From the President: Executive Committee Meeting

By William A. MacGillivray, PhD, ABPP

The Executive Committee (EC) of the Division 39 Board consists of the officers of the Division (presidents, secretary, and treasurer) and Division Representatives to APA Council. We meet four times a year, typically the evening before the Division Board of Directors Meeting to clarify the agenda items that will be discussed at the meeting. Once a year, however, we meet separately from the Board, and we met last week to discuss and decide the following issues.

Budget Issues

One of the most important items up for discussion concerned the budget. We are facing a number of "large ticket" items in the coming year and our board and committees will be asked to look very carefully at expenditures. We are actually anticipating an increase in income from member dues, a very rewarding piece of news, since our other source of income (that is, royalties from the electronic version of our journal), while significant, is leveling off. Our other source of income is the profits from the Spring Meeting and that is always a matter of concern, especially in this tight economy. That said, our financial situation is quite stable and under the leadership of Marsha McCary, we have succeeded in building up considerable financial reserves. The Division Board will review and decide on the final shape of our budget in January.

Board and Committee Retreat at the Spring Meeting: April 17-18, 2011

One unusual expense will be for the upcoming retreat. The board members and committee chairs will be meeting a few days prior to the Spring Meeting (April 18-22) to discuss the current issues facing the Division and to help identify priorities for us in the coming years. This will be the first retreat in ten years (also held in Santa Fe). We will be asking our members for their ideas and advice in a more formal way around the beginning of the year, but please let us know your own priorities for the Division by writing me.

Publications

No area of the Division has undergone such a dramatic shift in focus in recent years than our publications. One print publication, Psychoanalytic Abstracts has been reborn as an online publication, PsycScan: Psychoanalysis. The newsletter, Psychologist-Psychoanalyst, has been "retired;" and two new publications, DIVISION/Review and InSight have been launched. Finally, our website has been completely revamped and now is able to make full use of APA's Internet resources.

Our journal, under Elliot Jurist's leadership, has become leaner and more oriented to research articles than in the past. This shift has been made partly at the request of the Division leadership, but also as a way to give the journal a higher profile in the publishing world. Without going in to the various ways journal quality is calculated, this new emphasis should help bring the journal up in the rankings of similar journals. As noted above, the journal actually earns money for the Division. APA's electronic subscription services have rapidly expanded in the last few years both nationally and internationally and the Division shares earning from this service based upon the actual number of journal articles downloaded.

Our new publication this year, DIVISION/Review, has been developed under the editorship of David Lichtenstein who would like the review to become a more general interest psychoanalytic publication that will appeal to a wider public in addition to the Division readership. This shift in focus, however, comes at an increased cost due to a need to improve the production values of the publication to make it more appealing. This is a major undertaking and one that definitely has implications for how the Division seeks to "position" itself within both the psychology and psychoanalytic world.

The monthly online publication, InSight, under Tamara McClintock Greenberg has been more or less established in most members' minds over the last year as it arrives on our electronic doorsteps on the first of the month. As a publication available to anyone for the price of a request, it too is serving a varied audience and serves as an important reminder and updating service concerning Division activities.

Finally, there is the website, under the editorship of Barry Cohen. In many respects the website is intended to be the main replacement for the old newsletter, in that it has the capacity to highlight breaking news as well as serve as a repository for ongoing reports of our far-flung chapters, sections and committees. We hope to further the development of the site to provide more opportunities for interaction among our members, although we already have a Facebook account that members are free to post. Be sure to "friend" psychoanalysis!

I have focused on the changes in our publications as a way of highlighting our ongoing effort to develop a vision for our Division that meets the diverse needs of our membership. At the same time, our vision is always subject to clarification and reflection. The main goal of our retreat will be to think together about our publications, our meetings, and our outreach and "inreach" efforts to carry out our mission as an organization committed to psychoanalytic psychology.

Council of Representatives

Currently we have seven representatives to APA Council, although we will only have six in the coming year. If members support the Division by giving their ten votes to the Division on their apportionment ballot this month, we will be able to regain our seventh seat. While APA Council meets only twice a year, the work of our council representatives is an ongoing effort to keep abreast of issues of concern to the Division. APA is a vast organization with various boards and committees that play a major role in shaping APA policy. Although APA Council has the final say in the direction of our parent organization, much of the work is always happening "back stage," including in the various caucuses of Council. Our representatives are active in participating and leading these caucuses, including Divisions for Social Justice (DSJ), Association of Practicing Psychologists (APP) and so on. We are also grateful to our Division members who are serving as liaisons to APA Boards and other areas of APA governance.

Practice Directorate

During our meeting, Katherine Nordal, head of the Practice Directorate and the APA Practice Organization (APAPO) joined us by telephone to discuss the various ways the Division can cooperate with APA and to impress upon the APAPO the importance of protecting patients' rights to seek psychotherapy including psychoanalytic psychotherapy that is private, secure, and confidential.

The reality is that APA remains highly focused on promoting a vision of psychological care that is based on the concept of "integrated health care" and envisions psychologists working within large healthcare organizations and functioning primarily to direct and evaluate programs rather than perform individual, family or group psychotherapy. While Dr. Nordal expressed her thanks for a list of references documenting the evidence basis for psychoanalytic psychotherapy (compiled by Tamara McClintock Greenberg), it is clear that our view of how to promote emotional growth and change is not a high priority for the APAPO. During the Spring Meeting in New York earlier this year, Ken Levy, in discussing efficacy of psychodynamic psychotherapy, began with the simple but profound statement that long-term change requires long-term work, an observation that applies equally to emotional growth, cigarette cessation, and national infrastructure development. We live in a culture that demands only short-term improvements; and this applies equally to managed care, Wall Street, and our political system. The ability of our members to hold open a space for long-term emotional change (change that continues long after psychotherapy ends) will remain largely our task. We are likely to find allies within other Divisions and members of APA, but it is a struggle that this Division must uniquelybear.

Depressive Disorders Treatment Guideline Development Panel: During our discussion with Dr. Nordal we emphasized again the need for a psychodynamic perspective on the new panel that will be formed to develop guidelines for the treatment of depression. Two members of our Division have placed their names "in the ring" (Tamara McClintock Greenberg and Jared DeFife) and we reminded Dr. Nordal that our nominees for the original task force (that outlined the overall direction of this and future task forces) were not selected. The ultimate problem remains that treatment guidelines for specific DSM-IV-defined disorders is conceptually and practically difficult if not absurd. There is, to paraphrase Winnicott, no such thing as a "depressed person." At best the guidelines represent an attempt to prevent managed care from developing more onerous and absurd guidelines so that everyone can pretend that what we say we do is what we do. The best result is that the guidelines may help us be more successfully duplicitous with a healthcare system that cares not a whit for health or care. All that is lost, then, is a vision of psychotherapy as a humanistic endeavor to help people develop and deepen their emotional life and connection to others.

Division of Psychoanalysis Endorses Petition to DSM-V Committee

Many of you are aware of the revisions being proposed to the Diagnostic and Statistical Manual (DSM) published under the auspices of the American Psychiatric Association. The efforts of the earlier committees that revised the DSM were understandably directed toward developing standard diagnostic criteria for standard diagnostic categories. While a major reason for this development was to be able to bill for psychiatric services, the DSM has served to bring some order to the vast array of competing theories and descriptions of human ills. Perhaps ending up with a plethora of diagnoses for addicts (is a cocaine addict really all that different from the opiate addict he might be in a few years?), for example, is the price paid for increased order.

The new DSM, however, appears to not only suffer the faults of its predecessors, but to increase those errors in ways that are likely to be pernicious. In addition to the vast increase in behaviors now carrying a psychiatric label, the manual will place even greater emphasis upon pathophysiology as etiological (even in the face of an absence of coherent etiological models).

A number of organizations have weighed in against the proposed changes to the DSM including the British Psychological Society and American Counseling Association. The Division of Humanistic Psychology (32) has been circulating a petition calling attention to the problems noted above and others, calling for the DSM-V Committee to take note of these concerns. Division 32 is asking individuals and group to sign a petition supporting these efforts. View the petition.

The Executive Committee endorsed this petition and I would encourage our members to go to the petition site and review the information for themselves and consider signing on as individuals. As of today, eleven APA Divisions have endorsed this letter.

Division of Psychoanalysis Endorses Effort to have APA Withdraw the PENS Report

As I reported last time, the Coalition for an Ethical Psychology (CEP) has circulated a petition calling upon APA to annul the PENS report. This report, while it no longer represents APA policy is still being cited as a basis for psychologists making ethical decision concerning involvement with illegally held detainees in Guantánamo and other sites. The petition has been widely circulated and signatories include many individuals and groups that are not psychologists as well. View the report.

The Executive Committee struggled with the issue of endorsing this petition. There was a clear consensus that the PENS report was adopted in haste and error and should certainly not be used to represent or reflect APA policy. The efforts of many of our members to not only oppose the PENS report but to reverse APA and APA Ethics Committee position that psychologists could operate ethically in assisting in interrogation and other interventions is testimony both to the strong stand they took (wholeheartedly supported by the Division Board) and to their tenacious efforts to work within APA governance structure, however cumbersome and time-consuming.

Our concern in discussing the petition was our inability to see the petition as "moving the ball forward" to actually impact APA policy. The petition certainly addresses the ways the PENS report has continued to influence APA decisions and action, in contradiction to the spirit if not the letter of actual APA policy. While the EC ultimately voted to sign the petition, we have also conveyed to the leadership of CEP our wish and expectation that they will work to identify concrete steps to take to bring the issue of the PENS report to APA, specifically, APA Council of Representatives, and to develop the language and procedure that will actually allow the PENS report to finally be withdrawn as a document that has any standing inside or outside APA.

Division of Psychoanalysis Calls for Revision of the Proposed Ethics Casebook

Years ago, the Ethics Committee was charged by APA Council to develop an Ethics Casebook to clarify what psychologists could and could not do when serving in detention centers where detainees were being held illegally. At the time, there were strong reasons to develop a casebook in the face of several factors: 1) APA policy has long endorsed the principles of the Geneva Conventions that psychologists cannot ethically participate in any way in cruel, unusual, and inhuman treatment of detainees; 2) the PENS report outlined possible ways that psychologists could participate in interrogations of illegally held detainees without violating these prohibitions; and 3) the APA Ethics Code allowed an exception to the prohibitions when and if the psychologist was following "valid orders."

Subsequently APA Council of Representatives endorsed as APA policy the results of a referendum stating that psychologists could not operate ethically in detention settings such as Guantánamo (with certain strictly defined exceptions). It also endorsed a revision of the Ethics Code to eliminate the "valid orders" exception. Despite this the APA Casebook, as currently published for public review, contains reference to the PENS report, suggests that psychologists are able to decide when and if certain actions constitute torture, and so on. The public comment period was initially slated to end a month ago, but due to protests from a number of members the comment period has been extended until February.

The Executive Committee discussed this issue and our concerns that the Casebook should be either scrapped or extensively revised. While a number of our members have written comments along these lines, it is important that others write down their concerns and let APA Ethics Committee hear your opinions.

Division of Psychoanalysis Calls for the Release of Syrian Psychoanalyst, Rafah Nached

There has been a call from a number of psychoanalytic organizations to protest the arrest of Rafah Nached, a Syrian psychoanalyst. The EC voted to sign the petition calling for her release and to communicate this decision to APA leadership, other psychoanalytic organizations and the State Department.

The following information comes from Roger Litten and Betty Bertrand-Godfrey (Chair and Secretary of The London Society of the New Lacanian School): "I am writing to you concerning the imprisonment of Rafah Nached, a Syrian psychoanalyst who was arrested on 10 September at Damascus airport when she was on her way to see her daughter in Paris. Rafah is 66 and has heart disease for which she needs medication and we have recently received news that her health is deteriorating. She has been imprisoned and placed in solitary confinement by the Syrian authorities for practicing and transmitting psychoanalysis with her fellow countrymen in Syria. Beyond our concern for Rafah herself, we are concerned for what this imprisonment represents for humanity; the principle of psychoanalysis is speech, the freedom of speech, and thus our fight to save Rafah is also a fight to save the freedom of speech as fundamental to psychoanalysis as well as our humanity. We refuse to be silenced."

To comment on this post or any other matter before the Division, you may email me directly or post on my blog, where you will also find previous column you may have missed.