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Psychoanalysis had its origins in the late 19th and early 20th centuries as the result of Freud’s effort to understand and provide a cure for those hysterical symptoms that plagued his patients. The repressive society of Victorian Vienna imposed restrictions on sexual and other kinds of freedoms, generating multiple conversion symptoms that filled neurologists offices. Freud’s solution was psychoanalysis, the talking cure that stressed the centrality of unconscious fantasies as causal in producing these illnesses. From such beginnings, it isn’t surprising to find that psychoanalysts following in the Freudian tradition are concerned mainly with the
inner life of their patients. The idea of a mental life in conflict within itself allowed psychoanalysts to follow the interplay of drives and defenses and in doing so, reveal a virtual battle to keep memories and desires locked in the unconscious, thereby treating neurotic patients with considerable success. Unfortunately, this defined psychoanalysis as only marginally interested or concerned with the details of their patients’ external lives, and certainly, there was little to no attention given to the politics that surrounded them. A focus on the content of the unconscious as the aim of any analysis persisted despite a shift from Freud’s view that the oedipal complex was the central player in the analysis of adult patients to the Kleinian focus on the pre-oedipal period. The infantile past, residing in the unconscious and accessible only through the emergence in the transference, was what constituted psychoanalysis; concerns about the patient’s life outside the transference were to be minimized if the patient’s conflicts were to be accessed and resolved.
I have included the above history as an introduction to this review of Michael J. Diamond’s Ruptures in the American Psyche: Containing Destructive Populism in Perilous Times because the shift of including world events affecting our patients is a relatively recent occ