Psychoanalysis and Social Justice*

The questions I want to deal with in this essay concern whether psychoanalysis contributes or can contribute anything to our idea of a good society. Is it, as some people think, merely a privilege that only a minority could possibly have, the indulgence of having personal problems examined and thought about at great expense of time and money, a really Hampstead kind of activity? How could the non-availability of psychoanalysis possibly be considered an injustice, when it seems so difficult to imagine psychoanalysis in any form as a common experience?

This issue was given a particular topicality by recent press reports a propos threats to the funding of the Tavistock Clinic, which suggested that it was difficult to justify the priority given to psychoanalytically based treatment at a time of National Health Service economies. The suggestion in these reports was that psychoanalysis is too expensive; that it treats too few people for the resources involved; and perhaps also that the people it does treat are not those most needing or deserving of treatment — ‘merely a few hundred neurotics’, one report in The Observer said.

But there is a more general reason why this is an appropriate place to be discussing the question of the social value of psychoanalytic psychotherapy. This is because the Tavistock is unusual in being an institution where psychoanalytic methods are practised and taught, to a variety of different professional disciplines, within the National Health Service. Patients are accepted like others in the National Health Service on grounds of need, and the treatment services provided are free to those who receive them. I'm told that even people who go as patients to the Tavistock sometimes find this hard to believe. The National Health Service is an area of national life in Britain in which a particular equalitarian idea of justice — ‘to each according to his