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In The Question of Lay Analysis, Freud reaffirmed his conviction that the analytic process need not be restricted to the medical situation, but offered the alternative of the 'Seelsorger', a secular, nonreligious lay pastorate in which an analyst assists his neighbors in the tending of their psychic life. Boris describes his experiences when he undertook such a role in a depressed Vermont village under an NIMH grant. He realized that he could not expect the villagers to become patients because of his presence, nor could he expect them to conclude that what was amiss in their lives could be rectified or to believe he could make them willing to change.
He succeeded in organizing groups with members from all levels of the community that met weekly for an hour and a half. The task he hoped to accomplish in the first session was to reassure the members of his intentions and thus lower their resistances, confront their wishes for benefit with their internal resistances, and interpret inner conflict in a meaningful way. The members were essentially depressed and the author saw the need to reactivate the conflicts that had resulted in this mood. Otherwise, narcissistic issues and introjective solutions would rob the sessions of personal meaning. He interpreted their problems in terms of anxiety and impulses. After the session, the members lingered to organize a collective response to the experience—to find a means of facing the next encounter without shame, anxiety, and guilt. They considered themselves not as patients, but rather as citizens seeking proficiency in self-understanding, especially of their life situations.