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The Fortunes of Freud

The prestige that psychoanalysis gained in the midcentury was also its downfall.

Hans Casparius / Hulton Archive / Getty Images

At their first postwar meeting in 1949, the president of the International Psychoanalytical Association called upon his colleagues to focus their work only on the “primitive forces of the mind.” He wanted them to avoid the “influence of sociological factors”: economics, politics, and even potential social influences on sex. Particularly in America, the Freudian establishment steered clear of political entanglements, not just those of outré psychoanalysts like Wilhelm Reich, inventor of the orgone machine, but also of sociologically-oriented neo-Freudians such as Karen Horney. Doing so, the profession reflected the conservative and conformist mood of the immediate postwar years, but also the pressures felt by the many émigré analysts who had fled Hitler’s Europe and sought now to fit into their adopted home. 

Cambridge University Press, 316 pp., $34.99

Dagmar Herzog’s Cold War Freud traces the decline of psychoanalysis to this moment at the dawn of the Cold War, when political pressures began to narrow the profession in America, even as the meanings of psychoanalysis proliferated in other regions of the world. She begins in post-World War II America, where the medical and cultural authority of psychoanalysis was greater than anywhere else in the world, but would soon decline precipitously. In its heyday between the 1940s and 1960s, its most prominent practitioners enjoyed status as public intellectuals, and its ideas and therapeutic models figured in the popular culture. Freud’s central and pessimistic insight into the inescapably conflictual (and conflicted) nature of human existence, Jerry Adler argued in a 2006 Newsweek cover story titled “Freud is Not Dead,” resonated in an era lived under the threat of nuclear annihilation.  And when the end of the Cold War brought a spur of optimism in the 1990s, psychoanalysis reached its nadir.

Herzog’s account treats the Cold War less as a specific struggle between America and the USSR, and more as the setting for a broad range of political and cultural forces that swept up and transformed psychoanalysis. Not least among them were religion and sex. While many scholars have discussed the adjustment of psychoanalysis to postwar America, Herzog pursues an underexplored path when she asserts that psychoanalysis, long considered the “Jewish” science, underwent a profound Christianization in the early postwar years. Practitioners of the ‘40s might have believed that they could analyze the individual psyche, without taking political circumstances into account, but they couldn’t altogether avoid sexuality—a subject Freud knew would challenge puritanical Americans. Freud’s original theory, after all, rested on an account of great psychical torsions set in motion by the libido.

Sex could never be fully excised from psychoanalysis, but in the conservative climate of the late 1940s and 50s, it had to be tamed and demoted if psychoanalysis were to assert mainstream legitimacy. And, in Herzog’s account, it is sex that roared back in the 1950s and 1960s to avenge itself on a science that had begun with the promise of sexual liberation but had conspired with libidinal repression.

In his 1946 book Peace of Mind, Rabbi Joshua Loth Liebman argued not only that religion and psychiatry are compatible, but that Sigmund Freud had a spiritual purpose. An enraged Monsignor Fulton J. Sheen responded by attacking psychoanalysis for wallowing in “materialism, hedonism, infantilism and eroticism.” The analyst was not only lax on the question of the righteous life, thundered Sheen, he was more than likely to pathologize yearnings for purity and obscure their moral and spiritual importance.

Psychoanalysts from all religious backgrounds sprang to their field’s defense, but they tended to do so by deemphasizing the place of sexuality in their theory and practice. Karl Menninger, a leading analyst and a practicing Protestant, insisted that it was the patient, not the doctor, who had sex obsessions. He also countered the charge that psychoanalysis was indifferent to all matters of guilt, by claiming that analysis aims only to remove fantasmatic guilt, feelings of shame for things the patient did not actually do. Libido retained a place in the thinking of Karl Menninger and the so-called “ego psychology” that dominated American psychiatry until the 1970s, but the line between the normal and the pathological was sharply-drawn. Sex was understood largely as heterosexual, monogamous, and oriented to reproduction, essential to a stable personal identity, self-mastery, and the capacity of the individual ego to cope with the challenges of external realities

Ego psychology conquered large territories of American medicine and culture, but this strain of Freudianism also witnessed, beginning around 1970, the great rollback in medical, scientific and cultural authority from which American psychoanalysis has never recovered. Herzog cites numerous factors in this decline, including the rise of competing models of self-help and pop psychology, as well as a growing disrespect for high-handed experts in a culture that was leaning toward antiauthoritarianism. In this regard, one might add, psychoanalysis may have suffered disproportionately in the antipsychiatric mood that swept America in the 1960s and 1970s, generating works of protest such as R.D. Laing’s The Divided Self and Ken Kesey’s One Flew Over the Cuckoo’s Nest. At the same time, a burst of new drugs announced what Edward Shorter has called the psychopharmacological revolution. In Shorter’s History of Psychiatry: From the Era of the Asylum to the Age of Prozac (1997), this move toward medication rendered psychoanalysis nothing more than a “hiatus” in the march toward scientific understanding and medical treatment of mental illness.

The development of new-generation medicines aimed at altering brain chemistry undermined the scientific claims of psychoanalysis, by seeming to prove that Freud was tilting at windmills when he focused on the dynamic economy of the psyche instead of going straight to the physical constitution of the brain. Herzog recognizes the powerful effect of the psychopharmacological revolution upon Freudianism’s status, but she passes quickly onto other concerns. Nor does she mention at all the mounting philosophical attack on the discipline—exemplified by Karl Popper’s claim that psychoanalysis lacked the crucial feature of a true science, namely the possibility that its theories might be falsified. It bears mentioning that as the scientific credibility of psychoanalysis declined, the significance of its founder’s human, all-too-human weaknesses grew. Freud’s limits, whether personal (his obsessions, his sometimes vexed relations, his careerism) or historical (the specificity of Vienna, the peculiar hot-house atmosphere of the late Victorian bourgeois family, the persistence of patriarchy) came to look like the limits of his science.

The emergence of non-psychoanalytic accounts of sex also threatened the prestige of analysis. In the late 1940s and early 1950s, Alfred Kinsey published his studies on human sexual behavior, which showed that ordinary people reported a wider range of sexual activities—including a surprisingly high frequency of homosexual encounters—than had been previously suspected. Psychoanalysts responded with prudish insistence that “normal” sexual ecstasy depended on love for the other person. Without love, it is all “sexual promiscuity or experimentation or athleticizing,” wrote Karl Menninger. Kinsey’s insistence on a finely-graded continuum from exclusive heterosexuality to exclusive homosexuality was not far removed from Freud’s own recognition of the fluidity of human sexuality, but in the early 1950s, it incensed American psychoanalysts. 

A decade later Masters and Johnson’s Human Sexual Response (1966), writes Herzog, “took empiricism into the body itself, measuring pulse rates and erections and lubrications and flushed skin, providing data on what bodies really did in the run-up to and in the midst of and in the aftermath of climax.” From this physiological orientation, they argued for a therapeutic approach based on bodily responses and behavioral modification. They branded it as an appealing alternative to psychoanalysis. “Two weeks in a hotel in St. Louis making daily love with your spouse was certainly marketable as an improvement over seven years on the couch,” quips Herzog. Depends on the spouse, one might object; but the point was well taken in its time and continues to sway therapeutic decisions to our day, insofar as both individual people and insurers look for quick and inexpensive results.

Ultimately, it was the sexual revolution, the women’s movement and gay liberation that simultaneously bypassed psychoanalysis—and forced a reckoning among psychoanalysts with their hetero-normativity, misogyny and homophobia. An early victory against the latter was scored in 1973, when homosexuality was removed from the updated edition of the Diagnostic and Statistical Manual of Mental Disorders, but it took almost twenty years before the American Psychoanalytic Association passed a nondiscrimination declaration that permitted openly gay and lesbian individuals to certify as analysts. This breakthrough came at an ironic cost as gay-friendly analysts in the 1990s and 2000s often repeated their predecessors’ inclination to emphasize attachment motivations at the expense of phallic drives. Or as Kenneth Lewes put it, analysts showed a tendency to disrespect those who came out as gay not because they wanted a relationship or a family but because they sought “the bare, forked activity of sex again and again, in all its variety, anarchy, repetition, and insatiability.” 

The story of post-World War II Freudianism too often hinges on America, and when Herzog turns away from the United States—her book includes chapters on France and Germany—the picture looks different indeed. Viewed from beyond the United States, the story of psychoanalysis in the later years of the Cold War is not strictly one of decline, but of reinvention, renewal and proliferation. 

In a fascinating chapter, Herzog traces how Post-Traumatic Stress Disorder came to be recognized, after Holocaust survivors sought financial compensation in Germany after World War II. She notes that oddly and ironically, it was doctors testifying against such claims who first drew on Freud and psychoanalytic concepts. It is actually not so surprising. In World War I, as the medical communities of all belligerents grappled with traumatized front line soldiers, German psychoanalysts were among the least sympathetic. Much as they would later insist that Holocaust victims suffered from problems that predated the trauma of the camps, World War One era German Freudians often denied that battlefront conditions themselves might account for mental breakdown and instead fell back on clichés about latent homosexuality or pathological dependence on the mother.

As the subject of Holocaust trauma commanded growing attention in America during the 1960s, it set the stage, Herzog argues, for the medical profession to take seriously the psychological condition of US soldiers returning from Vietnam. This amalgam, she claims, finally pushed PTSD into the Diagnostic and Statistical Manual of Mental Disorders III, where it is pointedly the only condition for which origin or causation are considered significant. Herzog avoids telling a story of unmitigated success: As some astute critics noted, PTSD came with the price of amoralizing trauma, blurring lines between survivors of Nazi camps and US soldiers, between victims and perpetrators.  And, as she notes, “the possibility that the Vietnamese victims of US violence might be traumatized was not even taken into account.”

A 2006 New York Times article on Cambodia obliquely supports her contention. It reported that only 26 psychiatrists were grappling with the scars of a nation of 12 million people traumatized by the Khmer Rouge, American bombing, and Vietnamese invasion. That situation contrasted with America, where health professionals readily applied the PTSD diagnosis to refugees streaming in from southeast Asia, Africa, Khomeini’s Iran, and exiles from communist eastern Europe. Likewise, trauma became a crucial diagnostic tool for psychologists working in Latin American dictatorships, where torture, incarceration, and disappearance were brutal facts of life.

The decline of psychoanalytic authority among mental health professionals may be irreversible. Nonetheless, Freud’s language is woven into the everyday ways we speak of our own identities. The same is true for our politics, despite the efforts of post-war American psychoanalysts to purge their science of political analysis and commitment. 

Back in the 1930s, contemplating German fascists’ success in drawing popular support away from the Left, the radical Freudian Wilhelm Reich asked, “Why do the masses allow themselves to be politically swindled?” It was clear to Reich that the answer had to be sought at the intersection of the individual psyche and the political-social world, with both Sigmund Freud and Karl Marx guiding traffic there. Herzog, presumably finishing her book around a year ago, finds a contemporary equivalent to Reich’s question in the meme, “What’s the matter with Kansas?”  With the outcome of the 2016 presidential election, it is not only Kansas, but broad swathes of the nation that call for a reckoning with the enigmatic meeting place of politics and the psyche. 

Not just masses, but also leaders have tempted psychoanalysts to enter the political fray since the time of Freud and Reich. It may be that Trump will breathe new vitality into the power of psychoanalysis to address politics. Buried in the 2006 Newsweek article is a glib definition of the ‘id’ that today reads like a portent. “If you’ve watched Donald Trump, you know everything you need to know about the id: the part of the psyche where sexual and aggressive drives are given free rein.” With his erratic conduct, chronic lying, manic swings, fragile ego, and limitless narcissism, Trump has brought psychiatrists and psychoanalysts back into the political realm. 

For a similar intervention, we have to return to the halcyon days of American psychoanalysis, when over 1000 psychiatrists declared Barry Goldwater of Arizona, the Republican candidate for president, to be dangerously unstable. A decade later, in 1973, the American Psychiatric Association adopted what came to be known as the Goldwater Rule, declaring it professionally unethical to diagnose public figures from a distance and without authorization. It is remarkable to see doctors edging up to that line again, recognizing in Trump behavior they are more accustomed to seeing in their clinics than in the Oval Office. Modern-day psychiatry may be able to offer diagnostic tools, but psychoanalysis may offer the best arsenal for fathoming not only the personality of the 45th president, but more importantly, the webs of fantasy that bind him to his fervent base.