- Freud’s Free Clinics: Psychoanalysis and Social Justice 1918-38 by Elizabeth Ann Danto
Columbia, 348 pp, £19.50, May 2005, ISBN 0 231 13180 1
In 1918, Sigmund Freud gave a speech at the Fifth International Congress of Psychoanalysis in Budapest. It was two months before the Armistice, but he looked to the future rather than dwelling on civilisation’s obvious discontents: ‘The conscience of society will awake,’ he promised his audience, ‘and remind it that the poorest man should have just as much right to assistance for his mind as he now has to life-saving help offered by surgery.’ To this end, Freud, sounding more like a health reformer than a psychoanalyst, urged his followers to create ‘institutions or out-patient clinics … where treatment shall be free’. Keen to contribute to a better postwar world, Freud hoped that one day these charitable clinics would be state funded – ‘the neuroses,’ he insisted, ‘threaten public health no less than tuberculosis.’ Max Eitingon, the psychoanalyst who funded the first of these clinics, later wrote that Freud had spoken ‘half as prophecy and half as challenge’.
We don’t think of Freud as a militant social worker, but rather as someone likely to be found excavating the minds of the idle and twitchy rich. The psychoanalyst Karl Abraham complained of just such a clientele in a letter to Freud written before the outbreak of World War One: ‘My experience is that at the moment there is only one kind of patient who seeks treatment – unmarried men with inherited money.’ But in Freud’s Free Clinics, Elizabeth Danto shows that thanks to Freud’s speech in Budapest and the enthusiastic response to it, ‘between 1918 and 1938 psychoanalysis was neither impractical for working people, nor rigidly structured, nor luxurious in length.’ During the interwar years, a dozen or so free clinics were opened in seven countries and ten cities, from London to Zagreb.
Danto’s meticulously researched year-by-year account of the spread of these psychoanalytic clinics focuses on Freud’s pioneering, idealistic, socially committed side, almost to the exclusion of his legendary cultural pessimism. He once admitted that he had thought of becoming a politician, claiming that his schoolfriend Heinrich Braun, a prominent socialist in later life, ‘awakened a multitude of revolutionary trends in me’. The Habsburgs, he wrote to his colleague Sándor Ferenczi, had ‘left behind nothing but a pile of crap’. In postwar Red Vienna, Freud threw in his lot with the Social Democrats, using whatever influence he had to help politicians like Julius Tandler, the university anatomist who, as head of the Public Welfare Office, applied his surgical expertise to Austria’s body politic. As the conservative Christian Socialists grumbled about ‘tax sadism’, Vienna under the SDP became a model of social welfare, as did Berlin, with enviable public housing and public health services.
Freud, in turn, inspired the ‘revolutionism’ of a second generation of analysts, who staffed the free clinics. They included Helene Deutsch (‘revolutionism’ was her term), Wilhelm Reich, Otto Fenichel, Edith Jacobson and Karen Horney. They shared Marxist sympathies and met in Fenichel’s radical Children’s Seminar, so called not because it was devoted to child analysis but because Fenichel liked to think of the analysts as ‘naughty children’. They were ‘a very lively, smart, special group’, Jacobson remembered, and they believed that psychoanalysis could play a utopian role in liberating those it treated from sexual and social repression.
Reich, the group’s self-appointed leader, doubted whether ‘the bourgeoisie [could] live side by side with psychoanalysis for any length of time without damage to itself’. ‘In the 1920s and 1930s,’ Danto suggests, ‘analysts saw themselves as brokers of social change for whom psychoanalysis was a challenge to conventional political codes, a social mission more than a medical discipline.’ It is therefore puzzling that ‘the history of political activism in psychoanalysis has been consistently withheld from public view,’[*] while the Frankfurt School, which incorporated the Frankfurt Psychoanalytic Society and the free clinic it set up in 1929, is often celebrated for its fusion of sociology and psychoanalysis. Figures like Fenichel and Reich linger in the shadow of Horkheimer and Adorno, even though they were the first to marry Marx to Freud in the service of what Reich was to call the ‘sexual revolution’. The SDP newspaper, Die Stunde, mocked them at the time for ‘mixing literary chocolate with economic garlic’ and for confusing historical and ‘hysterical materialism’.
The first of Freud’s free clinics was established in Berlin in 1920 by two members of his inner circle: Max Eitingon, who had directed the psychiatric divisions of several Hungarian military hospitals during the war, and Ernst Simmel, who had been director of a Prussian hospital for shell-shocked soldiers. Almost all the 42 analysts who attended the 1918 Budapest conference appeared in military uniform, having been conscripted as army doctors. The Berlin Poliklinik might be seen as their attempt to adapt the intensive, over-subscribed treatment of ‘war neuroses’ to civilian life. Though he was too old to serve, Freud liked to use fighting talk: in his 1926 essay ‘The Question of Lay Analysis’, in which he hoped to build on the success of his Budapest speech, Freud imagined that social workers might ‘mobilise a corps to give battle to the neuroses springing from our civilisation’.
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[*] A notable exception is Russell Jacoby’s The Repression of Psychoanalysis: Otto Fenichel and the Political Freudians (1983).