Political Engagement of Analysts

American psychoanalysis faces formidable threats to its survival in the 21st century. Most analysts’ energies and attention are occupied with the most obvious and direct challenges to the legitimacy and viability of the profession, such as the hegemony of managed care, pressures to mandate the complete manualization and standardization of psychotherapy, and increased skepticism about the effectiveness of psychotherapy and of psychoanalysis in particular. Psychoanalysis is also being threatened by more diffuse economic and cultural processes that ignite and sustain the more organized and overt threats, and features of its own forgotten history that are seldom satisfactorily addressed.

Efforts to address these challenges are necessary. To confront and contain the indirect economic and cultural trends that threaten psychoanalysis’ future, psychoanalysts must engage in some collective soul searching, and discard or revise Freud’s attitudes toward politics and technology. It is because Freud’s theories did not make provision for the social changes we are witnessing today that current attitudes must change.

Leaving the doctrine of adaptation aside, another significant factor in the rapid rise (and recent decline) of psychoanalysis in the U.S. is the adoption of a purely professional ethos, rather than the stance of the committed and engaged intellectual. This was also a concession to middle-class sensibilities, albeit one that began in Europe, not in the U.S. At the risk of oversimplifying, the analyst qua professional, be s/he a lawyer, doctor, etc., offers their expert skills and services to individual clients for a fee, but declines to get involved in social and political issues on the grounds that it would compromise their professional credibility or competence. The analyst qua intellectual, by contrast, will also write, teach, or create art for a living, and is actively involved in the public sphere, while often maintaining a discrete distance from party politics by virtue of their disciplinary engagement in the arts and sciences.

Obviously, there are some noteworthy exceptions to both of these stereotypes, and there is no reason why — ideally, anyway — analysts cannot be both professionals and intellectuals. In the past, however, any deviation from the professional ethos was openly discouraged by the majority of institutes and subtly discouraged in most others as well. Significantly, this process did not commence with the exigencies of adaptation to America. Indeed, Freud himself set the tone for these developments. In response to Otto Gross, who advanced a Marxist and pro-feminist interpretation of his work in 1909, Freud disclaimed any political agenda for psychoanalysis, saying; “We are just physicians.” He was implying that remedial interventions which analysts undertake ought to be tailored strictly to the welfare of the individual, not to social change. However, later that year in a letter to Jung, Freud

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noted that the future survival of psychoanalysis was contingent on the success of various “progressive” (i.e., liberal) political forces that protect science from bullying by church and state. Later, in The Future of An Illusion, Freud even commended Mussolini to his readers, mistaking Il Duce for a courageous conservative who would presumably contain Hitler’s rabid anti-Semitism.

Experience suggests that this professionalizing process, though European in origin, became more pervasive in the U.S. than in Europe, where more analysts remain engaged intellectuals, and/or are actively involved in social and political affairs. In any case, in the process of disclaiming the intellectual role, analysts across the board embraced the misbegotten notion that clinical neutrality — and by implication professional competence — presupposes political neutrality. However, clinical and political neutrality are not at all the same thing, and the linkage between the two is highly questionable. In fact, just as psychoanalysis cannot prescribe a particular attitude or approach to politics — as Freud rightly insisted against Gross and Reich, for example — so it ought not to proscribe any particular approach to politics, including neutrality.

To thrive, much less survive in the 21st century, psychoanalysts must re-examine their own collective history and recognize the necessity of proactive political engagement, something many are reluctant to do. This is not merely a matter of doing battle with managed care, and the manualization movement, but of experiencing and interpreting the growing power and perceived legitimacy of these hostile forces as symptoms of a deeper cultural malaise that needs to be addressed. This is not merely for the benefit of the analytic profession, but for society as a whole. To tackle these problems insightfully, analysts must acknowledge that the rise of psychoanalysis in America created unprecedented inroads with the (then) growing American middle class, and that psychoanalysis became more respectable, less avant-garde and less oppositional, and inevitably, more conformist as a result.

Judging from recent experience, however, the middle class that furnished the bulk of analytic patients in days gone by is in decline. Economists report that the 60 percent of the population wedged between the bottom and the top twenty has been steadily losing financial ground from the late 1970s until very recently. Even if the recent stabilization of the middle class lasts, which is doubtful, present social trends ensure that only a steadily dwindling fraction of the population will be able to afford analytic therapy — never mind a traditional psychoanalysis — in the future. The availability of money (and/or insurance coverage), while crucial, is not the only factor. Time and literacy are also critical.

Furthermore, let us remember that in Freud’s hands, for better or worse, psychoanalysis slowly changed from being primarily a method for the alleviation of symptoms into an instrument for deepening self-knowledge. Admittedly, it was not to be pressed in the service of revolution. That much is crystal clear. What is less clear, but evidently implied — at least by the later Freud — is that even in the absence of robust benefits, psychoanalysis can and should be practiced for the sake of self-knowledge alone. The hedonic and utilitarian goals of “successful adaptation”, i.e., material prosperity and personal happiness, didn’t rate highly on Freud’s list of priorities, and with the passage of time, Freud seemed less and less certain that self-knowledge necessarily results in self-mastery in any case (e.g., Analysis Terminable and Interminable, p. 193).

In the present climate, however, Freud’s attitude obviously is untenable. Insurance companies want something tangible in return for their money, and if you cannot demonstrate rapid improvements in return for services rendered according to prevailing criteria — which are often trite, narrow, or misleading — you are likely to lose credibility and, hence, your “market share.” As a result, analytically oriented practitioners have met the emerging Zeitgeist half way already by devising manualized, short-term therapy protocols for anxiety and depression, which are just as (or more) effective than their cognitive-behavioral counterparts. Efforts like these should continue to prevent the cognitive and behavioral schools from gaining a monopoly of the short-term psychotherapy market, and the political leverage that goes with it. However, they are clearly insufficient to stem the rising tide of anti-analytic ideology in the mental health field, and do nothing to avert the threats to more traditional (i.e., long-term) approaches.

As their economic prospects become more precarious, perhaps, some American analysts will become more politically engaged, and attempt to address the more diffuse cultural threats to their profession. In view of the disparate political traditions that claim the allegiance of individual analysts, however, anything resembling a universal consensus on overall strategy is unlikely.

Fortunately, one issue on which all analysts

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can agree is that pressures for the standardization and manualization of psychotherapy practice, and for the de-legitimation of non-manualized approaches, should be resisted. It is not enough to compete with them on their own terms, or to match their efforts with modifications to traditional formats. To be effective in this regard, analytically oriented clinicians may soon have to join forces with outsiders and some traditional adversaries, i.e., Jungians, existential and humanistic psychotherapists, as well as pastoral counselors, to challenge the manualization movement. This will help create an effective counter-lobby, and call attention to the scientific tendencies to quantify, reify, and (inadvertently) debase human beings and human relationships in the name of efficiency and accountability.

To oppose manualization and managed care vigorously means to confront these deeper cultural problems only in their most overt and manifest form. In the long run, analysts must do more. They must realize that the cultural and economic changes that bode ill for the analytic profession are all linked to the headlong advance of technology, unchecked by other social and cultural forces that are capable of containing and diffusing its deleterious effects. Accordingly, they must ask themselves whether Freud’s attitude toward technology, or that of the average American, is really adequate or appropriate to circumstances. I think not. The average American — including the average analyst — is indoctrinated from early childhood to think of technology as a good thing, by and large, and to merely question occasional abuses and excesses of this process, not to view its systemic effects on society as a whole.

Freud was more ambivalent about technology, and therefore, closer to the truth, in my view. He realized that technology transforms us into “prosthetic gods” on the one hand, and enables us to destroy ourselves completely on the other. Even he lacked the foresight to discern the cultural problems it creates in peacetime. Despite all the talk of technology as a laborsaving device, the headlong advance of technology in the last two decades has created far too much work for those who are fortunate enough to have it and little or no work for many others. More to the point, netheads [avid Internet users] don’t read Sophocles, Shakespeare or Proust, as a rule. As Jane Healey reports in Endangered Minds (1990), and as educators all over the continent know, America’s educational system is producing successive generations of students who are aliterate, or allergic to reading: who can read, but prefer not to, and who seldom extract much meaning from what they do read. As current trends intensify, those who can afford analysis from a purely monetary standpoint, because of their successful adaptation to the emerging techno-social order, are less and less likely to have the time or inclination to pursue it, or the ability to benefit from it if they do.

What is the solution? There is no single or simple solution to our current cultural malaise. Unless analysts see the nature of the problem clearly, they have no hope of addressing it effectively. Let us hope they see the bigger picture soon, before it is too late.

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