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In his 1918 address to the Fifth International Psychoanalytic Congress, Freud offered his clearest assertion of the social obligation of psychoanalysis (Jacoby, 1983). He acknowledged that large masses of people suffer from neurosis as much as the smaller numbers of rich. Freud openly admitted, however, that the financial necessities of the analyst's existence “limit our work to the well-to-do classes” (Freud, 1918). Nevertheless, “the poor man has as much right to assistance for his mind.” Freud proposed an idea for the future when “the conscience of the community will awake” and provide free psychoanalytic care for the wider social strata (Freud, 1918).
As the history of the psychoanalytic movement has shown us, however, Freud's vision was split in two. On one hand, there were followers who took this social consciousness quite seriously. In 1923 Ernst Simmel and Max Eitinger organized the Berlin Institute, composed of a circle of early analysts with liberal social and political ideals. From its inception this institute was committed to providing therapy to those who lacked financial means. Motivated by its own social ideology, this early circle was committed to emancipating psychoanalysis from its exclusive reliance on wealthy neurotics (Lewy, 1947; Peck, 1966; Jacoby, 1983).
Subsequently, in the wake of the Nazi era, when the psychoanalytic movement was forcibly dispersed to other parts of the world, the vision of a social consciousness was kept alive by some factions. Of note was the steady and consistent thrust of British analytic workers who devoted much of their time to the assessment and care of poor and working-class