Some Notes on the Pre-History of AFTA

Don Bloch

In 1968, when Jay Haley was editor of Family Process, he wrote an editorial strongly opposing the forming of a national organization. Sixty-five signatures were appended; some, such as Roy R. Grinker and Iago Galdstone, were eminent psychiatrists, but by no means family therapists. Of the 65, there were 6 women including Virginia Satir. Nathan Ackerman did not sign, nor did I for that matter, although I believe I was not invited. For what it is worth, I succeeded Jay as Editor of Family Process in the following year and, after Nathan's death in 1971, became Director of the (Ackerman) Institute. In the material that follows, my comments are italicized in [brackets].

Murray Bowen, Bob Ravich, John Spiegel and Iz Zwerling, had signed Haley's editorial in Family Process in March of 1968 and ten years later found themselves members of the organizing committee for what became AFTA. In 1968 Haley had presciently argued, "The question of membership in a family therapy organization automatically involves the problem of accreditation and approval of who should, and who should not, do therapy. To determine who shall be a member, the leaders of a family organization cannot easily use the criteria of other professional organizations. To restrict membership to psychiatrists or even to psychiatrists, psychologists and social workers would not fairly represent the participants. What about the ministers who now face many family problems and use family therapy? What about nurses … sociologists and anthropologists? A more difficult problem arises from the participation of lay people … (who can) treat disadvantaged people better than middle class therapists. … Should skillful family therapists who are high school drop outs be allowed to be members?" [Jay Haley was, of course, not a M.D. or Ph.D. or M.S.W.?which might have sensitized him to these issues but does not in any way disqualify his observations].

The organizing meeting for the formation of AFTA took place in Chicago on April 19-21, 1979. The events leading up to it have been set forth by Jim Framo in his article "How AFTA got started" which appeared a decade later in this Newsletter. Jim noted that his "own biases have crept into (the) narrative" and said he was setting forth "one person's story…" I can make no better disclaimer myself. I will quote extensively from Jim's fine account. Interested readers will want to consult the original.

In the late 1970s, when AFTA was created, Family Therapy was blooming as a profession. The field seemed to many of us a bottomless cornucopia from which spilled intellectual stimulation, clinical innovation, private practice opportunities, workshops, institutes, trainees, and honoraria. Ackerman (in 1971) and Jackson (in 1968, at the age of 48) had already died, but then there seemed to be a temporary moratorium on such calamities. From its modest beginnings in the 60s, the field had grown exponentially. The 1970s were the decade during which the largest number of new training facilities, along with a major post-pioneer cadre of innovators and teachers came on the scene. Women were entering the field in greater numbers but were still much under-represented in the leadership of the field.

Gerald Berenson, a student of Ackerman's, had initiated a series of organizing meetings that took place in his office. He took the initiative for this process, meeting at first with Ivan Nagy and his colleague Geraldine Spark, to discuss the possibility of starting a national organization of family therapists. After a bit, they contacted Murray Bowen and John Spiegel who had had experience as an officer of the American Psychiatric Association. Eventually, the group was enlarged to include 16 mental health professionals (not all attended every meeting). Four were women: Mary Framo, Geraldine Spark, then working with Ivan Nagy on a book, Judy Ladner, a friend of Berenson, and Kitty LaPerriere, then Director of Training at the Ackerman Institute. In addition to Framo and Berenson (both PhDs) there were 10 white male psychiatrists: Murray Bowen, the AFTA founding president and dark brooding genius of the group, Fred Ford, Chuck Kramer, Norman Moss, Ivan Nagy, John Pearce, Bob Ravich, John Spiegel, Harvey White and Israel Zwerling.

Some quotes from Framo's article follow; my comments are in [brackets]. The title was "How AFTA Got Started."

"From time to time students in marriage and family therapy training programs around the country call me and say that they have been assigned the task of writing up a history of the family therapy organizations. They tell me that the history of AAMFT (American Association for Marriage and Family Therapy) is readily available, but that they can get almost no information about AFTA's (American Family Therapy Association) history. Since I was there at the beginnings… I decided to write my version of those early events.

"Almost from the first time some maverick therapists began working with whole families there was talk about starting a national organization of family therapy. As the years went by, strong opinions about the idea, pro and con, were expressed, but I got the impression that most family therapists had mixed feelings [see Haley above].

"Jerry Berenson, a student of Nat Ackerman's, deserves credit for overcoming our inertia and ambivalence and pushing us when the time was right. Toward the end of 1976, Jerry called me and said he thought we should go ahead with forming a national organization, that he had already met with Ivan Nagy and Gerry Spark, had been in touch with Murray Bowen and several others, and would I join them? I said something like, 'Gee, Jerry, I don't know. Let me think about it. It's a complicated matter.' A while later, Murray Bowen phoned me and asked what I thought about this matter and I told him I was uncertain, like him. Jerry had arranged a meeting in New York City and I suggested that we at least attend that meeting and Murray said, 'Hell, Jim, let's go and see what happens.'

"The meeting in a lawyer's office in Manhattan on February 19, 1977, lasted a few hours as we went back and forth on the complex issues and complications of this move. Murray Bowen made a statement that tipped the balance, at least for me. Paraphrasing, he said, 'Well, this family therapy movement is growing and the chaos is not healthy anymore. There are no standards and people go to weekend workshops and call themselves family therapists. Somebody is going to start an organization, and what better people to do it than those of us who helped start the field?' [That there was an American Association of Marriage and Family Counselors seems to have been in the peripheral vision of this group.] I believe that without the prestige of Murray Bowen, AFTA would not have gotten off the ground. Although he became disenchanted with the organization later, during the first years he enthusiastically tackled the enormous job of launching this new organization. Lyman Wynne and Don Bloch called me and asked what had happened; they seemed intrigued but were reluctant; they both had serious doubts about the enterprise.

[Our doubts were that the war that seemed to be brewing between this group and AAMFC over accreditation would be a disaster for the field. Among other things we were veterans of the destructive psychoanalytic wars over accreditation.]

"On November 5, 1977, the first officers of AFTA were elected by the existing Board. During the meetings we struggled with defining the goals and purposes of AFTA. What, exactly, did AFTA stand for? What directions should it take? Should it set the standards for the field? ... Become the gatekeeper of family therapy? ... Simply serve as an interest, collegial group? How do we avoid appearing elitist? Should it become an academy or think tank for family therapy? Who should be admitted to membership? Should AFTA become involved in influencing social policy? We did make some decisions: We signed the incorporation papers, established a Board of Trustees and set of bylaws, John Pearce started a Newsletter, and we decided to expand the membership by inviting as charter members family therapists we each could vouch for. Five criteria were also established as guidelines as we networked; representation by different theoretical orientations to family therapy; representation by discipline; geographical representation; gender representation; and the inclusion of family researcher-theoreticians.

[In 1969 Jay Haley and the Mental Research Institute of Palo Alto, organized the Don D. Jackson Memorial Conference held at Asilomar, California. The Advisory Editors of the journal, Family Process, which Jackson had co-founded with Nathan Ackerman, were invited to attend. This pivotal meeting, quite unwittingly, established the Advisory Editors as an unofficial oversight group for the new family therapy field. It became the prototype for the Quadrennial meetings of the Advisory Editors held thereafter.

In 1977 Lyman Wynne was President of the Family Process Board and I was the Editor. We reasoned that the incipient war around the accreditation issue between AFTA and AAMFT might be headed off if there were some direct sharing of information, there being pitifully little knowledge in the opposing camps about the other group. We invited the new organization to send representatives to the upcoming Quadrennial meeting of the Advisory Editors of Family Process in Cancun, Mexico, in February 1978.]

"The AFTA Board declined because it was in its formative stages and had not thought through its positions on a variety of matters. The news about the forming of AFTA, however, had created intense feelings, and the small group of AFTA members found it necessary to make some sort of presentation at this meeting. … The statement that was presented to the group by John Spiegel (Bowen had not come to Cancun) declared that the rapid growth of the family movement had created a need for an organization for family therapists who had nowhere to go. There were no standards in the field, and training programs, some of dubious merit, had proliferated. … The statement further declared that we planned to enlarge the membership by balancing theoretical orientation, gender, region, and discipline; that major decisions would be postponed until the first national meeting of AFTA in 1979 … that a family systems approach had such unique premises that it could develop into an independent profession (italics added).

"After the Cancun meeting, Lyman Wynne, as President of the Board of Directors of Family Process, wrote a long, thoughtful letter where he suggested, among other things, that for AFTA to try to exert political power and set standards for family therapy would be inappropriate and impossible to achieve. He endorsed the concept of AFTA as a forum for sharing interests, and stated that AFTA could well end up being an organization of teachers of family therapy; in this way the group could influence training programs. Lyman took strongest issue with the idea that AFTA would be filling a vacuum in the family field, and he claimed that AFTA and the American Association of Marriage and Family Counseling (AAMFC) shared similar current goals and functions. Then he stated, in a prophetic statement, 'AFTA's late entry into this field is now likely to be viewed by impartial outsiders as a political effort to horn in on a scene that already has been pre-empted by AAMFC.' Wynne concluded by indicating he might participate in AFTA if it became a meaningful organization.

"Following federal government endorsement of AAMFT as the official accrediting agency for Marital and Family Therapy, AFTA had to confront its moment of truth. At the eighth AFTA Board meeting on November 5, 1978, it became clear to all on the Board (now joined by Carolyn Attneave, Norman Paul, and Carlos Sluzki) that AFTA was years away from being in a position to accredit, conduct examinations and site visits, etc. Ivan Nagy, for whom standards had always had high priority, was motivated to continue the effort. Even Bowen, however, who had originally involved himself with AFTA in order to establish standards in the field, had to face the unfeasibility of that endeavor. I have often thought that this turn of events began Murray's gradual change of attitude toward AFTA.

"Once it was recognized that getting involved with the huge organizational task of accreditation was way beyond the resources of AFTA, there was a marked shift to another purpose for AFTA's existence. There was implicit recognition that AFTA was to become a kind of academy of advanced professionals and teachers in family theory, practice, and research and that it would provide a forum for the exchange of ideas and interests. … At the point where this decision was made and the discussion moved to establishing standards of membership in AFTA, the group tension relaxed considerably.

"There were a number of consequences that emerged from this pivotal decision. We had moved in the direction which the majority of the Family Process Advisory Editors had wanted, which lessened resistance to AFTA on the part of most outstanding family therapists. After this decision all of the disagreements and struggles between AFTA and AAMFT disappeared. Just like that! In the ensuing years the two organizations, instead of being rivals, have become models of cooperation and cross-fertilization. Most members of AFTA are now also members of AAMFT. Looking back on these events, there were two other beneficial, but serendipitous effects of the crisis: it helped AFTA define itself, and it influenced AAMFT to greatly upgrade its standards and procedures (much to the chagrin of future applicants to AAMFT for clinical or supervisory membership). [Framo always looked on the bright side of things.]

"A lot of interesting things happened at the first national meeting in 1979 in Chicago; the excitement and spontaneity were contagious. The most important action taken was that after considerable and heated debate the bylaws were ratified by the charter members; if that had not happened AFTA would have ceased to exist. Prior to the Chicago meeting the charter members felt it was the Board's organization; afterwards they could say, 'AFTA is now our organization.' The other issues that were debated were: how restrictive should AFTA be? What should its size be? What criteria should be used to determine membership? … Murray's reaction to the first meeting was: 'Not as good as it could have been but not as bad as it might have been.' I remember leaving that first meeting with the satisfying feeling that all the work and financial cost had been worth it. AFTA was going to be!"

Coda: The foregoing is yet another edit of family therapy history. My edit, I think, has merit in that it draws attention to some of the political and economic issues in AFTA's beginnings. The psychiatrists involved in its origins could be seen as defending a turf against the inroads of the group of counselors and marital and sex therapists who were arming themselves with credentialing power to invade what then seemed to be a valuable territory. That view is unduly cynical of course. Most of us were, and continue to be, besotted by family therapy, but the shared social and economic status of the organizing group was of consequence, I believe.

Another struggle was brewing as well for the small band of beleaguered male psychiatrists who started AFTA: the women of family therapy would shortly came on stage as leaders, teachers, and competitors for political power in the organization. Nor could anyone have foreseen that these and other concerns in turn would be quickly dwarfed by the changes in US corporate healthcare that appeared to make irrelevant any of the versions of family therapy that had moved the founders. One could not have guessed that the internal struggles would seem so soon to be faintly musty and out of date or that one might almost feel nostalgic for them.

AFTA Newsletter. (1989). Winter, 10 -15.