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A
Small Striking Committee
The assault on GAP by the Committee
for the Preservation of Medical Standards in Psychiatry served
to hasten the decision which the GAP membership had been rather
reluctant to face: Was their organization to continue
indefinitely on a makeshift, temporary basis, or was it to reconstitute
itself as a permanent group? The experiences of the early
years convinced most members that, notwithstanding the APA reforms
and other gains, a small Striking force for American psychiatry
could be of value for years to come. In a communication
addressed to the Commonwealth Fund in 1948, the underlying rationale
for a GAP-type organization was restated in this wise:
| It must be
progressive. It must be devoted and willing to
spend many personal hours for the advancement of psychiatry....The
size will determine its cohesiveness, flexibility and
mobility. It needs to be militant so that it may
tackle problems of the day. It must be small enough
to mobilize quickly and to act promptly. It must
be willing to pioneer; to investigate and take action
on the "neglected" areas concerned with psychiatry;
to deal aggressively with the "hot potatoes."...Its
membership must not only be willing to undertake the
difficult, but they must be willing to sacrifice in
time and money and energy to accomplish these aims.
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GAP was
incorporated in 1947, a step taken, as was carefully explained
at the time, to facilitate the receipt of foundation grants.
In 1950 a GAP constitution was adopted. This proved quite
a stabilizing step for the youthful group--youthful in spite
of the fact that some of the Young Turks of 1946
were already calling themselves old goats.
For one thing, the constitution permitted an orderly change
of GAP officers, relieving President William C. Menninger and
Secretary Henry W. Brosin from an enforced servitude
against which they had vigorously protested. They had
both been elected--drafted, rather--over their objections, year
after year. The constitution provided for the election
of officers every two years, declaring the president ineligible
to succeed himself for two years following his retirement.
While this prohibition did not obtain for the secretary-treasurer,
Dr. Brosin seized the opportunity to retire with his teammate,
Dr. Menninger, at the April, 1951, GAP meeting, when the constitution
went into effect and new officers were chosen. Dr. Jack
R., Ewalt (now professor of psychiatry at Harvard University,
director of the Massachusetts Mental Health Center, and also
executive head of the Joint Commission on Mental Illness and
Health) was elected president of GAP, and Malcolm J. Farrell,
superintendent of the Walter E. Fernald School at Waverley,
Massachusetts, secretary-treasurer.
Dr. Walter
E. Barton, superintendent of the Boston State Hospital, was
president in 1953-55; Dr. Sol W. Ginsburg, a psychoanalyst in
private practice, 1955-57; and Dr. Dana L. Farnsworth, director
of University Health Services at Harvard University, 1957-59.
Dr. Marion E. Kenworthy, professor emeritus of psychiatry at
the New York School of Social Work and president of the American
Psychoanalytic Association, succeeded Dr. Farnsworth in 1959.
Although
often referred to as a Young Turks movement,
GAP from the first included in its membership a wide age-range
of psychiatrists. A statistical study of its membership
was undertaken in 1950, revealing that the youngest member was
aged twenty-eight, the eldest sixty-five, and the average forty-seven.
Three ex-presidents of the APA were among GAP's charter members,
along with many heads of university departments, mental hospital
superintendents, executives of state mental health departments,
and directors of psychiatric research institutes.
While the
membership roster of GAP does indeed include a great proportion
of distinguished psychiatrists, it includes also a goodly number
of younger unknowns of demonstrable ability.
If GAP is an organization of the elites, it is an
elite of talent rather than reputation.
The uniqueness
of GAP was well-stated in a communication to the Field Foundation
in 1950, which declared:
| GAP differs
from other medical organizations in that (1) it consists
of highly selected members on the basis of special abilities,
all of whom work actively on some project; (2)
the organization is not for the benefit of members;
(3) the core of the organization is its working committees
and not the administrative officers.
GAP is an experimental
group, a loose federation of investigating committees,
each with its own research and educational functions
and goals. Each explores pertinent ideas and
methods of communication in its field. The devotion
of the committee members to their projects is illustrated
by the fact that many of them have determined to continue
their joint activities even if GAP as a whole cannot
continue for lack of finances to hold two general
meetings a year....
Because GAP committee
work is creative and exerts widespread influence,
we believe it is justified in requesting foundation
support in the same sense that research projects are
renewable as they develop new programs on the frontiers
of knowledge. Each committee is an investigative
team equipped by the talent and interests of its members
without regard to geography or social determinants
to do a distinctive job which is highly desirable
to further psychiatry and the progress of psychiatry
and its allied disciplines.
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This writer,
who was privileged to sit in as a guest at one of the founding
meetings in Chicago, and has since attended a number of GAP
conferences as a consultant, can attest to the extraordinary
degree of dedication as well as the democratic spirit that pervades
the gatherings.
Asked for
his observation on what makes GAP go, former President Dana
L. Farnsworth says:
| The beauty
of GAP is mainly in its loose organization. The
committees practically run themselves. Nobody
can get pushed around. The officers have no real
power; they are more like errand boys. I am sure
that one vital reason why so many stay on and come to
meetings regularly, and work between meetings, is this
very informality--the knowledge that there is no pressure,
that one may drop out at any time without traumatic
explosions. If we were to get too formalized,
we'd break up. |
As a matter
of fact, it seemed during the first years that GAP might be
stifled by the general reluctance of members to drop out and
make room for fresher, younger blood. Since membership
was strictly limited, a danger loomed that the extraordinary
dynamic quality of GAP might be vitiated by lack of circulation.
The problem was solved by developing a category of contributing
members, whereby members who had served actively at least
three years might retire to inactive status while still remaining
GAP members. Contributing members pay dues of $25 annually.
According to the latest available figures, there are now 189
active, 73 contributing, and 3 life members (an
honorary category now including Drs. Earl D. Bond, Bruce B.
Robinson, and Arthur H. Ruggles).
At each
GAP meeting, four selected residents in psychiatry attend and
participate in committee sessions as invited guests, with their
expenses paid by the host group. Each one attends four
successive meetings. this provides a chance for men who
are entering the profession to enjoy the stimulating and often
inspirational fellowship of older men on a basis of equality.
GAP gives
us all a chance to be among people who are interested in the
same thing, and who are interesting people in their own right,
says Dr. Farnsworth. Here is how he sums up GAP's significance
to American psychiatry:
- GAP is
small enough to get the real opinions of thoughtful people
in the field. These opinions are not watered down by
excessive caution, such as is manifested so often in larger,
more formalized groups.
- The body
of GAP reports represents the summation, the distillation,
of what is generally the best thinking being done collectively
in any specific aspect of psychiatry.
- GAP presents
a forum for the interchange of different approaches in a
disputatious atmosphere where individuals can disagree
openly and frankly with their peers without the threat to
reputation, friendship, or self-esteem.
- GAP has
demonstrated that it is an effective agency for harmonious
interdisciplinary collaboration leading to action on common
fronts of interest. The psychiatrists and their cooperating
consultants meet here as peers in a setting of equality.
Nobody pulls rank, regardless of profession, position, or
reputation.
In GAP we
are continually testing ideas on the advancing edge of psychiatry,
Dr. Farnsworth adds.
It is a
unique experiment in collaborative thinking, this Group for
the Advancement of Psychiatry. Its further contributions
will be followed eagerly by large numbers of persons outside
GAP who are concerned with the application of modern knowledge
of human behavior to the broader problems of society.
Albert Deutsch
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The
Financial History of GAP
The Financial history of GAP may be
of interest to some readers. A small assessment was made
after the Chicago meeting to cover printing, postage, and other
administrative charges. Shortly afterwards, the Commonwealth
Fund made a grant to support GAP for its first three or four
years. This money was used to cover the costs of meetings
and publications and to defray in part the expense of travel.
With respect to this last item, the first fifty dollars of expense
was paid by the members themselves, thus equalizing the cost
of attendance for those members coming from great distances
and those residing near the meeting place.
With the
exhaustion of the Commonwealth Fund grant, GAP faced a financial
crisis. A Finance Committee, under the chairmanship of
Dr. Jack R. Ewalt, was appointed to study the financial needs
and resources of the organization. As a result, grants
were obtained from several other foundations--notably the Field
Foundation and the New York Foundation. In addition, more
than $17,000 was pledged by the membership. At this time,
members voted to assess themselves $100 a year for dues and
to drop the $50 deductible clause on the understanding that
all members' expenses to the meetings would be paid for by the
organization. With continued support from foundations,
GAP managed to operate more or less on this same basis.
In 1957 dues were raised to $150 a year.
GAP reports
were originally distributed to interested persons free of charge
and without limitation as to number. They are now offered
for sale on a cost-recovery basis, but subsidy is still needed
to cover the expense of the research committee meetings and
the immediate costs of publication.
Jack R.
Ewalt, M.D.
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