A Case of Entitlement

During his conversation with Alan Kraut (APS Observer January 2002), Alan Leshner said, “When I came to the federal government, I always hesitated before I told my colleagues that I was a psychologist.” Leshner then described how psychology has changed. His comments evoked vivid memories of my early days as a psychologist intern at Bellevue Psychiatric Hospital, and later, as a psychologist at New York University Prosthetic and Orthotic Studies.

There was a recurring scenario at Bellevue, which at the time was a stronghold of unyielding psychiatric conservatism: Chief Psychologist David Wechsler always insisted that his intelligence scales (WBI, II, WAIS and WISC) be given in their entirety, not in an abbreviated form preferred by some staff psychologists. Wechsler deplored the minimization of psychometric and psychological evaluations by the staff psychologists who were more interested in gaining the right to pursue the lucrative field of psychotherapy, then dominated by psychiatry. Wechsler’s favorite admonition to those who minimized the importance of the Wechsler Scales was “You are taking bread and butter from your own mouths!”

Ironically, some psychiatry residents were cannibalistically incorporating into their own reports the main findings of the psychologists, without acknowledging the contribution of the psychologists who had tested and evaluated the patients. Some psychiatrists underplayed the value of the psychologists, ignoring the times when the psychological evaluation determined the true diagnosis.

One psychology intern, passing through an office, heard a psychiatrist ordering a psychiatry resident to ignore a psychology intern’s diagnosis of psychosis for a woman patient. The intern asserted himself, pointing out the distorted quality of the Bender Gestalt figures which unambiguously highlighted central nervous system involvement. The supervising psychiatrist sniffed at this assertion but, caution triumphing, revoked the planned discharge of the patient. A short time later the patient went into a psychotic rage. Her central nervous system disorder was later confirmed.

(A notable exception was the well-known psychiatrist, Joseph Zinkin, translator of Eugen Bleuler’s classic Dementia Praecox or the Group of Schizophrenias. He valued psychology’s contributions, and would burst into a psychologist’s office shouting, “What have you got!?”)

In the broader public arena, the contributions and stature of psychologists were often similarly overshadowed. I took on one small element of this: the use of the title “Dr.” in print.

By chance, before reading the Observer interview, I had been perusing my overstuffed correspondence file. (I always hesitate to destroy any document or letter of substance.) Dating back 40 years were letters from March-July, 1960, to and from Basic Books, Inc. and The New York Times, and from the Chairman of the Public Information Committee of the New York State Psychological Association. My letters make the case to various publishers that PhD psychologists deserve to be referred to as Dr. in their publications.

As shown, the correspondence with Basic Books led to a successful conclusion, noted in the June 17 letter from the chairman of the Public Information Committee. The successful intervention prompted my correspondence with The New York Times.

Sometime after my July 3 letter to the editor of the NY Times Sunday Book Review, I received an excoriating telephone call from an officer of the NY State Psychological Association Public Information Committee. “How dare you condescend to tell the Book Review editor that the title “doctor” is derived from the Latin ‘docere, to teach!'” he thundered. “Dr. Brown is of such superior education that you have no right to teach him Latin.”

As a psychologist in my first full-time position, I was shocked to be bludgeoned so, but I recovered quickly, soothed by support from my colleagues. The extent of my recovery from this trauma can be gauged by my final letter of July 14 (Bastille Day, fittingly) to the assistant editor, Raymond Walters, who had addressed me as “Mr.” Weiss. I never received another communication from the NY Times. However, since then the NY Times uses the title “Dr.” for all those who possess the PhD degree.

Psychology has grown in stature, as noted in the Observer interview, and there is no need to elaborate. But I now note that psychological journals and publications, e.g. APA Books, Fall 2001, list nearly all psychologist authors without their “PhD.” Is it to save ink, or to avoid appearing “stuffy?” Or is it evidence of such security that no degree listing is necessary? In contrast, I have before me Journal of Information, Journal of the American Medical Association (JAMA), and Archives of General Psychiatry, in whose pages the MD, PhD and other titles are ubiquitous. I wonder whether the elimination of titles in psychological publications denotes a lingering feeling of insecurity and a remnant of the denigrating image foisted on psychologists in the past? (The head of Psychiatry at Bellevue Hospital, many years ago, condescendingly told me that only physicians are entitled to be called “Dr.” Psychologists in a college would use the title “professor”).

We psychologists had been enslaved to medicine and psychiatry. Are we completely emancipated now?