Our Psychotherapy for the People

In September 1918, Anna Freud was in the audience at the Hungarian Academy of Science, in Budapest, on the day when Sigmund Freud offered to “review the position of our therapeutic procedure” (S. Freud, 1919/1955). This “review” would lead Freud to repudiate his earlier and far better-known writings from 1913 on fees and the psychoanalyst/physician as a medical entrepreneur. With the end of the war, he said, “the conscience of society will awake,” and the new psychoanalytic perspective would advance a platform of modernist beliefs in achievable progress, secular society, and the social responsibility of psychoanalysis. Nearly four months later, when the Social Democratic Party won Austria's first post-Monarchy election, the government would use its firm majority to promote a highly innovative program of community policies and to redesign virtually every municipal resource. Psychoanalysis fit in perfectly.

Yet even then, Freud worried that psychoanalysis was at risk of isolation partly because “our therapeutic activities are not very far-reaching.” Why? Because therapy was only one side of the psychoanalytic coin. Engagement with social democracy demanded the kind of activism that would mitigate social stigma and place mental health care on a par with physical health care. Poor people, Sigmund Freud (1919/1955) said, have “just as much right to assistance for the mind as they now have to life-saving help offered by surgery. …This treatment will be free.” This goal—psychoanalytic treatment provided for all in the context of a free clinic—would shift the provision of mental health care from the paternalism of individual charity to a broad social welfare paradigm, the welfare of society as a whole.

In the historiography of the psychoanalytic movement, descriptions of the clinics tend to frame them as mere adjuncts to their respective training institutes, essentially laboratories where candidates would find patients on whom they could exercise new skills and theories. Fort