Psychoanalysis in Community Psychiatry: Reflections on Some Theoretical Implications

Dr. Viola W. Bernard, Chairman of the Panel and of the Committee that prepared it, opened the session. She explained that this Panel, presented by members of the Association's Committee on Community Psychiatry, reflects the stage reached in a process that evolved over the five and a half years of the Committee's existence. She thought it would be of interest, therefore, to review some of the factors that gave rise to the Committee, how it has sought to carry out its charge, and some of the steps by which it arrived at focusing today on certain theoretical implications from community psychiatry for psychoanalysis.

Although the Association's interest in social and group phenomena is by no means recent, the development of community and social psychiatry has certainly accelerated and intensified within the past two decades, gaining its greatest momentum in the nineteen-sixties. Furthermore, the push for changes in mental health service delivery, itself a sociopolitical issue, occurred in the dynamic context of social ferment with which it became inevitably enmeshed: the civil rights movement, the "war on poverty," the black protest movement, student unrest, and Vietnam with all its psychosocial repercussions. Even though much of the pioneering in community psychiatry was done by psychoanalysts, unfortunately, these two approaches to psychological well-being, one focused on minutia within the individual mind, the other directed toward population groups, became polarized, with consequent mutual misperceptions and derogation. The establishment in 1968 by this Association of the Standing Committee on Community Psychiatry expressed a counterthrust to such an adversary situation, by community-oriented analysts, to bring the concepts and practices of both into synergistic relationship. Although surveys show that a majority of analysts work in a range of non-office settings, and in multiple roles, many of them apparently dissociated such work as incompatible with their se