Our Multi-Layered Professional Identity

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Posted October 15, 2007

I am a psychoanalyst!

That pronouncement might seem obvious and redundant to you, the reader, considering the office I’m running for – and you would say the same about yourself. I emphasize it because I think we need to give some thought to the many layers of who we are.

Throughout my long career in the governance of professional associations, I have returned from tense and often tedious days of contentious meetings, gone to my office the next day, and breathed a deep sigh of relief. It feels so good to be an analyst sitting with a person, one-to-one, working together to unravel a neurotic tangle, doing something that can more directly make a difference. For all the complexity that analysands present, working with a troubled person seems much simpler than dealing with a roomful of people with differing, strongly-held views.

The psychoanalytic framework yields such rich material and so many possible avenues for tailoring the work to that person’s individual needs. It is flexible, attuned to human experience and sensitive to our relationship in the moment. Other therapies only seem to capture a small corner of the multi-dimensional way that a psychoanalyst addresses mental life. Since my first days of psychiatry lectures at Harvard, the psychoanalysts have seemed to understand patients in the most useful ways. That determined my future career course.

But before I was a psychoanalyst, I was a physician and then a psychiatrist. Those identities are also deep rooted in my life. My professional ethics are grounded in all three identities, as well as in my personal morality and sense of civic responsibility. Among my psychoanalytic colleagues there are others with deep roots as psychologists, social workers, counselors, or college professors. Each brings particular strengths and expertise to our psychoanalytic profession. We draw on these professions, as well as the law, early childhood education, and others, for our psychoanalytic candidates.

Please note that my interest in psychoanalysis began in medical school, before my decision to go into psychiatry. An early professional ideal was Leston Havens, an analyst and my clerkship director at Massachusetts Mental Health Center. I selected University Hospitals of Cleveland for psychiatric training because the pioneering medical curriculum at Western Reserve involved psychoanalysts extensively in interviewing, understanding, and helping patients in all branches of medicine. Perhaps that is why my main educational focus in psychiatry has been teaching medical students; I directed the psychiatry clerkships at Case Western Reserve for twenty years. Our contribution is even more critical in this era of depersonalized medicine.

I believe that it is vital that the leaders of the American Psychoanalytic Association maintain relations with the leaders of all of the mental health professions. Historically, APsaA has had especially close ties with the American Psychiatric Association (APA), but these have weakened considerably. Most regrettably, there is a strong trend among psychiatric psychoanalysts not to maintain membership in both of their organizations. This profoundly weakens the psychoanalytic influence on the policies, diagnostic manuals, practice guidelines, and advocacy positions of the APA – whereupon psychoanalysts bemoan the perceived biological reductionism of psychiatry.

While building closer relations with the leading organizations of psychology, social work, and counseling, I also want this Association to restore its close interaction with the American Psychiatric Association. As a past Trustee and Speaker of the Assembly of that APA, well regarded by their leadership, I am an unusually good position to do so during my terms as President-Elect and President of APsaA over the next four years.

As we increasingly bring the unique scientific achievements of psychoanalysis into an interface with neurobiology, neuroimaging, cognitive neuropsychology, linguistics, anthropology, literature, and other sources of knowledge, we decrease our splendid isolation and advance our field into a more integrated world of the 21st century. I hope you will agree with me and vote for my leadership.

Please browse this web site. I’d love to hear from you at naclemens@cs.com or my home, (216) 371-4373, or (after hours only) my cell phone, (216) 536-4399.

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