The Impact of the Social Welfare System on the Psychoanalytic Process

It is fascinating how psychoanalysis has a capacity to accommodate to different circumstances. The analytic setting with the analyst meeting the patient three, four, or five times a week sitting behind the patient has remained the same since the beginnings of psychoanalytic practice. Still the social context in which this setting is realized is different, and this context certainly affects the psychoanalytic process.

Freud invented both the practice and the setting. His own office was situated in the center of Vienna, on Berggaße 19, and it remains in many ways the prototype for a psychoanalytic practice. It is located in the middle of a large city in a magnificent apartment, richly equipped with personal things—especially small antique statuettes. Freud did not make any effort to hide his personal taste. I imagine that the daily life of the Freud family took place around the consulting room and that the apartment was filled with both noises and smells from the kitchen. Considering these circumstances it is not difficult to understand a notice in Freud's records of the analysis of a patient who has entered into psychoanalytic history under the pseudonym “The Rat man,” where Freud wrote, “He was hungry and I gave him to eat.” The conditions for the good act were there.

Not many psychoanalysts in Sweden are lucky enough to have a consulting room in such a beautiful apartment. I know only a few. These kinds of apartments are not easy to find, and the income from a psychoanalytic practice would not cover the rent. Family life is also different today. Most members of an ordinary family are away from home during daytime. They are at work, in school, or at the nursery; the older generation lives on its own.

Necessity is often made into a virtue. I think of the recommendation given by Freud, that the analyst should be neutral, and how this recommendation