Group for the Advancement of Psychiatry - The Story of GAP

About GAP

Table of Contents

Introduction
The Story of Gap
Postwar Challenge
Gap is Organized
Basis for Action
 No Auditors Needed
APA Reforms
Light on the Law
Psychiatry and Socials Issues
Child Psychiatry
Brain Surgery
International Relations
Federal Agencies
Medical Education
Industry
How Reports are Processed
Influence Abroad
Gap Symposia
Statements on Current Issues
Mental Health Campaign
The Essence of Gap
The Attack on Gap
A Small Striking Committee
The Financial History of Gap

Statements on Current Issues

In the early years, GAP occasionally issued statements or adopted resolutions on specific questions of the day that affected psychiatry in some manner.  Among them were:  a statement on psychiatry and religion and another endorsing the film,  Snake Pit,  and resolutions urging Congress to ratify the World Health Organization charter and supporting the report of President Truman's Committee on Civil Rights.

The Group for the Advancement of Psychiatry, or a particular GAP committee, is frequently queried by other organizations for authoritative information on a specific question.  When the British Royal Commission on Capital Punishment visited this country several years ago to interrogate legal, psychiatric, and other specialists on far-ranging problems of criminal responsibility, it sought and obtained the cooperation of GAP, especially of its Committee on Psychiatry and the Law, as a major source.  GAP publications and verbal statements by GAP members were repeatedly cited in the Royal Commission's stimulating report.

Mental Health Campaign

In 1947 the Advertising Council's interest in mental health problems was sparked by the late Dr. Alan Gregg, an honorary member of GAP.  The Advertising Council is a non-profit agency  supported by American business to conduct advertising campaigns informing U.S. citizens how they can help with important national problems.   From time to time it selects  good causes --in health, welfare, education, safety, and the like--which it  adopts  for public service campaigns free of charge.  The Council is able to mobilize millions of dollars worth of free advertising through mass media, such as radio, press, television, and billboards.

To a financially starved movement like mental health, such a multi-million-dollar prospect in public education loomed as a tremendous boon.  A special GAP committee headed by Dr. Carl Binger labored long and hard to develop the basic campaign material, and tendered a document to the Advertising Council in 1948.  The Council decided against a mental health campaign at the time, but in 1957, its interest still alive, it did adopt a program developed by the National Association for Mental Health and proceeded to conduct an effective two-year national campaign, using advertising methods and outlets that would have cost an estimated $10,000,000 to duplicate.  In 1959 it decided to extend this campaign for an additional two years.

The Essence of GAP

In its origin, GAP was virtually a creature of spontaneous generation.  Its founders insisted on a loose, informal body that would not be hog-tied by rules, regulations--or even a constitution.  They knew that action was needed to bring psychiatry in line with present-day needs and challenges.  They knew that organized effort was required for effective action toward constructive goals.  Most of them felt, apparently, that they could disband, go home, and cultivate their own gardens once their immediate aims were realized.  But like many another dedicated group before them, they found in time that new problems arose as old ones were solved, and that some steps which were confidently expected to repair an ill or defect did not turn out to be completely effective.

For example, many of GAP's founders cherished the notion that if the American Psychiatric Association and the American Psychoanalytic Association could be persuaded to set up study-and-action committees paralleling those of GAP, the group would then have no more reason for existence.  Thanks largely to the energetic work of GAP members, many such parallel committees were indeed established in the aforementioned organizations.  But somehow, in the larger, more formally constituted bodies, the committees usually were unable to function with the verve, mobility and action-directed approaches that so strikingly characterized GAP committee work.  Again, in spite of truly great advances in psychiatry during the postwar decade, the peacetime challenges that still confronted the profession proved as formidable as those of the wartime period.  These and other factors exerted pressures toward continuance on a hastily conceived and loosely constructed body which had seemed at first to represent a temporary effort to meet an emergency situation.

Within three years after its creation, GAP was giving serious consideration to the issue of transience or permanence.  The membership was polled several times on the question.  A number were for terminating GAP, mainly on the thesis that its major goal--reform of the APA--had been realized.  But the great majority favored going ahead with  GAP.

The Attack on GAP

About this time, the Group for the Advancement of Psychiatry was confronted with a series of attacks from another group of psychiatrists frankly organized as an anti-GAP body.  This was the Committee for the Preservation of Medical Standards in Psychiatry, organized toward the end of 1948 for the express purpose of combating the influence of GAP in American psychiatry.  It became a rallying point for APA members who, for one reason or another, were disturbed by the sudden dramatic emergence of GAP as a powerful force on the psychiatric scene.  These included:  organically oriented psychiatrists who feared that GAP represented a deep-seated plot by Freudians to  take over  the APA; others, including some psychoanalysts, who suspected that GAP comprised a small coterie of power-hungry  elites  who sought to dictate to the rank and file of psychiatry; some who saw GAP as an exclusive club of psychiatric snobs; men who had no major differences with GAP policies, but who resented not being invited to join it; some who surmised that GAP might be tainted with leftist tendencies because of its concern with social issues; others who thought that GAP's emphasis on multidisciplinary studies might lead to a denatured psychiatry; some who simply were satisfied with the status quo in American psychiatry and were want to resist any efforts to change it; other who were concerned lest organized psychiatry be torn asunder by factionalism as a result of GAP's efforts to reform it.

Over a period of several years, the anti-GAP committee issued sporadically a Newsletter containing vigorously voiced and often unfair and unfounded charges against GAP.  It never succeeded, however, in enlisting more than a scattered support among APA members.  In 1953 it changed its name to Associated Clinical Psychiatrists for the Preservation of Medical Standards in Psychiatry, and in the following year it quietly went out of existence.

One wholesome by-product of the opposition rallied by this committee was to cause the GAP membership to do a considerable amount of self-study and so to re-evaluate its public relations vis-à-vis its own profession.  For, to some extent at least, GAP itself had been partly responsible for the opposition which found organized expression in the committee.  It had done too little to make its policies and modus operandi clear to non-GAP colleagues.  Unfortunately, isolated statements by several of its members had certainly given some semblance to the charge that it represented an exclusive Freudian clique--despite the fact that its membership always included prominent non-Freudians and even anti-Freudians.  Its dramatically successful efforts to nominate opposition slated for APA officers from the floor gave some substance to the charge of  political power drives,  in the absence of sufficient explanation if its broader goals.  The important  reorganization plan  for APA, supported by GAP in 1948, proved defective in a few respects, although most of its innovations were excellent.  The plan was fortunately modified by wise compromises.  In its early period of over-ebullience, several brash actions by GAP members and committee units served to stir up needless resentments and antagonisms.  In time, however, the friction created by rapid changes and organizational ferment wore off, and today there is no active opposition to GAP within the psychiatric ranks.