Discussion of Eisold's “The Profession of Psychoanalysis”

KENNETH EISOLD's assessment of the status of our profession is provocative, challenging, and anxiety-inducing, but ultimately optimistic and constructive. True to his basic idea that psychoanalysis is a critical discipline that questions accepted assumptions, Eisold encourages us to be self-critical and to take responsibility for what he sees as the failure of psychoanalysis to remain a respected profession after its initial success with the public. And this is certainly a crucial concern, since the vitality of psychoanalysis and its roots are in the clinical encounter. Eisold thinks of psychoanalysis as having lost authority because it failed to make a move from charismatic authority to technical authority, and presents instead a confused and fragmented picture and cannot demonstrate its effectiveness to a disillusioned public. This is a serious indictment; yet I believe that some of those factors that Eisold sees as liabilities can also paradoxically be seen from another standpoint as essential aspects of psychoanalysis and part of its potential strength as well.

I think it also needs to be noted that in regard to the field's standing with the public there are significant factors outside of the control of the profession that have contributed to the current state of a diminished public interest. Some of the more accessible applied variants of psychoanalysis as well as other forms of psychotherapy have had greater appeal to a public that now can choose from a large variety of treatment alternatives, and practitioners of these alternatives often promise to achieve results in a much shorter time. We also have recently suffered from a rather massive materialistic attack on the mental health field by what the insurance companies have disguised as managed care. This has created striking economic constraints today, in stark contrast to a time when psychoanalysis flourished because insurance coverage was available for long-term mental health treatment. (As a case in point: