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The relation between ideals and idealizations is examined with regard to the aims of the American Psychoanalytic Association in advancing psychoanalytic education, practice, and research. Ideals are essential for preserving the past and as guides for the future. However, the idealizations that often develop in response to new discoveries and innovations may lead to a defensive clinging to the past as well as to an overly enthusiastic embrace of new ideas. Both these forms of idealization may serve as powerful resistances to creative and constructive change.

From 1969 to 1979 senior medical students from the University of Colorado School of Medicine entered psychiatric residencies at an average rate of 3.8%. The university gradually instituted a series of changes in its undergraduate psychiatric education program for medical students, and the senior class of 1980 was the first to be exposed to all of the changes. In 1980-1982 7.7% of the seniors went into psychiatric residencies. The authors describe the curriculum changes and speculate that more attention to the quality of medical students' psychiatric education at the undergraduate level enhances recruitment into psychiatric residencies.

I strongly support the inclusion of self-defeating personality disorder and sadistic personality disorder in our diagnostic nomenclature because I believe that these are valid clinical entities that need to be diagnosed before appropriate treatment can be undertaken. Failure to diagnose these conditions will lead to inadequate and imprecise treatment at best, or at worst, no treatment at all.

(1970). Cryptorchism and Homosexuality. The Psychoanalytic Quarterly: Vol. 39, No. 2, pp. 251-268.

Summary In addition to the use of the term as a specific type of countertransference reaction, it is proposed that the term “counteridentification” also be used to describe an excessive and inappropriate identification on the part of a mental health consultant with all or a portion of the value system of a consultee or consultee organization. It is suggested that this is a ubiquitous phenomenon in all mental health consultation, since mutual identification between consultant and consultee appears to be a prerequisite for the development of an effective consultative relationship. It is also suggested that such counteridentification may prove disruptive to the consultative relationship, as well as injurious to individual clients and patients. If these impressions are correct, then there is additional support for Caplan's admonition to all workers in the field of mental health consultation: “The need for professional self-awareness and self-control in this area is similar to that which is familiar to us in our interaction with individual patients. The difference is that the therapeutic role of the psychiatrist has become well defined, as has the complementary role of patients, as a result of many years of experience and as a development of a much older doctor-patient role relationship in the general medical field. The role of the preventive psychiatrist in social action is relatively new, and its development must be carefully watched to ensure adequate professional safeguards.”

A survey of the psychiatric literature on female monozygotic twins has revealed: (1) there are no clearly documented case reports of overt homosexuality in both members of a female monozygotic pair, (2) there are no clearly documented case reports of persistent overt homosexuality in even one member of a female monozygotic pair, and (3) there are no clearly documented case reports of mutual homosexual contact between female identical twins either in childhood, adolescence or adulthood. This paper has presented the cases of Connie and Muriel, 36-year-old female identical twins concordant for overt and persistent homosexuality, with a history of mutual homosexual contact with one another extending over several years during adolescence. Some of the technical problems involved in treating twins are discussed, questions are raised regarding the paucity of published material dealing with this topic, and suggestions are offered for further investigation deriving from this report.

(1965). The Use of an Ongoing Training Group in a Military Mental Hygiene Clinic. International Journal of Group Psychotherapy: Vol. 15, No. 2, pp. 228-241.

Introduction The process of conversion as manifested in the hysterical syndrome was the framework around which Freud3developed psychoanalytic theory and technique. In recent years there has been a renewal of interest in the conversion process, and this has resulted in efforts by a number of authors to make a clear distinction between the conversion process and the hysterical personality, and to demonstrate that the conversion process is a symptomatic defensive operation which can exist along the entire range of personality types and psychopathological syndromes.6,11,21,22,28,33 However, those cases in the literature which describe conversion symptoms in a schizophrenic illness often present certain difficulties. In the so called "borderline cases,"14,16,20,35there are the problems of chronicity, of multiple and mixed symptomatology, of concomitant psychotic and neurotic defensive patterns, of varying degrees and phases of regression and restitution. In cases which have been