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Contents

President's Message by Henry Evans, MD

I hope the holiday season just past has been a rewarding one for you and yours. As we begin this last year of the millennium we face much upheaval and uncertainty on the national political level. The impacts of this process are already reverberating locally and personally. I suspect many of you have been approached by friends, family and/or neighbors for your views on this turbulent time. As analysts we can bring potentially helpful perspectives on such issues as the psychology of leadership, disillusionment with leaders, factors which can contribute to abuse of power, et cetera. If you feel your thoughts on some aspect of this crisis could be of help to others, I encourage you to contact Dottie Jeffries (312/938-1969). As our Public Relations expert, she can help determine whether your ideas could usefully be brought to the attention of one of her media contacts. In keeping with this theme of representing psychoanalytic views, I also urge you to consider how you can become active on one or another committee of the American. Increasing our representation automatically increases dialog with analysts from other parts of the country, giving opportunities for individual Societies to benefit from one another. If you are interested, please contact me, our Councilor Mark Levey, or Bob Gordon, our Alternate.

Locally, we have been and continue to be busy with agendas for our membership. The vote concerning establishment of a Psychoanalyst Assistance Committee passed by a large margin, making it a new Standing Committee of the Society. We will be making all efforts to insure that any member-related concerns brought to the attention of this committee will be handled in a careful, thoughtful manner aiming first to be of assistance to that member.

You have probably heard discussion concerning establishment of "professional wills" by our members. In such a will, each Society member would be asked to specify one or more individuals who would be available to help family, patients and colleagues when a member becomes incapable of carrying on the responsibilities of his or her practice, or dies. In the midst of inevitably difficult circumstances, a professional will would be of significant help to all concerned. An article in TAP has enumerated many points that can usefully be included in such a will. The Executive Committee has discussed this proposal and is unanimously in support of establishing a policy for our members, using the article as a model. You will receive a copy of the TAP proposal in the near future for your study. We plan to invite discussion of this proposal at our Business Meeting in April and to submit some form of it for a vote as soon thereafter as feasible.

In another agenda, the Executive Committee has voted to consider creation of an Association for Psychoanalytic Thought. This is a program developing under the auspices of The American and created through efforts from local Societies. Membership is generally open to a large variety of individuals interested in psychoanalytic ideas and in applying those ideas to their own fields. Master's level clinicians, educators, lawyers, religious leaders, psychiatric nurses, et cetera have been among the members in other locations. Existing APT organizations have drawn up to a few hundred members in individual cities. These are typically freestanding organizations which develop their own programs and sources of funding. In some locations the members have been granted a special category of nonvoting membership in a local Society. In several locations some Society members participate in the APT programs. Societies and Institutes have benefited from the existence of APTs. APT members have generally been enthusiastic about analytic practitioners and educational programs. They have generated increased requests for supervision, treatment, and applications for participation in educational programs, including analytic training in some cases. We are gathering information about this program and will keep you informed.

After further discussion in the November Business Meeting and in the Executive Committee, we have also decided to change the Society Matinees program. The programs held so far have only been usable by a limited segment of our members. My requests for new program ideas have brought suggestions which will likely appeal to the group already being served. Since the program was intended to draw wide participation from within our membership we have deemed it unfair for the Society to pay for programs enjoyed largely by one segment of our members. The Matinees program can continue if those attending are willing to split the cost of light food and beverages, probably amounting to $10-15/person. We already have music and opera programs in the wings for such gatherings.

We are also proposing a series of small dinner gatherings to be held at the homes of Society members in the city and suburbs. We are looking for ways to advance relationships among Society members, in the interest of increasing cohesiveness in our organization. The dinners would be hosted by one or two members who, together with any partners, would invite a few/several other Society members and any partners of different ages from a list of those who have voiced interest in participating in this program. The dinners might well be done potluck. I will be sending a questionnaire concerning this agenda in the near future.

Confidentiality by Jerome Beigler, MD

Editor's note: This article first appeared on the American Psychoanalytic Association's Bulletin Board as a response to the numerous postings regarding the issue of confidentiality. The discussions were an outgrowth of the Monica Lewinsky affair. This is an edited version of the original posting.

I first want to acknowledge Paul Mosher for his incredible energy and devotion to educating us further to the importance of confidentiality as a prerequisite to the effectiveness of our profession (and, also, incidentally to the survival of our Democracy). I wanted to call everyone's attention to a recent court decision entitled Jaffe, Redmond and Hawaii P.S. v. Ariyoshi. This ruling, by the U.S. Supreme Court established by a 7-2 majority, states that society must provide a circumstance in which injured or ill citizens have access to appropriate treatment. If the treatment is psychotherapy, absolute confidentiality is a pre-requisite. This decision helps all of us to actively assert our ability to maintain confidentiality in the face of strong opposing views and already has been supported by a ruling in the District of Columbia. It emphasizes the psychiatrist's responsibility to protect the confidentiality of his records from incursions (as from Medicaid). For example, there is currently a campaign from "so called" researchers to obtain APA's (The American Psychiatric Association) approval for unimpaired access to identifiable clinical records, all of which would be computerized and thus automatically exposed to public accessibility. Paul Mosher says "this can erode the need for strict privacy." One should call their APA representative, APA Trustee, APA President, Vice President or Trustee-at-Large to voice our opinion.

I also want to comment upon an often heard remark that "The privilege of confidentiality belongs to the patient." In 49 of our States, it is true the privilege belongs only to the patient. But, in the state of Illinois, our statute for over 30 years provides for a supra-ordinate privilege to the therapist when it is exercised "on behalf of and in the interest of the patient." This statute was enacted to protect the unauthorized disclosures by the patient of events of treatment, thereby providing the therapists with the privacy to become optimally therapeutic. The law also enables the therapist to over-ride a patient's uninformed permission for the release of information the patient either doesn't remember or whose significance is not understood. Often a patient will agree to disclosure without realizing the entire record will be released. There have been cases in the past in which the therapist's privilege has enabled interventions to their patient's benefit. The law does not impair the patients' right for legal redress when it is appropriate while placing a sense of equal responsibility to maintain professional confidentiality.

We have a great profession and a great cause. Let's do what we can. There is a word of good news: At the September meeting of the Managed-care Association in Chicago, their president, who originated the system and is revered by its members, announced that managed care has succeeded in alienating the public and that there are thousands of legal cases all over the country suing managed care entities. This illustrates the effectiveness of individual attention. The American Psychiatric Association has been active at the grass-roots level in promulgating these cases. We don't know what system will succeed managed care, but we must learn to be active, learn where the channels of power are and how to influence them.

PR Remarks by Mark Smaller, Ph.D.

WHY A PSYCHOANALYTIC FOUNDATION?

The Institute for Psychoanalysis in Chicago is one of the oldest, largest, and best known Institutes in the country. Known for its innovations in the advancement of psychoanalytic treatment and theory, education of candidates, training programs for therapists, and adult and child clinical services, our Institute has been a model for many younger Institutes across the country. In recent years we have developed better community and public relations, and therefore are on the verge of finally being what we should have been years ago: friendly, usable, and available. Our Institute is finally to be trusted again by the community, by potential mental health professionals seeking our training, by potential patients seeking our clinical services and by potential donors interested in contributing to psychoanalytically informed programs that help people in the community. Yet, with all that we have finally accomplished, we are having problems-- serious problems in the areas of development, internal tensions, and following through in making known to the public who we really are, and what our cause or mission is.

In the area of development, we have a Board made up of thoughtful, successful, and creative people who are committed to psychoanalysis. Yet something interferes with our motivation and ability to raise money, convincing our friends, and others in the community to contribute to our cause. But, what is our cause? What is our mission, individually and as a Board? Why is it that we cannot raise money for our programs that benefit the community and the advancement of psychoanalysis?

We have one of the most creative psychoanalytic faculties in the country. Members of our past and current faculties have made some of the most significant clinical and theoretical contributions in the history of psychoanalysis. Sadly, these days, if we are all in a room together, the tension, if converted to electricity, could light up the city for weeks. What is that tension about? What is the Institute's cause? What is the Institutes mission? We have reporters from the media who are hungry for what we have to say, mental health professionals starving for psychoanalytic knowledge, and cultural institutions which, once opportunities are created to offer psychoanalytic ideas, value our thoughtfulness about art, literature, film, and music. Our clinic has created affordable opportunities for adults and children to be treated and move on toward symptom free and productive lives. Yet, we have faculty members, candidates, graduates of our programs, who themselves publicly and privately devalue what we do. How many of our recent graduates and alumni contribute to our annual campaign? We must ask, again, what is our cause? What is our mission?

We live in one of the most racially and ethnically diverse cities in the world. Have we ever had a program at the DuSable Museum on the South Side? Have we ever had a film program in a South Asian, or Arab/Chaldean community? How many minority candidates have graduated from our Institute since we opened our doors in 1932? Three? Four? How many African American patients, South Asian, or Hispanic patients utilize our clinic services? How many know about them?

Creating a Psychoanalytic Foundation WILL NOT solve these problems. But, it could begin to address some of the serious problems we are having and create an atmosphere fostering an entire attitudinal change needed here at our Institute and Society. When a small group of analysts and community people met to form the Michigan Psychoanalytic Foundation back in 1987, the goal was to create an organization that would provide financial support for the educational, clinical and research programs of the Michigan Institute. The Foundation would be responsible for increasing the community's awareness and appreciation of psychoanalysis. When a similar group met in San Francisco six years ago, the goal was to form a foundation that would have the triadic purpose of Public Service, Public Information, and Fundraising. By isolating the San Francisco Institute and Society's assets (endowment and segregated funds) from liability generating operations of the Institute's and putting those funds into a foundation, this money would be used only for the advancement of psychoanalysis and psychoanalytic ideas in the Bay Area. All teaching, training, treatment and clinic, and extension division activities would remain under the auspices of the Institute and its Board, while the Foundation would have its own board. In other words, the training of analysts, the central mission of every Institute in the country becomes separate from the fundraising, outreach programs and the advancement of psychoanalysis in the community. Currently, in Los Angeles, three and possibly four institutes are meeting to see if they can form one foundation rather than forming separate ones, with the goal of advancing psychoanalysis in the community. Each institute will benefit.

The most exciting aspect of a foundation is that community members of the board of the foundation are in charge of activities that most analysts have little interest or time in pursuing. However, this does not suggest that all analysts are not involved. In Michigan, analysts, on the average, donate ten hours a week toward Foundation activities and programs. Ten hours per week--it's expected. But then, the Michigan Psychoanalytic Institute has one of the most successful programs in the country, with a community being served by psychoanalytic treatment and programs, and an institute with large classes of candidates, and analysts with full psychoanalytic practices!

To create a Foundation here in Chicago would be revolutionary for the Institute. Aside from the practical aspects of what would need to be done to change to new organizational structures, it would mean creating a whole new attitude. If we value psychoanalysis, if we are committed to its future, we must come to recognize how connected we must be to the community, through our clinic, our programs and our expertise. We must invite the community and other experts to share their expertise in order for us to learn and advance our cause.

I call this "the new psychoanalysis," psychoanalysis that advances by its usefulness to all individuals regardless of race and socioeconomic levels. The new psychoanalysis is one that can be applied to serious social problems in our community; violence, the problems of children and families, and disappointment with leadership. The new psychoanalysis advances theoretically and clinically from these applications. Ironically, this is not new in the history of our psychoanalytic cause. Freud was always interested and committed to the application of psychoanalysis to the problems of the world. His writings on leaders, war, education related to child development, and his ideas about art and literature, are some of his finest. Without a commitment to this new attitude we will be stuck in psychoanalysis of the past and our survival as a profession and Institute will remain uncertain.

Creating a Foundation would allow the Institute to get back on course and focus on its mission: to train analysts and others in psychoanalytic treatment. Public relations, outreach, and fundraising would be the responsibility, cause and mission of the Foundation and its Board. Contributors in the community do not want to contribute to the training of analysts who are charging $150 an hour. People WILL contribute; psychoanalysts WILL contribute, knowing that funds go for a low fee clinic for children and adults, and meaningful outreach programs that speak to critical social issues.

I am not reporting anything new. We have discussed these issues over and over again in our Board and Faculty meetings. I am suggesting a concrete way to achieve our goals, a new means to take us where we need to go, where other Institutes have gone and with great success. We have the leadership-- on the Board, in our new Director, our Society President, on our Faculty, and among our Candidates.

Therefore, I am recommending to the Board that a committee be formed to study this issue of a psychoanalytic foundation, and report back to the Board in the early spring and make a recommendation about the feasibility of such a change. I believe that the Chicago Psychoanalytic Foundation is the way of our future.

Coming Events!

CPS Events

Tuesday
May 25, 2010 Scientific Program

Note: Attendance at this evening’s meeting is restricted to clinicians and clinical trainees.

Tuesday Evening Presentation – 7:00 P.M.
National Louis University, 122 S. Michigan Avenue, Chicago, IL – Room 5006
Admission is free. No reservations are required.

The Limitations of Freud’s (1933) Bisexual Hypothesis to Explain Impediments to Creativity in a Woman

Presenter: Barbara Rocah, M.D.      Discussant: Virginia Barry, M.D.

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