Psychoanalysis and its Vicissitudes: The Doctor's Dilemma

Colleagues and friends: I have spent the last 30 years—since I began psychoanalytic training at Columbia Psychoanalytic Institute—preparing for today's address. I have been reading many obituaries of late and have attended many gloomy funerals where the corpse of medical psychoanalysis lies in state. I must tell you, however, paraphrasing the words of Mark Twain, “The news of its death has been greatly exaggerated.”

Before proceeding further I would like to share with you a psychoanalytic dilemma with which I was faced several weeks after my graduation. I had presented my third control case to a famous European psychoanalyst, well known for his brilliant theoretical contributions to the field. Although he was a medical doctor himself, he had never completed an internship; he immersed himself in psychoanalytic training immediately upon completing medical school. He told me although my work with the patient was very good, I demonstrated too much zeal for curing the patient of his neurosis. Psychoanalysis, he believed, must be devoted to the study of human behavior, not it's cure. I was shocked because I considered myself to be a physician who dealt with ill people in need of a special kind of help. “Then you should choose another line of work,” he stated emphatically.

Never one to be daunted, I ignored his comments and continued along the path I had carried out as a medical psychoanalyst and psychodynamic psychotherapist. Following the classical Freudian tradition, however, was also fraught with problems. The rigidity of some psychoanalysts reminded me of Shaw's satiric theatrical treatise on