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Pyles, R.L. (2003). The Good Fight: Psychoanalysis in the Age of Managed Care. J. Amer. Psychoanal. Assn., 51S(Supplement):23-41.

(2003). Journal of the American Psychoanalytic Association, 51S(Supplement):23-41

Plenary Addresses

The Good Fight: Psychoanalysis in the Age of Managed Care

Robert L. Pyles

Robert L. Pyles

At its midwinter meeting every second year, this association graciously grants its immediate past president the privilege of speaking to the membership about issues of special note or concern. It is my singular opportunity to be the first president to make such an address at the start of a millenium—an opportunity that mandates a look back to our founding in 1911, an assessment of where we have come since, and an exploration of where we must go in this new century.

We stand at a crossroads. The strength of our will and the clarity of our vision will determine our future. It is my great hope that in three to five years we can look back as a profession and see our members, our association, and our societies fully engaged in the major political and social issues of our time; an extensive national and local network of psychoanalysts interacting with the media; a lean, effective, and responsive governance in our national and local organizations; and a new spirit of experimentation and collaboration among our colleagues in the profession. To achieve these goals, we will need to understand the factors that underlie our highest ideals, and build on our inherent strengths to further our mission. It is in this context that I address myself to our history, to our culture, and to our future.

Psychoanalysis today is under siege. We are fighting for survival—the survival of our profession and of our ability to deliver quality care to our patients. It is a hard fight, one that in the beginning left us at times feeling helpless and despairing. In fact, when managed care, the Clinton plan, and draconian legislative measures such as the Maryland databank law crashed down upon us in 1992, we were helpless.

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