I saw the article in the Times, she began. It was my first day back in the office after the 2000 Fall Meeting. My 2:00 patient began her session referring to a major story covering the front page of the feature section of the New York Times on the Strategic Marketing Project. In New York I had received the expected spectrum of comments from my colleagues, ranging from enthusiasm about the increased publicity for psychoanalysts to concern about some of the quotes by colleagues in the article to a sense of insult and injury that analysts could be caricaturized in a cartoon-like illustration. I had no idea how my patient might respond.
“So what did you think?” I asked. She was silent and reflective. Then, to both of our surprise, she became tearful as she said, “What just occurred to me is that if you all had marketed yourselves thirty years ago, you could have saved me thirty years of unnecessary suffering.”
Knowing the patient's history, capacity for analytic work, and previous attempts at getting help (through what she had reason to believe were appropriate referral sources), I knew what she meant. She had found me quite incidentally through a chain of rather uninformed medical and mental health referrals.
Most people seeking help aren't so lucky. We learned from our marketing research that what most patients seek is what psychoanalysts provide, though they seek it under every name but psychoanalysis. They don't seek us because of ignorance about analysis. They are not referred to us because of ambivalence about us. We don't reach out to them, because of both our ignorance and our ambivalence about marketing. We have come by this ambivalence honestly.
When Freud wanted help in promoting his work, he turned to the best public relations expert in the world. Edward Bernays, twice Freud's nephew (the son of Freud's sister and the son of Martha's brother) was becoming a legend in his own field as Freud was entering the prime of his career. Larry Tye, in The Father of Spirt: Edward L. Bernays and the Birth of Public Relations, writes that Bernays's client list “read like Who's Who in American commerce and culture of that era” — General Electric and General Motors, playwright Eugene O'Neil, Columbia Broadcasting Systems, the National Broadcasting Company, and Time magazine, to name a sampling. Just as Freud became known as the father of psychoanalysis, notes Tye, “Edward Bernays became known around the world as the father of public relations.”
“What most patients seek is what psychoanalysts provide, though they seek it under every name but psychoanalysis.”
Freud relied on his nephew for help with promoting his publications, obtaining referrals, and managing his finances. Yet despite deep personal affection for Bernays, Freud was ambivalent about his help. Fearing that his public relations efforts would trivialize psychoanalysis, Freud vacillated between his suspicion of Bernays's profession and his appreciation for its benefits.
After instructing Bernays to translate, publish, and promote the Introductory Lectures in English, Freud demanded that Bernays halt his efforts, fearing Bernays would publish them in the newspaper, which would be “too American.” When Bernays arranged for a series of opportunities for Freud including a six-month lecture tour of America and an offer of $1,000 per article for a series of 3,000-word stories on such topics as “the wife's mental place in the home” and “what a child thinks about,” Freud's initial response was a two-word cablegram: “Not convenient.”
In his memoirs, Bernays wrote, “I felt frustrated in my effort to be helpful. It was furthermore quite clear that Freud had no idea how widespread his popular appeal was here nor did he realize that a scientific body of knowledge could be popularized without diminishing its scientific validity.” Ernest Jones, Freud's close friend and colleague, was taken aback by Freud's reaction: “I cannot help thinking that some of his indignation emanated from feeling a little ashamed at himself at having descended from his usual standards by proposing to earn money through writing popular articles.”
However, after Freud's anxieties about Bernays's management of the English translation of Introductory Lectures, Tye notes that “Freud's anger seemed to subside as positive reviews poured in from newspapers and cash poured in from Liveright,” Freud's publisher in America.
While Freud owed much to his nephew for promoting his work and managing his business affairs, Bernays also owed much to Freud. It was upon his uncle's discoveries that he built his career of public relations. Not only did Bernays apply Freud's understanding of unconscious motivations, but also he took a rather analytic approach to working with potential consumers. Bernays did not seek to impress his target audiences by direct competition and glitz. Instead he sought to understand the consumers' resistance to responding to his client's products or services and then sought ways to address this resistance. His main objective was to remove obstacles in order to free potential consumers to respond to his client's products. According to Tye,
his philosophy in each case was the same. Hired to sell a product or service, he instead sold whole new ways of behaving which appeared obscure, but over time reaped huge rewards for his clients and redefined the very texture of American life … plotting a path to a client's goal that seemed round about but ultimately removed underlying as well as immediate impediments.
Glenn E. Good, Ph.D., is on the faculty of the Michigan Psychoanalytic Institute and of Wayne State University School of Medicine's Department of Psychiatry. He is chair of the Committee on Marketing.
While we may be tempted to attribute ambivalence about psychoanalysis to peoples' fear of their personal unconscious, we found little support for this in our research. Consumers actually seek therapists who will help them understand their unconscious conflicts, and most of the mental health professionals in our focus groups credited Freud with providing the theoretical framework from which they help their patients understand themselves.
The impediments to seeking analysis or referring to analysts turn out to be surprisingly much more concrete. Like the method of Bernays, our approach to marketing analysis must be a more genuinely analytic one. Advertising, media, and glitz alone will not help us.
By the time you read this article, the strategic marketing research will be complete, the data will be analyzed, and the recommendations will have been presented to our leadership. These recommendations will include ways to address the impediments to patients seeking an analytic experience and to referral sources seeking to refer to therapists who can understand and help. As we understand and address these impediments, perhaps, there will be fewer patients who will say, “I wish you had marketed thirty years ago. You could have saved me thirty years of suffering.”
[Editor's note: In the next issue of TAP, we'll have a summary of the recommendations of the strategic marketing project.]