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I have spent my career working at the border between psychoanalysis and psychiatry. The characteristics of this intellectual territory have changed dramatically in recent years. When I began my psychoanalytic training at Columbia in 1968, there was much communication between psychoanalysis and psychiatry, but the vector of communication was primarily from the former to the latter. Psychoanalysts had greater status than general psychiatrists.
During WWII, psychoanalytic ideas had been of enormous assistance in treating what today would be termed PTSD among combat forces. In the large citizen armies and navies that fought in that war there were many individuals who had psychiatric disorders of various types. The so-called “organic psychiatrists” had relatively little to offer these troops but the analytically oriented psychiatrists did. They practiced what today would be called “psychodynamic psychiatry” and their results were impressive. They assessed their patients under all conditions, and used flexible and diverse treatments to help restore function.
As a citizen soldier/psychiatrist in 1970-72 working in the States with evacuees from the war in Vietnam, I was grateful to read their reports. I learned a lot from them.
Between WWI and the Vietnamese War the field became bureaucratized and driven by ideology. On the one hand, many important contributions were made during those years. On the other, however, the negative consequences of a rigidly hierarchical stance were serious and deleterious effects are still evident.