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The Politics of Exclusion
Authors:Gail S Reed PhD  Howard B Levine MD
Institution:1. New York Freudian Society;2. Department of Psychiatry , Mount Sinai Medical Center;3. Psychoanalytic Institute of New England;4. Massachusetts Institute for Psychoanalysis;5. Southwest Center for Psychoanalysis
Abstract:Starting as a movement based on the discoveries of a genius, psychoanalysis aspired to be a science. A deeply subjective method of data gathering, it had to transform new findings into its founder's objectively coherent theory or revise it and challenge the founder. Exclusion from the group emerged as scientific judgment and punishment. From early on, when Freud barely distinguished between disagreement and enmity, assessment of new ideas was entwined with narcissistic conflicts. Exclusion not only maintained the relative coherence of the theory—a reasonable, laudable goal—but led to an enhanced in-group motivated to maintain the theory and a devalued out-group that would need to turn the tables. The way was paved for fortification of established ideas and overidealization of new ideas. But the decision by the American Psychoanalytic Association (APA) to accept only physicians for psychoanalytic training extended exclusion to group membership. The result was the establishment of training outside the official APA/International Psycho-analytical Association umbrella. Formation of nonestablishment psychoanalytic institutes not only allowed more heterogeneity of ideas during the rule of orthodoxy but introduced seemingly less hierarchical organizational structures. Ideas embodied in these structures are now advocated by those who find hierarchy too oppressive. The paper ends with an examination of some of these ideas.
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