From the President

Barry Dauphin, Ph.D.  

We practice in a profession that can be lonely despite working with various people on any given day. We, of course, have all read papers or books that concern themselves with the abstinence that benefits our work and serves as an essential part of our professional identities. The demands of our work require that we attune ourselves to the emotional lives and unconscious communications of others throughout the course of our work. Also our work often occurs in a private or small group setting, and we usually are not interactively working under the same conditions that so many in more conventional occupations are working, At times this could lead a therapist to feel somewhat disconnected from colleagues in the psychoanalytic community unless he or she undertakes efforts to remain engaged with others who practice in this distinctive profession of psychoanalysis.

This risk of feeling disconnected or cut off from one’s colleagues seems even greater these days when the broader profession, within which we practice, is actively pursuing the means to undercut the intimate and idiosyncratic work of psychoanalytic forms of knowing and understanding others. I ask the reader to bear with me, for I fear that some might accuse me of beating the proverbial dead horse. We face significant challenges to our work in the form of efforts by organized psychology to use government mandates to control our forms of learning (Mandatory Continuing Education or MCE), to stigmatize and delegitimize psychoanalytic versions of working (Evidence Based Treatment or EBT) and to fully transform psychology into a type of medicine and thus further undermine the already difficult work of talking therapy (Prescription Privileges). Coming on the heels of the Managed Care rampage through psychology practices, it would be understandable if psychoanalytic thinkers and clinicians were simply content to head home on weekends and retreat into more diversionary pursuits.

Let me discuss some of these temptations as occurring within organized psychology, namely the EBT movement, MCE and Prescription Privileges and urge a course of action for ourselves. If we consider these movements together, they all contain elements of attempts to divert us from the difficult, often confusing and involving work of psychoanalysis. Although packaged as serving the public or consumer, together they risk diminishing the role of independent, critical thinking that has traditionally defined professionalism and supplanting the most intimate aspects of the relationship between the professional and those with whom he or she works. I wonder if these three movements are themselves diversions from the anxieties that can accompany idiosyncrasy.

On the educational front, MCE laws appear to create menus for approved activities and formulas for the ingestion of educational encounters. These laws serve to shrink the number and kinds of experiences that can count as officially sanctioned education. At the same time these laws act to burden many professionals with bureaucratic requirements that greatly risk squeezing out the time and energy for the forms of education that don’t count as far as the state is concerned but which are probably the most significant kinds of experiences any psychoanalytic thinker and clinician can have.

The EBT movement seeks to create protocols to treat diseases rather than enrich the possibilities for ways of working with people. The diagnosis will drive the treatment, and a particular DSM diagnosis is the same no matter which font you print it out in. The kind of treatment will follow from the code, of which there are a limited number. For EBT, there is no yes, but possible. This aims to shrink the possibilities for the shrinks to use. Knowing the diagnosis becomes all, and knowing the person not at all. For EBT diagnoses are like fingerprints: when you’ve seen one, you’ve seen ‘em all.

Prescription privileges, in part, aim to enhance the status of psychologists, so that we can stand as high as the fabled doctor on a pedestal. This seems hardly like a move that would bring us closer to our patients, if the current practices of biological psychiatry are any indication. Prescription Privileges for psychology, to my mind, rest upon many shaky bases, not a good sign for pedestal stander wannabees. One is the vision of laissez faire, namely those disinterested in obtaining these privileges have nothing to worry about because this won’t adversely affect the field. This ignores the overwhelming evidence that they have drastically changed psychiatry. Somehow psychology is expected to be immune from catching the same flu as psychiatry. Another premise I call the Michelob® dream, based upon the jingle from one of its old commercials: Who says you can’t have it all?! By this I mean the idea that obtaining such privileges only adds to one’s repertoire and diminishes nothing else. So in other words whatever efforts one has always undertaken in studying psychotherapy, assessment, psychological theory, etc. won’t be reduced when one adds the education and effort needed to obtain and maintain these privileges. If true, these folks must either give up recreational or other activities or decree there to be more than 24 hrs. to a day. Maybe the Zeus dream is more like it. When Odysseus understood that he and his crew would pass near the seductive Sirens, he had his crew plug their ears with wax and tie him to the mast ears unplugged, for he understood he would be otherwise unable to resist their tempting calls. I wonder if obtaining Prescription Privileges will be like trying to listen to our patients with our ears plugged or like pretending oneself to be superhuman enough to eschew temptation unconstrained.

Fortunately, or unfortunately depending upon your take, we at MSPP don’t have such powers to bestow. We seek to go about the hard work of psychoanalytic thinking without cutting corners and in as jolly a way as practicable. Perhaps you could consider spending some time on some weekends with those colleagues who share a common language with you, though hardly identical thoughts. Instead of refraining from more engagement, perhaps you might find your work and your professional life enriched through active communication in our society where one size never fits all.

MSPP has been strongly invested in maintaining the space needed in our profession to undertake the difficult but rewarding psychoanalytic work. This space includes spending some Sunday mornings listening to psychoanalytic work, discussing our thoughts and connecting with our colleagues. This space also includes efforts to be informed and keep our members informed about the broader professional issues that can affect psychoanalytic theory and practice.

Unlike the more solitary work of the consulting room, this form of working for psychoanalysis is best undertaken as part of a group. Running a psychoanalytic society involves a great deal of effort on the part of many people. The effort is worthwhile, but there are never too many involved, only, at times, too few. I encourage our readers to participate in MSPP to the degree you are able. Come to some meetings, enjoy coffee, bagels and scones and join in the conversation that is both personal and professional. Write something for the MSPP News, such as a letter to express your opinion, a book review, a brief psychoanalytic essay, your thoughts about the field, etc.  Consider joining a committee, volunteering to assist with tasks of the society or joining or starting a section. Currently MSPP is experiencing a shortage of helping hands to best manage and further the purposes of the society. If any would like to find ways of being involved, please let me know.