indeed you want our organization to proceed thoughtfully in the direction of greater transparency, diversity, and democracy, without any diminution in its quality and value, then I humbly ask that you at least take the minimum step towards involvement and send in your ballot. I will do everything I can to be worthy of your vote. I am passionate about making our organization the best it can be, for all of us and that means embracing meaningful change rather than standing in place.
Warren
2nd Letter to Our Members
Dear Fellow APsaA Member,
“We will transmit the City not only not less, but better and more beautiful than it was transmitted to us.”
This is the oath that Athenian citizens took on behalf of their city-state. It is guiding me in my candidacy for President-Elect of APsaA.
The preeminent issue in our upcoming election is the future of our Association. At the moment we are strong and stable, but there are some warning clouds that we must not neglect. The decline in our overall numbers has been very slow so far, but the decline among our active dues-paying members is more rapid, and our senior constituency is growing even larger. We are aging and graying, and it is time to address this.
On my web page (www.wrprocci.org or http://warrenprocci.blogspot.com) I have outlined a set of goals I will pursue as President, if you elect me. I will review them briefly here. All are intended to prepare our Association for a future that is better than the present.
1. Relaxation of the exclusionary linkage of certification and TA/SA eligibility. This requirement is a direct contributor to our membership problems. In the evolving psychoanalytic world of today, prospective candidates want to choose their TA’s freely. And in today’s world they can. The more narrowly we restrict our own offerings, therefore, the more likely they are to elect to train not with us, but at any one of the many competitive non-APsaA institiutes. Furthermore, it appears that many of our recent graduates have decided against seeking certification. Only about 15-20% of these colleagues are applying to be certified, and this will narrow TA possibilities for new candidates even further. Add to these practical considerations the contribution that the delinkage issue makes to our current plaguing dissension, and it is easy to see how vital it is for us to resolve this question. In fact, I would make it the number one priority of my presidency.
Efforts to address it in the past have failed, because task forces and pilot groups have been weighted far too heavily in favor of the current balance of power. I would call immediately for a balanced task force to address the issue, and to explore once more a local option proposal that would allow individual institutes to set their own requirements for their own TA’s and SA’s.
2. Pluralistic and democratic government. Hierarchal decision-making has ruled the day in our Association for a long time. Why is this a problem? Because hierarchies are loath to relinquish their power, even when they no longer serve the best interests of the organizations that house them. Like the delinkage struggles, past efforts to deal with membership, education, and appointment issues have often been unbalanced in favor of the very hierarchies they were supposed to democratize. As President I would ensure that our task forces and exploratory committees fairly reflect all components of our membership. I would also move to shift decision-making away from centralized structures and towards our local organizations, where individual voices are more easily heard.
3. A stronger Executive Council. Lately we have become aware that our by-laws do not support a bi-cameral organization. They designate our Executive Council as our Board of Directors. If we are to plan effectively for the future, we will need a strong Board of Directors to set and realize organizational priorities. Too often in the past our Presidents have set our priorities. Presidents may certainly offer individual initiatives; however laudable these may be, however, they are generally abandoned when that President leaves office. The Board of Directors is the structure to which enduring initiatives must be entrusted, as it is only the Board that can safeguard them over the years of changing administrations. I strongly support a much greater role for our board in setting priorities and carrying them out. The way to do this is to add several directors to the Executive Committee, give the Committee on Council a greater role in setting our organizational agenda, and establish an expanded presence and role for Board Committee Chairs at our quarterly governance meetings. These steps haven’t been taken before because the need to empower the Executive Council has not been sufficiently recognized. It is obvious now, however, that the Executive Council must be our policy planning and setting body.
4. Financial Development. Five years as treasurer have made clear to me that we do not possess the resources to do the things we have to do to advance our field. Our current income sources enable us to carry out our basic functions, and we carry them out well. But there is little left over for creative, bold, or innovative efforts. One solution is certainly to bring in more income by encouraging the growth of our membership – yet another reason to resolve the delinkage issue. But I would also encourage the establishment of an endowment fund sufficient to fund the efforts we must make to deal more effectively with the outside world. During my eight years on the Board of Directors and Executive Committee at Wagner College, my alma mater, I was actively involved in just such a major fundraising process. Wagner’s most recent capital campaign has expanded their endowment by $50M.
5. Advocacy. I have a long history in support of APsaA’s advocacy efforts in Washington, D.C. As Treasurer, I worked hard to assure that our Committee on Government Relations and Insurance (CGRI) would have the funding it needed to do its work. Before that, I myself served as Chairman of CGRI. Under my leadership, CGRI made its voice heard on the essential issue of protection of patient privacy. I was part of the team that discovered our current government representative in Washington, Jim Pyles, who has greatly helped us advance the cause of patient confidentiality. During my tenure as CGRI chair, we organized a meeting in Washington where CGRI members had the opportunity to meet with legislators, regulators and policymakers. We also organized (in conjunction with a spring meeting in Washington, D.C.) a “Meet your Legislator” program. We were able to introduce individual members to their legislators, and teach them effective ways to deliver talking points to lawmakers. As President, I would re-establish the tradition of periodic CGRI meetings in Washington.
There are two other areas that interest me greatly and which I would support as President: psychoanalytic research, especially outcome research as in the new research proposal advanced by our current President, and public information and communication efforts. But the five priorities listed above are the ones we must address first if we are to ensure for our Association a future in which these will be relevant – and in which we will have the morale, the structure, and the infrastructure to face that future in a rational and effective manner.
I am absolutely committed to maintaining and enhancing our Association so that we can pass it on to the next generation of psychoanalysts in better condition than we received it.
Best regards,
Warren R. Procci, Candidate for President-Elect, APsaA
“We will transmit the City not only not less, but better and more beautiful than it was transmitted to us.”
This is the oath that Athenian citizens took on behalf of their city-state. It is guiding me in my candidacy for President-Elect of APsaA.
The preeminent issue in our upcoming election is the future of our Association. At the moment we are strong and stable, but there are some warning clouds that we must not neglect. The decline in our overall numbers has been very slow so far, but the decline among our active dues-paying members is more rapid, and our senior constituency is growing even larger. We are aging and graying, and it is time to address this.
On my web page (www.wrprocci.org or http://warrenprocci.blogspot.com) I have outlined a set of goals I will pursue as President, if you elect me. I will review them briefly here. All are intended to prepare our Association for a future that is better than the present.
1. Relaxation of the exclusionary linkage of certification and TA/SA eligibility. This requirement is a direct contributor to our membership problems. In the evolving psychoanalytic world of today, prospective candidates want to choose their TA’s freely. And in today’s world they can. The more narrowly we restrict our own offerings, therefore, the more likely they are to elect to train not with us, but at any one of the many competitive non-APsaA institiutes. Furthermore, it appears that many of our recent graduates have decided against seeking certification. Only about 15-20% of these colleagues are applying to be certified, and this will narrow TA possibilities for new candidates even further. Add to these practical considerations the contribution that the delinkage issue makes to our current plaguing dissension, and it is easy to see how vital it is for us to resolve this question. In fact, I would make it the number one priority of my presidency.
Efforts to address it in the past have failed, because task forces and pilot groups have been weighted far too heavily in favor of the current balance of power. I would call immediately for a balanced task force to address the issue, and to explore once more a local option proposal that would allow individual institutes to set their own requirements for their own TA’s and SA’s.
2. Pluralistic and democratic government. Hierarchal decision-making has ruled the day in our Association for a long time. Why is this a problem? Because hierarchies are loath to relinquish their power, even when they no longer serve the best interests of the organizations that house them. Like the delinkage struggles, past efforts to deal with membership, education, and appointment issues have often been unbalanced in favor of the very hierarchies they were supposed to democratize. As President I would ensure that our task forces and exploratory committees fairly reflect all components of our membership. I would also move to shift decision-making away from centralized structures and towards our local organizations, where individual voices are more easily heard.
3. A stronger Executive Council. Lately we have become aware that our by-laws do not support a bi-cameral organization. They designate our Executive Council as our Board of Directors. If we are to plan effectively for the future, we will need a strong Board of Directors to set and realize organizational priorities. Too often in the past our Presidents have set our priorities. Presidents may certainly offer individual initiatives; however laudable these may be, however, they are generally abandoned when that President leaves office. The Board of Directors is the structure to which enduring initiatives must be entrusted, as it is only the Board that can safeguard them over the years of changing administrations. I strongly support a much greater role for our board in setting priorities and carrying them out. The way to do this is to add several directors to the Executive Committee, give the Committee on Council a greater role in setting our organizational agenda, and establish an expanded presence and role for Board Committee Chairs at our quarterly governance meetings. These steps haven’t been taken before because the need to empower the Executive Council has not been sufficiently recognized. It is obvious now, however, that the Executive Council must be our policy planning and setting body.
4. Financial Development. Five years as treasurer have made clear to me that we do not possess the resources to do the things we have to do to advance our field. Our current income sources enable us to carry out our basic functions, and we carry them out well. But there is little left over for creative, bold, or innovative efforts. One solution is certainly to bring in more income by encouraging the growth of our membership – yet another reason to resolve the delinkage issue. But I would also encourage the establishment of an endowment fund sufficient to fund the efforts we must make to deal more effectively with the outside world. During my eight years on the Board of Directors and Executive Committee at Wagner College, my alma mater, I was actively involved in just such a major fundraising process. Wagner’s most recent capital campaign has expanded their endowment by $50M.
5. Advocacy. I have a long history in support of APsaA’s advocacy efforts in Washington, D.C. As Treasurer, I worked hard to assure that our Committee on Government Relations and Insurance (CGRI) would have the funding it needed to do its work. Before that, I myself served as Chairman of CGRI. Under my leadership, CGRI made its voice heard on the essential issue of protection of patient privacy. I was part of the team that discovered our current government representative in Washington, Jim Pyles, who has greatly helped us advance the cause of patient confidentiality. During my tenure as CGRI chair, we organized a meeting in Washington where CGRI members had the opportunity to meet with legislators, regulators and policymakers. We also organized (in conjunction with a spring meeting in Washington, D.C.) a “Meet your Legislator” program. We were able to introduce individual members to their legislators, and teach them effective ways to deliver talking points to lawmakers. As President, I would re-establish the tradition of periodic CGRI meetings in Washington.
There are two other areas that interest me greatly and which I would support as President: psychoanalytic research, especially outcome research as in the new research proposal advanced by our current President, and public information and communication efforts. But the five priorities listed above are the ones we must address first if we are to ensure for our Association a future in which these will be relevant – and in which we will have the morale, the structure, and the infrastructure to face that future in a rational and effective manner.
I am absolutely committed to maintaining and enhancing our Association so that we can pass it on to the next generation of psychoanalysts in better condition than we received it.
Best regards,
Warren R. Procci, Candidate for President-Elect, APsaA
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