The PANY Bulletin

Psychoanalytic Association of New York
Volume 39, Number 2 Summer 2001

President's Column
Robert Chalfin, M.D.

It is with pride and pleasure that I assume the leadership of PANY. Along with Charles Goodstein and the Board of Directors, I hope to continue the work of the past leadership, most recently that of Len Barkin. With Len as President, PANY has taken some steps in refocusing our efforts in new directions-PRACTICE, OUTREACH and EDUCATION. This will be a progress report and some plans for the future.

Our main efforts have been in the area of practice development. We have developed a program with the NYU School Of Medicine in which we provide courtesy (free) consultation and affordable psychotherapy for medical students and house officers. The school is extremely pleased that we are available to provide this service to them. So far, between mid-November and early April, we have had about 30 referrals mostly of medical students. The program for house officers has only recently become widely distributed. There are over a thousand house officers. We now offer our services to spouses and children as well.

All program directors at the medical school are now aware of who we are and what we are offering and we are on the new RESWEB site for house officers of the NYU medical center/school. We have been discussed in the Dean's Committee set up to oversee the education of these young physicians. Our offer of service came at a propitious time for them as they were preparing for a site visit from the organization overseeing residency education. The house officers have only recently come under the aegis of the medical school. Likewise our efforts towards medical students occurred when there was some reorganization regarding the mental health needs of medical students.

In our presentations to the medical school we have emphasized our expertise as psychotherapists able to provide ongoing treatment when indicated, our training and dedication, our ability to provide private and confidential treatment, and our allegiance and interest in being of service to the school and their students and young physicians. Seventy members agreed to participate in this program.

There are issues that continue to need clarification. Referrals are made for medical students directly to our members after an initial contact by the nurse practitioners in the Medical Student Health Service. The insurance coverage of medical students is somewhat unclear but tends to be limited. After the courtesy consultation, setting a fee can be an issue. Some students are limited in their ability to pay and we have stated to the Medical School and the students that we will provide affordable psychotherapy. If affordable therapy can't be worked out there are resources within the PANY community for helping. House officers have varying coverage depending upon their rotation. Without going into detail they can get back up to $50 or $60 per session from their insurance even for "out of network " treatment. Calling myself or David Frank as the main facilitators for the program for problems is always available.

Related to this is that all referrals are private to the members leaving us with no idea if a referral occurs unless the PANY member lets either David or myself know. This service is private and confidential, which is what the Medical school prefers. For house officers and their families, most referrals will come from them directly. There will be occasional referrals via a program director for a house officer having' "trouble" of one kind or another, but these will be relatively few. We would like to be informed if you have seen someone to keep a count of how the program is going.

What is of extreme importance for the success and further development of this program is that we-as PANY-do not turn back any cases. We are assuming a responsibility as practioners and we have the resources to treat these patients. Our rapport with the school would be destroyed if we came across as not able or unwilling to provide the services we have said we would.

Finally it should be clear that this structure has the potential to eventuate in psychoanalytic cases for our members-both regular and affiliates. Our thinking is that psychoanalysis is dependent upon psychoanalytic practice if it is to survive as a form of treatment and appeal to young people as a profession. To promote psychoanalytic practice we need a flow of patients to treat. Our members need to practice as a source of income and as a source of pride. To be underutilized in our profession is demoralizing and leads to anger towards ourselves and demeaning feelings towards our profession. Seeing patients keeps us alive in many ways. I also see our profession as including dynamic psychotherapy as well as psychoanalysis. Psychoanalytic patients are developed nowadays for the most part from initial psychotherapies and a flow of potentially suitable cases is a prerequisite for that. Our program with the medical school provides such an opportunity for our members.

Our progress report continues with the issue of Website development. In conjunction with the NYU Psychoanalytic Institute we are developing a website at the NYU School of Medicine. Charles Goodstein is leading this development He envisions a number of links involving PANY, our scientific programs, our Bulletin, other forms of outreach and links for our individual members to present themselves. A more extensive presentation of this will be
made in future Bulletins. Allied with this to a degree is our internal survey. This is to document for ourselves what our members do aside from psychoanalysis-other aspects of our professional identity. This includes areas of interest, special training and expertise that can serve as a source of information for each other and a potential for referrals.

We need to further foster educational opportunities for members. We have a tradition of excellent scientific meetings which has been the mainstay of PANY activities. Under the strong leadership of Arden Rothstein and Warren Seides, it has been extended into the wider psychoanalytic community bringing us more into contact with current psychoanalytic ferment and controversy. To this we have added our combined seminars for graduate members with the faculty of the NYU Psychoanalytic Institute on Contemporary Kleinian Issues led by Roy
Schafer. This program, set up by Len Barkin, was stimulating and provocative for the attendees. It is the kind of programming we need to promulgate. This will be a prime task for the Board of Directors in the coming year.

Along with this was our participation with the other International Psychoanalytic Societies in New York City in a conference on "Affects in Psychoanalytic Treatment" that was attended primarily by non-members. In this we were ably represented by Sandra Leong and Monica Michell. The next such conference is likely to be organized by PANY. Whether such conferences should primarily be for the members of these societies or for a more general
interested public is not yet clear to us. This is outreach to the larger psychoanalytic community as well as the public.

Another outreach effort is The South Asian Forum organized by Mimi Ismi, originally with sponsorship from the Institute and now from PANY. This is an important program, but up to now only a very limited number of PANY members have attended, although it has drawn a large number of attendees. Are we xenophobic? This like all other initiatives will only benefit those who participate.

A new study group has been formed by James Schluger who as Clinical Director of the Laboratory of The Biology of Addictive Diseases at the Rockefeller University has a rich background in substance abuse and addiction along with his psychoanalytic training. Those interested in these topics including treatment of these conditions and neuroscience in general should contact him.

Another set of issues has been raised by Rita Clark, Chairwoman of the Ethics Committee. She is interested in promulgating a more informal structure through which problems can be presented before reaching the need for an ethics complaint. It would be patterned somewhat in the style of a committee currently active in Michigan. As the American is coming out with new guidelines on ethics this fall (see p. 8), her proposal is timely and worth careful scrutiny.

We need to reorganize our committees. Some have been inactive, others need to be redirected and one or two active new ones will probably have to be formed. The 50th Anniversary of PANY is coming up in 2005 or 2007 (depending on whether we count from its organization or membership in the American Psychoanalytic Association) and obviously some kind of celebration-social and/or scientific-is truly warranted.

We hope members continue to use the Bulletin as a forum to communicate their ideas and interests as well as to respond to reports such as this.