The plight and promise of contemporary psychoanalysis in the light of its social history

This paper addresses the many changes which have beset psychoanalysis and the psychoanalytic community since the widespread, general acceptance of both by the educated, middle-class public in the 1950s. It attempts to explain these changes, at least in part, by reflecting upon them in the light of the history of the psychoanalytic movement and upon the rise of dynamic psychology as well.

Many in the psychoanalytic community think that their work is being ignored, devalued, and even attacked by an increasing number of influential persons and organizations. Critics claim that, epistemologically, psychoanalysis is scientifically invalid; therapeutically, it is ineffective; economically, it is too costly and takes too long; and theoretically, it is pluralized to the point of fragmentation. This is the plight of psychoanalysis.

This paper argues that many of the major problems which once beset Freud and his colleagues, and which beset the psychoanalytic community today, are best understood in terms of two sociological processes, legitimation and institutionalization. Legitimation is the socio-cultural process whereby a new idea (e.g., Freud's theories, Jung's theories) contests the established web of ideas which give coherence and meaning to social and personal identity. Institutionalization refers to the way legitimated ideas replace once-contested views of reality.

The single most decisive factor generating the plight of contemporary psychoanalysis is the ‘decision’ (1) to socially locate (institutionalize) psychoanalysis in institutes, rather than in clinics or universities, and (2) to represent psychoanalysis to the public (legitimation) as a medical science.

In order to illustrate and advance these claims, I first define and distinguish sociologically the institute, the clinic and the university. Second, I describe the origins and development of the ‘decision’, made by Freud and his followers, to locate or institutionalize psychoanalysis in institutes. Third, I compare and contrast this early pattern of legitimation and institutionalization with that of the present-day psychoanalytic movement in England (relatively benign institutionalization) and in the United States (relatively destructive institutionalization). Throughout this discussion I draw upon the new literature on the history of psychoanalysis, past and present.

As for the ‘promise’ for psychoanalysis, it can materialize insofar as psychoanalysis establishes contact with the clinic and the university (re-legitimation) and insofar as that contact becomes so self-evident that it is taken for granted (i.e., it is re-institutionalized).