A cottage industry of mental health professionals has developed to opine on the behavior of the person now at the helm of the most powerful country on earth. As the Twittersphere developed into the focal point of presidential agenda setting, a vibrant debate flared between mental health professionals who argued it was unethical at worst or irrelevant at best to characterize President Trump’s behavior in diagnostic terms and those who felt his behavior posed such a clear and present danger that old rules no longer applied.
During the last two years, our private listservs have rung with indignation attempting to give voice, coherence, and momentum to the sense of political urgency that long before the 2016 election a handful of contemporary psychoanalysts such as Donna Orange and the historical Freudian left have attempted to inject into the community. Conference programs have taken up with unprecedented vigor the intrusion of the political and social domain into the consulting room. Scholar-analyst Ricardo Ainslie called the summer 2017 APsaA town hall meeting on race and borders previously “unthinkable” because of its “overtly political message.” In a 2018 issue of Self and Context devoted to the American Psychological Association’s controversial role in the development of tools of political torture, Orange went beyond the descriptive to the prescriptive, asking whether psychoanalysts have “the right to remain silent … or … the obligation to speak.”
For the most part, however, this wholesale re-examination of the political has been at best only a minority strain in psychoanalysis. Largely forgotten in current laments about topics such as incipient fascism is that the most famous psychoanalyst to use a psychoanalytic lens to address this topic was virtually written out of the profession for his political involvement. Widely embraced as a hero by the student left in the 1960s because of his challenge to authoritarianism, Austrian Wilhelm Reich died in an American prison a decade before seeing his book The Mass Psychology of Fascism thrown by German students at police during the student uprisings of this period.
It is not surprising, then, that psychoanalysts have historically tread warily in these domains and that a sense of “duty to speak” has still not achieved sufficient and consistent volume to markedly amplify the public voice of psychoanalysts in social and political problem solving. While institutes have begun to develop public programs to engage the broader policy community in psychoanalytic thinking and help illuminate the potential contribution of psychoanalytic thought to public problem solving, these efforts have focused on bringing the public inside rather than propelling the analytic community outside the walls of their offices and institutes. To be sure, our professional organizations have issued a plethora of position papers on topics such as immigration and family separation. However, psychoanalysts, themselves, are rarely the
political shock troops in the many areas where they perceive they have expertise and where they have more successfully shared it in the past.
From the Issues in Psychoanalytic Education Editor
This column continues our inquiries into the intra and interdisciplinary aspects of psychoanalytic education.
Flora Lazar’s article is a searching consideration of the sociocultural frontier of psychoanalysis and its educational mission. Its impassioned message of responsibilities and opportunities in the public domain is deeply informed by her methodical archival review of some historical chapters of the psychoanalytic movement in America. It offers a sober critique of the consequential turn away from engagement in the academic domain of sociopolitical research to the insulation of the consultation room. This inward orientation away from the university model truncated the opportunities for creative intellectual and civic ferment in the educational mission of the psychoanalytic institutions.
The convergence of the fraught present sociopolitical moment in America with such historical perspective makes for a compelling and important reading.
—Luba Kessler
From the Editor to Our Readers:
Luba Kessler, our psychoanalytic education editor, is moving on to other projects. It is with sadness and gratitude that we say goodbye. Luba has contributed a spirit of curiosity, intellectual energy, and rigor we will all miss.
Thank you, Luba!
How then has the field of psychoanalysis found itself at the margins of public debate when many analysts would consider its ideas more important than ever? Why has the field been so short of members like James Gilligan, who specializes in studying violence and terrorism, and has served as a consultant on violent crimes and terrorism to heads of state like Bill Clinton and Tony Blair. To be sure, there are those like historian and social critic Christopher Lasch who would find little unusual for a field he claims “has no faith in social progress” and which he believes at first glance might not “commend itself to reformers or revolutionaries.”
Attempts to explain the seeming trepidation of psychoanalysts to embrace the machinery of public problem solving have largely invoked external restrictions. Fear of running afoul of the Goldwater Rule limiting the political commentary of members of the American Psychiatric Association has provoked enough self-doubt among psychoanalysts, even when issues relate to policy not people, that much of the perspective the field could potentially offer has been confined to our own internal vehicles for deliberation rather than shared broadly with the public. Trauma therapist Betty Teng, one of the 26 co-authors of The Dangerous Case of Donald Trump, has explained the political silence in psychological terms as a “sanctuary … a psychic place to go when feeling unrecognized, afraid and alone.” For Teng, it is a “byproduct of ‘interpersonal’ and ‘political dissociation’… part of the social fabric that blots out parts of our personal and communal selves.” Philip Cushman goes much further, faulting everything from the field’s scientism to its individualism and consumerism.
How then has the field of psychoanalysis found itself at the margins of public debate when many analysts would consider its ideas more important than ever?
In reality, though, the large-scale disenfranchisement of psychoanalysts from public debate and public problem solving is a product less of court rulings visited on the field from outside than of a much earlier set of institutional developments stemming from within, most notably the development of psychoanalytic education outside the university system. Much has been made of the impact of this educational isolation on the perceived scientific stature of psychoanalysis as well as the impact of the medicalization of psychoanalysis. The declining stature of social work, where psychoanalysis in the early 20th century had reached its high-water mark addressing issues such as juvenile justice and prostitution, did little to amplify the voice of psychoanalytic ideas in public problem solving. Rarely, however, has the impact of the system of
American psychoanalytic education been viewed as a contributor to the field’s declining role as a source of expertise in public problem solving.
Yet the role of psychoanalysts as experts on social issues cannot be understood apart from the increasing misalignment with the larger changes in the institutional configuration for the advancement of knowledge and certification of expertise in the early 20th century. In particular, the diminishing voice of psychoanalysis as a source of social problem-solving expertise fell victim to the migration of social research from the community-based institutions such as Chicago’s Hull House and Institute for Juvenile Research, where social research originated, into the university departments of social science. This left psychoanalysts largely outside the network of philanthropists, academics, and higher education reformers whose financial investments and intellectual networks converged by then to confer authority and legitimacy on social problem-solving expertise. Radiating from the Rockefeller philanthropies and the philanthropic intermediaries they funded, such as the Social Science Research Council, the National Research Council’s Committee on Research in the Problems of Sex, the Bureau of Social Hygiene, and the National Committee for Mental Hygiene, these groups included such varied professionals as psychiatrists, primate behaviorists, sex researchers, prison reformers, and charity workers. By the mid-1920s, their research contributed to public policies ranging from military readiness to the control of prostitution.
A small handful of psychoanalysts, most notably Harry Stack Sullivan, did recognize the defining role such groups would play in certifying social science expertise. But for the most part, the field did not and psychoanalysts cast their lot with medicine or the community organizations where analytically-oriented philanthropists like Chicago’s Ethel Sturges Dummer had succeeded in exciting interest in the promise of Freudian thinking in social problem solving. By then, however, social science expertise that had developed in community organizations was increasingly eclipsed by male academics in departments of sociology and their informal philanthropic networks. It was a development whose institutional significance the psychoanalytic community largely failed to grasp as it increasingly focused on medicine over behavior and practice over science.
Part of the failure to recognize the full cost of the field’s isolation from university social science no doubt relates to a misconception about the degree to which psychoanalysis was actually embraced by university-based social scientists. Some have suggested the rise of scientism in higher education and behaviorism in psychology came at the expense of psychoanalysis. However, psychoanalysis was often embraced by the very social scientists then considered the apostles of the new empiricism—influential sociologists such as Ernest W. Burgess, author of the classic sociology textbook of the era and ardent exponent of the case history method of sociological research, and his colleague William Fielding Ogburn, who chaired the American Sociological Society and the University of Chicago’s Sociology Department before chairing the board of the Chicago Institute for Psychoanalysis. In fact, for many of the most influential social scientists of the era, psychoanalysis was actually central to the scientific prospects of social science, whether to eliminate bias or to provide intimate understandings of individuals in their social surround.
By replicating the European psychoanalytic institutes and concentrating psychoanalytic education in independent institutions with part-time voluntary faculty focused on clinical education, psychoanalysts erecting a system of education and theory development in the 1930s were actually working at cross purposes from those creating the machinery of social problem solving in the modern research university. Developing on its own path, organized psychoanalysis pushed many academic researchers fascinated by the cross-pollination of psychoanalysis and social problem solving outside mainstream educational institutions of organized psychoanalysis. It left them alone to acquire their clinical knowledge improvisationally in brief trips to the continent like those taken by largely forgotten political scientist Harold Lasswell, who conducted the era’s classic studies of political propaganda, or sociologist John Dollard, who wrote the era’s most important study of race relations. At the same time, it left psychoanalysts, trained outside the university, vying for scientific authority as research and scientific expertise increasingly centered elsewhere.
It is no accident that the most promising effort to preserve the intimate connection between psychoanalysts and the rising class of university-based social science experts actually played out in Chicago, both the seat of Progressive Era reform and the location where the contours of the modern research university were shaped. No public policy in the early 20th century issue bore the signature of psychoanalytic social problem solving more clearly than the issue of juvenile delinquency, with agency workers and social researchers devouring Austrian analyst and educator August Aichorn’s work on the psychological roots of delinquency. By the time an English translation of Aichorn’s Wayward Youth appeared in English, it had fundamentally reformed public efforts to address delinquency. Excitement about psychoanalysis in addressing delinquency paved the way for Berlin analyst Franz Alexander, an authority on delinquency, to secure a University of Chicago appointment as the first ever university professorship in psychoanalysis, even against the opposition of the university’s medical faculty.
Whether Alexander understood it or not, to work in the social sciences at the University of Chicago in the 1920s meant working in the inner sanctum of scholars and leading edge philanthropists connected to the Rockefeller Foundation and related philanthropies’ efforts to transform the American university system. This Chicago-based network brought together philanthropists like Ethel Sturges Dummer and university scholars like sociologists William F. Ogburn, Robert Park, and Ernest Burgess, with Rockefeller-backed social hygiene movement alumnae G.V. Hamilton and Earl Zinn. Dummer, whose son-in-law Walter T. Fisher would eventually become the board chair of the Chicago Institute’s lay board, had been a longtime and well-known observer of Freud. She made her confidence in the utility of Freudian ideas unequivocal in her 1923 foreword to the era’s classic study of prostitution, The Unadjusted Girl, where Dummer attributed “much of the modern success in the rehabilitation of the young prostitute” to psychoanalysis.
For an outsider, Alexander got quite an insider’s view of the nexus of philanthropy and academia during his year at the University of Chicago, where he spent the better part of 1930 under the tutelage of Zinn, then attempting to create an academic center for psychoanalytic research. Head of the Rockefeller Foundation’s Division of Studies, Zinn was the first psychoanalytic researcher to attempt to conduct research using recorded psychoanalytic sessions. He was also the consummate new-style academic expert, effortlessly navigating between university-based social scientists like Ogburn and Yale’s Robert Yerkes, a central figure in the U.S. Army’s intelligence testing program, and their philanthropic patrons sprinkled between the foundations and outside research centers like the Bureau of Social Hygiene. But even the prospect of borrowing Zinn’s then state-of-the art psychoanalytic recording device, was inadequate to the task of convincing Alexander of the urgency of forging the link Zinn hoped to develop with psychoanalysts to assure a reliable source of research subjects. No amount of pressure from those who understood the implications philanthropic reforms in the organization of research within higher education would succeed in convincing Alexander that he could not straddle, as he had attempted unsuccessfully to do, the worlds of academic research and clinical practice.
Social science experts working outside the increasingly university-based system that certified public problem-solving expertise would face diminishing public influence from the time of Alexander’s arrival. No institution created outside the university system came closer than the Chicago Institute for Psychoanalysis to conferring comparable public stature on its leading authorities and for preserving the role psychoanalysts had within places like the University of Chicago social sciences and Yale’s Institute for Human Relations.
Some have mischaracterized the institute as an effort to replicate the so-called Berlin Model with its attached low-cost policlinic. In fact, the Chicago Institute was established with goals set not by its first director Franz Alexander but by a lay board of directors whose members were among the leading prophets of the modern research university. Their singular aim, documented in archival material rarely consulted by psychoanalysts where Alexander’s suitability for the role was candidly and often skeptically discussed, was the creation of a research center more akin to the Rockefeller Institute or the University of Chicago than to a clinically-oriented institute like Berlin. Organized on the celebrated “full-time plan,” the institute was the only one in the country designed to advance knowledge by replacing part-time voluntary faculty with the creation of a full-time salaried faculty. This was the centerpiece of Rockefeller reforms in higher education. As such, the Chicago Institute bore the unmistakable stamp of its lay board, that included the same foundation executives and scholars at the center of the Rockefeller Foundation’s efforts to build the modern research university. In particular, the institute bore the mark of medical educators such as Franklin McLean from the University of Chicago and Alfred E. Cohn of the Rockefeller Institute, charged with creating a system of scientific medicine and rooting out the widespread commercialism condemned by the Flexner Report.
Organized on the celebrated “full-time plan,” the Chicago Institute was the only one in the country designed to advance knowledge through the creation of a full-time salaried faculty, the centerpiece of Rockefeller reforms in higher education.
It was not a vision wholly embraced by Alexander with whom the institute’s leaders clashed, often intensely, from the founding days in the early 1930s. To be sure, the choice of Alexander to lead the new institute was not without some promise for psychoanalysts hoping to preserve a role for psychoanalysis in the public domain. His work bringing together criminal justice and psychoanalysis was well known in the 1930s among mental health reformers, some of whom had even traveled to Berlin to meet him. This combination of interests had made Franz Alexander the toast of the town at the First International Congress on Mental Hygiene in May 1930 in Washington, where a who’s who of social reformers had gathered to establish a policy agenda for mental health. Supported by Rockefeller philanthropy, the gathering had, in the assessment of the journal Psychiatry, “influence … beyond measure or estimate” that would be “reflected for many years
to come in wiser laws relating to the mentally abnormal and delinquent classes, in more intelligent handling of behavior problems in children, in better hospitals, better schools, better prisons, and better social relations.”
However, hobnobbing with leaders of the mental hygiene movement such as the informal dean of the field, St. Elizabeth’s Hospital Superintendent William Alanson White, was not enough to establish Alexander’s expert authority, especially when the terrain of the new institute quickly favored medical over social science and shifted his social science allies into the background of the institute’s work. Indeed, having penetrated the philanthropic elite of the mental health field briefly during his one-year tenure at the University of Chicago probably tarnished Alexander’s reputation as a scientific authority by bringing him into the inner sanctum of philanthropically backed higher education reforms where his institutional apostasy was more intimately on view.
Nowhere was the cost of Alexander’s University of Chicago misadventure higher than in the reputation he developed with Chicago philanthropist Harold McCormick, heir to the International Harvester fortune, son-in-law of John D. Rockefeller, and member of the University of Chicago board. Few members of the philanthropic elite were more directly immersed in the still obscure world of psychoanalysis in the 1920s than McCormick. However, it was on McCormick’s watch that Alexander revealed his insufficient grasp of the new culture of expertise in American higher education and his seeming willingness to breach an increasingly inviolate principle of this culture. Although the excitement surrounding Alexander’s participation in the DC Mental Health Congress had succeeded in securing him an invitation from the young and innovative president of the University of Chicago, Robert Maynard Hutchins, to teach there beginning in the fall of 1930, the excitement died down quickly when it was discovered Alexander was earning a side income conducting a clinical practice when his medical colleagues were being compelled to live under the constraints of the full-time plan. The situation was made worse when it was learned that a young medical student in his care was compelled to drop out of the university because he could no longer afford his studies. The scent of commercialism never quite escaped Alexander, whose appointment as head of the new model psychoanalytic institute was vigorously opposed in private correspondence between McCormick and those who questioned his commitment to science.
Consulted about Alexander’s potential leadership of the Chicago Institute, McCormick blasted Alexander for squandering the University of Chicago’s opportunity to develop psychoanalysis by “running a business institution on the outside for commercial profit” (McCormick to White, January 29, 1932, William Alanson White Papers Note). He remained unconvinced by William Alanson White’s effort to explain the “great misfortune” of Alexander’s university debacle on the latter’s ignorance of “public opinion, customs and traditions, professional and otherwise in this country.” McCormick empathically refused to believe White’s contention that the “glorious opportunity to put psychoanalysis on the map in a splendid way as part of university training,” was not a matter of avarice (White to McCormick, February 9, 1932, Records of St. Elizabeth’s Hospital).
To be sure, interest in the use of psychoanalysis in social science had faded with Alexander’s departure from the university, after which his key allies, John Dollard and Harold Lasswell, decamped to a more hospitable environment for this work at Yale’s Institute of Human Relations. A modest program of lectures for social workers and educators survived in the Chicago Institute’s early days. But the debates among the institute’s philanthropic sponsors about the relationship between science and clinical work proved prophetic. Many forces contributed to the demise of the Chicago Institute’s pioneering research program as a medical enterprise, but it was the unresolved tension about the institutional foundations of expert authority in the mid-20th century that eroded the promising possibilities inherent in the social sciences’ Chicago effort.
Today’s debates about the ethics of public commentary by mental health professionals make me look back wistfully at the 1920s and 1930s and especially at the doomed Chicago effort to ensure the burden of psychoanalytically-informed public problem solving would not be left entirely in the hands of those who, through practice and policy would find themselves most constrained in shouldering it. As I listen today to the debates, I often wonder what political scientist Harold Lasswell, the author of such classic works as Psychopathology and Politics and World Politics and Personal Insecurity would have said. One thing seems certain: He would have been better positioned to comment on the substance of the issues than on the ethics of the commentary itself. Lasswell, a patient of psychoanalyst Theodor Reik, who had made “lay analysis” a cause célèbre, had spent much of his early career trying to develop a clinical infrastructure for collaborating with psychoanalysts, imploring the psychiatric directors of the most important psychiatric institutions in the country, such as St. Elizabeth’s or Sheppard and Enoch Pratt, to describe cases of politicians they had treated. Unsuccessful in forging reliable connections with analysts, he ended up setting up his own lab at the University of Chicago and conducting analyses there.
Psychoanalysis is still paying the price for its failure to progress substantially beyond the Lasswell and Zinn days. Nowhere is it more apparent today than in the absence of clinically informed political scientists whose perspectives on the electoral process as a whole, is sorely needed. Small signs of progress are discernible, however, especially with the
collaboration created by the opening of research tracks in institutes. But these programs are sparsely populated perhaps in part because of the resistance such programs can unleash. Even as psychoanalysts bewail their declining professional stature and the inadequate attention paid to their science, some clinicians at institutes protest the inclusion of non-clinical academics who they say dilute the discussions in their case conferences or compromise confidentiality. So too with teaching, where alumnae status often trumps expertise as a prerequisite; institutes have yet to update the full-time plan for the 21st century.
In our eagerness to assess how best to add a psychoanalytic voice to political discussions, we should take a step back and ask ourselves whether it is really the Goldwater Rule or our own historical reluctance to share our clinical perspective more freely with experts outside our clinical realm who may be less encumbered than we are to offer this commentary. Robert Wallerstein, the one-time head of the America Psychoanalytic Association, noted just about a century after Freud’s only visit to the United States, that our field’s isolation from the university has exacted a high scientific price in terms of theory development and science. Its lack of inclusiveness has also exacted a high political price, perhaps higher than anyone might have anticipated.