To the Editor:

The August issue contains a letter I wrote discussing an article by Joseph Adelson and Chester E. Finn, Jr., “Terrorizing Children” [April]. The authors commented on my letter.

In my letter I agreed with them that Robert Jay Lifton, one of several people they mentioned in their article, whom they identified as a psychiatrist and psychoanalyst, could be faulted for showing intellectual bad faith and corrupting his scientific and professional values in the interest of furthering his missionary cause, which was to attempt to prove that there is general and widespread anxiety about the possibility of nuclear war among the nation’s children.

I went on to point out the similarity of what Dr. Lifton has done to what is being done in the Soviet Union by Dr. Andrei Snezhnevsky, whose sloppy and uncritical thinking and failure to use minimal scientific controls have provided the “scientific” cloak of respectability for the psychiatric abuse of political dissent in the Soviet Union. Messrs. Adelson and Finn did not comment on this portion of my letter.

I pointed out, however, that they were in error in identifying Dr. Lifton as a psychoanalyst. I documented my statement from the various professional directories. I also noted that Dr. Lifton did not consider himself a psychoanalyst, but rather thought of himself as a writer and as a psychohistorian—something which I have heard from Dr. Lifton directly. I said further that Dr. Lifton had misidentified himself in a major professional directory as a psychoanalyst, which may have been the basis for the error made by Messrs. Adelson and Finn. (I might have added, but did not, that for them to identify Dr. Lifton as a psychoanalyst was incorrect not simply because he lacks psychoanalytic credentials, but also because he does not obtain his data by the psychoanalytic method.)

In their reply to me, while not contesting these statements, they went on to say: “He ought to remember that ‘psychoanalyst’ is not an official title, that a great many training institutions confer that designation quite legitimately, and that it is not up to him to determine by fiat just who is and is not a psychoanalyst.”

This comment clearly contains a misleading distortion of my remarks. I did not determine that Dr. Lifton is not a psychoanalyst; I pointed out that he was not one, uncontestably, and did not himself consider that he was, to my direct and personal knowledge. At this point it seemed to me that Messrs. Adelson and Finn had other fish to fry in bringing up this matter as they did. This impression was heightened when they went on to introduce, de novo, a remark which is wholly irrelevant to the point at issue. They referred to a letter of mine printed in the Sunday New York Times, May 19, 1985: “Dr. Post seems bent on becoming the Torquemada of psychotherapeutic credentialism, e.g., he recently sent a letter to the New York Times taking Sigmund Freud to task for having had Anna Freud trained in psychoanalysis.”

This is mischievously inaccurate. It misrepresents and distorts what I said, and is taken wholly out of context. In my letter, titled by the Times “And Now the Age of the Barefoot Psychotherapist,” I traced the historical, social, and economic antecedents of the present wave of independent lay practitioners of psychotherapy who no longer have psychiatric and medical supervision, as they did when they were initially pressed into service in mental hospitals and outpatient clinics. I pointed out that they lack the medical and psychiatric training which is the only basis for diagnosis and treatment. I stated, there and elsewhere, that since they function willy-nilly as primary-care physicians (a task for which they are wholly incompetent), they were consequently responsible for much malpractice. I pointed out finally that Gresham’s Law is having the effect of discouraging medical students from entering the field of psychiatry to emerge as the peers of a multitude of lay therapists with lesser academic and apprentice training, and that all of this combines to produce a current crisis for the public health. I stated that nepotism prevents many psychiatrists, from Freud’s day to the present, from speaking frankly about this problem because of their conflict of interest.

Messrs. Adelson and Finn quite clearly did not like what I had to say about lay psychotherapists. That is their privilege, although my Times letter, which has been republished in several places including the Internatonal Herald Tribune, has received widespread approval from my professional colleagues and disinterested parties. But that they would drag the Times letter in by the heels, gratuitously, irrelevantly, and in a manner designed to misrepresent and distort, is surprising. Perhaps not totally surprising, though, since one of the authors is a psychologist, and not wholly disinterested in the issue he raises.

To paraphrase them, I would not have believed it possible, but their comments leave me in greater sympathy with Dr. Lifton. If their statements about me are indicative of their scholarly accuracy and ethics, then I will have to reevaluate my opinion of their criticism of Dr. Lifton.

Seymour C. Post, M.D.
College of Physicians and Surgeons
Columbia University
New York City

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To the Editor:

In the August letters section, Seymour C. Post attacks Robert Jay Lifton for identifying himself as a psychoanalyst and implies that Dr. Lifton discredited the American Academy of Psychoanalysis through “politically motivated activity.”

As president of the American Academy of Psychoanalysis, I want to state emphatically that Dr. Lifton is a respected member of the Academy and that this organization is certainly not discredited by his activity.

Sidney S. Goldensohn, M.D.
American Academy of Psychoanalysis
New York City

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Joseph Adelson and Chester E. Finn, Jr. write:

We hope—we pray—that Sidney S. Goldensohn’s letter puts to an end this increasingly strange correspondence, on one of the most trivial issues facing America—whether Robert Jay Lifton is entitled to the title of “psychoanalyst.” He is, he is, just as we said, and we trust Dr. Post can now find another outlet for his indignation.

Dr. Post is equally ill-informed, and even more abusive, on the question of who should do psychotherapy. Those interested in a rational and balanced presentation should read Freud’s The Question of Lay Analysis, written sixty years ago and as fresh as the day it appeared. Freud was determined to save his creation from the intellectual provincialism he feared would follow its capture by the medical profession; and he wanted to recruit to psychoanalysis the best minds interested and available. Although he did not quite succeed, he did not quite fail, either. The fruitful era following his death is marked by the contributions of a remarkable group of psychoanalysts drawn from non-medical disciplines—Anna Freud, Ernst Kris, Erik Erikson, Peter Bios, Selma Fraiberg, Joseph Sandler, Roy Schafer, to name only a few. Dr. Post would have banned all of them, and to judge by his letter, perhaps he would have had them locked up for malpractice.

He is right about one thing—psychiatry is in trouble. It cannot attract enough medical students, and what is worse, except at the best programs, those it does attract tend to be drawn from the bottom of the medical talent pool. It is of course a serious problem: it means that many mental hospitals are staffed by physicians of marginal quality. It also means that those needing good psychotherapy often pay high hourly rates for little more than a pill and a peptalk. Caveat emptor.

Somehow Dr. Post has developed the extraordinary idea that other professions, and not medicine itself, ought to be held responsible for this situation. Yet as everyone save Dr. Post seems to understand, a great part of the problem arises from the selection and training of physicians. Despite occasional efforts at reform, the medical schools continue to prefer those heavily educated in science, and (much of the time) mechanistic in outlook. These initial inclinations are then reinforced by the physicalistic bias of most medical teaching, and above all by the contempt for psychiatry openly expressed by so many of the medical faculty. As a medical student once told one of us, explaining his shift from psychiatry to internal medicine: “Real doctors don’t think psychiatrists are real doctors.” There are, of course, other deterrents, such as the unpleasant and at times dangerous conditions in some psychiatric institutions, but the major disincentives appear to be the low prestige of psychiatry in medical school and the discomfort so many physicians feel about the non-linear, non-reductionistic modes of thinking required in psychotherapeutic work—just as Sigmund Freud pointed out so many years ago.

Dr. Post’s preoccupations have taken us a considerable distance from the original theme of our article—nuclear education. Since we have the readers’ attention, here are the latest figures we have seen on adolescent worries. Nuclear fears have just about fallen off the chart, now ranking eleventh behind the following: school performance, looks, being liked, parents dying, how friends treat one, hunger and poverty, U.S. violence, losing a best friend, drugs and drinking, future unemployment, and one’s physical development (Harper’s, September 1985, citing a survey of 8,000 adolescents conducted by the Search Institute). So much for nuclear anxiety. Still, its withering away has had no apparent effect on the nuclear curricula designed to cure it. Those continue to flourish. Is anyone surprised?