The PANY Bulletin

Psychoanalytic Association of New York
Volume 43, #3 Fall 2005

Local Option Pro and Con

For the Local Option
by Howard Welsh

As I understand it, members of the American Psychoanalytic Association will soon be asked to vote on a by-law change which would allow institutes the option to require or not require certification as a prerequisite for training analyst appointment. The change would be an anathema to many in our institute who view certification as a lynchpin in the American's role as a standard bearer for psychoanalytic education and practice. They fear this by-law change would severely erode the American's capacity to promote standards and may have a negative impact on an institute like ours which has always been especially proud of its comprehensive training program and vision of analysis as a treatment modality. I am in favor of the “local option” and would like to explain why.

Some years ago, another faculty member and myself conducted an informal survey within our institute to try to determine why a number of apparently well-qualified and highly regarded members were not certified. We did not find any consistent theme. Some seemed stymied by a perfectionistic vision of the required terminated case. Perhaps some female analysts, who tended at the time to have fewer male patients, were disadvantaged by the requirement for a male case. There were many and varied individual reasons: time constraints, family obligations, the daunting task of writing up years of analysis, resentment at having to jump yet another hurdle after many years of professional training, or not accepting certification as a valid way of judging analytic competence: it seemed contrived and artificial compared to the years of familiarity with one's clinical work that led to graduation from our training program. The one most consistent finding in our survey was that a graduate who had not applied for certification within five years after graduation was unlikely ever to become certified. Only a few applied for certification between five and ten years after graduation. Virtually no one applied after ten years. One of the justifications for certification has been that it assesses a level of analytic maturity beyond graduation, yet most of the applicants from our institute have been recent graduates. The majority of graduates who applied for certification found it a demanding but worthwhile experience. Some, who were rejected, deferred, or were, indeed, certified, found it an unhelpful ritual, disparaging, or even traumatic. Most importantly, however, the assumption that the institute held at the time, that those seeking certification would be more likely to have analytic identities and practices, did not prove to be the case. There appeared to be no difference between the certified and non-certified analysts in their commitment to analytic work and to their proud identification as analysts.

Our own institute has evolved, like many others, to require certification only as a condition for training analyst appointment. All other faculty functions, including chairs of major committees, membership on the Education, Student Progression, Admissions and Curriculum committees do not require certification. The value we place on our own faculty members is not determined by certification. Some institutes in the American believe their training programs are seriously compromised because they feel that having the option of appointing qualified but non-certified analysts to TA is essential at this time. The American would not lose its power to promote standards if certification were de-linked from TA appointment. It will continue to do that through the Committee On Institutes, its well-received site visit program, and the stimulation of analytic discourse and debate through its scientific program and national meetings.
In allowing the local option, certification could still be used by those analysts who feel it would be of value for their professional development and by those institutes who would still require it for TA appointment. The American Psychoanalytic Association is the only society in the International Psychoanalytic Associa-tion that has created a national certification process beyond graduation. I believe this was done out of a sincere effort to maintain the highest standards. But it also mirrored the singular medicalization of organized psychoanalysis in the U.S., and was modeled after national certification bodies in the traditional medical specialties. I believe analysis will not be damaged but rather will be enlivened by the proposed by-law change.

Finally, I felt it was especially important for PANY and our faculty to be able to openly discuss all aspects of this very important by-law vote. I was shocked to learn that the American intends to distribute only arguments against the local option in the ballot mailing. Unfortunately, it is often precisely the fear of this kind of abuse of power and stifling of divergent viewpoints that has led many credible analysts to decline certification.

Against the Local Option
by Michael Singer and Robert Fischel

The proposed “Local Option” By-Law is not simply a delinkage of certification and Training/Supervising Analyst appointment.
Soon you will be asked to vote on the “local option” by-law proposal which states: “The Board on Professional Standards shall not require certification … as a precondition for appointment as Training Analyst or appointment as Supervising Analyst. Nothing in this section shall be construed as prohibiting individual institutes, at their discretion, from requiring certification as a precondition for such appointments.” This is similar to the by-law proposal put forward in 2003 which also asked that certification be delinked from TA eligibility. The 2003 proposal was voted down by the membership.

Much is being said in various venues about the current proposal, and with good reason. While it seems to be simply about the link between certification to TA/SA eligibility and about giving institutes the choice of linking them or not, the proposal is also about a fundamental change in the way the American Psychoanalytic Association (APsaA) has operated for many years. This change has the possibility—even the probability—of altering the very nature of our national organization and the cohesion of our institutes, despite claims to the contrary.

The proponents of the by-law change claim it will not affect the Board on Professional Standards, Training Analysis, certification or the reorganization process. This is simply not true. The essence of the by-law proposal is about how national educational standards are determined. Since its inception, the APsaA has integrated the advantages of a national professional organization with the advantages of a national educational/standard-setting organization. Historically, the Board on Professional Standards (BOPS), as the body of institute representatives, has been responsible for setting educational standards for institutes, including those that apply to Training Analysts. This by-law proposal prohibits BOPS from setting a particular standard (certification as a prerequisite for TA/SA), and it is asking the membership at large to determine an educational standard. As membership expands to include more and more members who are not connected to institutes of BOPS, membership needs will more and more override institute educational needs. Passage of this by-law sets a precedent: it will adversely affect our educational mission by placing educational/standard-setting functions in a subordinate position to the ever-changing demands of the professional-guild demands of the organization. If educational standards are made a matter directly decided by the membership at large, it will erode the semi-autonomous nature of the collective body of institute representatives (BOPS) which has always engaged in a process that enabled standards to evolve through methods of study, deliberation, compromise and mutual agreement.

Legislating that institutes can independently decide which standards to use defeats the purpose of having a national standard setting body. Institutes have traditionally relied on the national organization to guide them when they are unsure and to calm local divisiveness by relying on the national organization's standards. Having each institute go its own way will weaken the cohesion around high standards that has made APsaA the admired, preeminent psychoanalytic organization in the world. It will lead to institutes being influenced primarily by local politics and all the pitfalls that implies. This is one of the main reasons national standards were established in the first place, especially for Training Analysis.

Regarding the reorganization process: It is argued that the by-law change will not influence this process because, as a result of the reorganization of APsaA's governance, new by-laws will be created for the general structure of the organization and the new BOPS will be able to devise its own procedures, etc. However, it will be very difficult to reinstate the link between certification and Training Analysis. Once something is taken away it is very hard to put it back. Those proposing the by-law change know this. Why else would they be expending such an enormous effort to get it passed if they believe that the link between certification and TA would just be reinstated by a future iteration of BOPS?

As with the last by-law proposal, claims are being made that certification is the root of various problems and discontents. It is being said that certification is not supported by the membership and that the linking of certification to TA eligibility has been a source of contention within institutes. It is also being asserted that the certification requirement discourages graduate analysts from applying for TA status, making it difficult for their analysands to apply for candidacy. This is stated as if it is a widespread problem when data is lacking to support this assumption. Some institutes have had trouble filling their candidate rosters, but this problem has been developing over the years and has many sources: morale has dropped as psychoanalytic practices dwindle due to the appearance of competing therapies, more effective medications for a wide range of problems, etc. There have also been many reasons for conflicts and disharmony in institutes just as there are many reasons why not all graduates apply for certification and/or TA status. Thus, an underlying effect of this by-law proposal is to reduce complex problems to a simple, misleading solution. In doing so, it scapegoats certification and diminishes its value.

Data about certification have been variously used and misused. It might be helpful to state the facts. Regarding the members support for certification, there have been two major surveys in the past 13 years and these indicated that the majority support certification. The membership survey of 1992 indicated the following: 15% supported certification unconditionally, 66% supported certification with improvements (which were subsequently made), and 19 % were opposed to certification on principle. Ten years later, the membership was surveyed again and the response was essentially the same although the scale was different. To the question “Do you support some form of certification in psychoanalysis?”, 56 % were strongly in favor, 14% were somewhat in favor, 7% were somewhat opposed, and 23 % were strongly opposed. Thus, in 2002, at least 70% supported certification. The chief architect of the poll wrote “This indicated the response may be more like a vote or referendum on the issue”. In this 2002 survey, when asked about whether they favor “a certification procedure conducted by the APsaA”, the members were split down the middle. When asked whether they “favor a certification process conducted by an external certifying body”, 64% were opposed. It's hard to know how to read the responses to the last two questions, but it seems at least it can be said that the membership is mixed about whether to externalize certification. It can be definitely said, though, that certification of psychoanalysts has been consistently supported by the members.

The certification committees intend to make APsaA's certification procedures a model for other fields. The initial tests of the inter-rater reliability of the certification examiners and of an independent group of analysts not connected to the certification committees or to BOPS have shown a very high degree of concordance. The certification oversight committee (CARD) is working to improve the selection and training of examiners, broaden the procedure, regionalize it, and eventually externalize it. Many professions have certification or its equivalent for their practitioners. We are a mental health profession; what more important use of certification can there be than to have it as a post graduate test of analytic clinical competence for those who have the responsibility for the analyses of future analysts?