Editorial Comment

As the general public becomes increasingly aware that many illnesses, both social and medical, have their roots in emotional difficulties, the demand for care has increased proportionately. Neither individual nor group approaches are adequate to answer this need. Community mental health programs have developed in response to these exigencies. These have arisen with minimal involvement on the part of psychoanalysts, the very personnel who are the best equipped to make relevant contribution to this field, and thus to the public at large. However, a strong tendency toward isolationism is observed, and it is expressed in terms of hopelessness, and even pessimism. At its center may be an aversion to leave the cloistered shelter of the private consulting room. In addition, one observes that the analyst has become excessively involved in recording the aberrant in his patient, at the expense of eliciting the possible, and thus the constructive. The question is, therefore: How can the constructive be brought to the attention of those individuals most in need of it? How is one to reach the vast numbers of individuals who cannot be seen in the office? Figures for mental illness are moving toward the thirty and forty percent levels, a seeming explosion in mental illness. Does this explosion represent a contagion, or is it rather evidence of a heightened awareness—a coming to life of persons who otherwise might be content to live in resigned deadness? The answers to these questions will help to illuminate desirable approaches.

One of the most important of these approaches lies in the area of prevention. Modern psychoanalytic theory which is grounded in cultural and interpersonal factors, as well as the intra-psychic, is eminently equipped to provide the understanding of the dynamics which would underlie prevention theory and approaches. Perhaps the question is not only one that asks: How can the psychoanalyst respond to this urgent demand?—but also one that asks, Will he respond?