Psychoanalysis has long been a part of Chicago's rich and often innovative cultural life. In the city that has given the world modern architecture, not to mention its many other contributions to the natural sciences, the social sciences, and the arts, it is hardly to be wondered that it was the radical young president of the University of Chicago, Robert Maynard Hutchins, who in 1930 invited Franz Alexander from Berlin to become the first professor of psychoanalysis at that institution's new medical school. Hutchins, at 30, had just become chancellor the year before, and the medical school had opened its doors a scant three years earlier, in 1927, with the then revolutionary innovation of a full-time faculty. Unfortunately, the hostility directed at the school by the Chicago medical community—the local Medical Society had blacklisted all of the medical faculty—was even more fully expressed in the school's own attitude toward Alexander and the psychoanalytic ideas he had brought with him. Though the reasons for this intense animosity had many roots, the faculty in general behaved like many victims of abuse, becoming themselves even more sadistic abusers. Alexander's every statement was challenged, and eventually he was accused of ethical impropriety. After a single year of utter bewilderment, he left the University, not before having catalyzed the formation, in June 1931, of the Chicago Psychoanalytic Society.
Among the twelve charter members were Leo Bartemeier, Lionel Blitzsten, Thomas French, Helen McLean, and Karl Menninger. Later, the Chicago Society would spawn the Detroit Psychoanalytic Society, upon Bartemeier's emigration to that city, and Menninger was of course active in the establishment of the Topeka Society.
After a year back east, Alexander was persuaded to return to Chicago to set up a training facility. And so began, in 1932, the Chicago Institute for Psychoanalysis, the second such organization in the United States. Its model, the Berlin Institute, founded by Max Eitingon, preceded it by a mere dozen years. “The ideas of Eitingon and his German Institute had great impact upon Alexander's undertaking. From Berlin, Chicago borrowed the designed curriculum which represented the first break with teaching psychoanalysis on a preceptorial, apprenticeship basis. From Berlin also [the Institute] took its new Director and its associate Director, Karen Horney.” But there were departures from the European pattern as well: in the emphasis on critical reevaluation of psychoanalytic principles; in the development of collective research, “free from the exigencies of private practice;” and in the assembling of a full- and part-time teaching staff, housed together, to develop standards of training and to supply new leadership for the field.
This was, in other words, a serious scientific enterprise, based on principles of free inquiry, as were German universities of the nineteenth century and the American research universities of the twentieth. And this institution has surprisingly, if imperfectly, fulfilled the mission envisioned by Alexander and its other founders. It has, over these decades, been a hotbed of new ideas. In the 1930s the staff of the Institute developed various hypotheses about the specificity of psychological conflict in the generation of psychosomatic disorders. Although they did not prove valid, out of these ingenious efforts came Therese Benedek's pioneering studies about the changes in women's psychology during the menstrual cycle, findings still pertinent today.
In the 1940s, Alexander formulated some very controversial notions. Disliking the “dependency” that analysis seemed to foster, he shortened treatment and made it less intense. Seeing patients three times a week instead of four or five, he manipulated his attitudes to act counter to figures in the patient's past. These manipulations he called “corrective emotional experiences,” thus giving a bad name to a good concept. These iconoclastic experiments raised the ire of the psychoanalytic establishment in the East, but they also met increasing resistance locally. A group of analysts who had been analyzed by Blitzsten, led by Maxwell Gitelson and Joan Fleming, and joined by the young Heinz Kohut, managed a sort of palace coup, and in 1956 Alexander fled to exile in Los Angeles.
Believing that the analytic process had been vitiated by the gimmicky manipulations of Alexander, and having a commitment to exploration in depth, these analysts made important contributions to the ego psychology that prevailed in 1950s. Fleming investigated parent loss and psychoanalytic supervision, and Gitelson published a number of clinically prescient papers, including one entitled “On Ego Distortion”; there he coined the term narcissistic personality disturbance and put forward a unique view of this diagnostic category. Contrary to what was then conventional wisdom, he held that such patients do not have ego weaknesses. Rather, they suffer ego distortions, which have originated as adaptations to situations of unusual stress. This view of narcissistic pathology was to influence Heinz Kohut very deeply.
Kohut's ideas, now known as self psychology, first appeared in 1966, in his presidential address to the American Psychoanalytic Association. Though greeted then with great enthusiasm by the psychoanalytic establishment, they quickly lost their Eastern welcome with the publication of The Analysis of the Self, in 1971, and engendered outright hostility when The Restoration of the Self, appeared six years later. Though deeply rooted in the psychoanalytic situation, indeed as its unique product, self psychology has nonetheless challenged the foundations of drive theory and the sufficiency of ego-drive explanations of development. It has replaced a closed-system model of development and function with an open-system model. In the process it has powerfully shaped and influenced the work of many original thinkers in Chicago and elsewhere, and has affected the way all of us practice psychoanalysis and psychotherapy. It is a new and powerful paradigm, but surely it is neither the last, nor the only one.
David Terman, M.D., is President of the Chicago Psychoanalytic Society.