Psychoanalysis for the People
Sigmund Freud dedicated his life to developing a scientific theory of mental functioning, birthing the field of Psychology. Psychoanalysis is a theory that looks at the relationship between conscious and unconscious forces and their impact on mental health and relationships. Freud’s ideas were revolutionary at the time, and continue to shape the practice of mental healthcare. Over time, psychoanalysis has become associated with social conservatism and the economic elite. This association is not without merit, because many psychoanalytic thinkers promoted oppressive ideas that continue to produce harm in the field of mental health today. However, there are roots in psychoanalysis that align with more liberatory aims, and psychoanalytic theory provides fertile ground for understanding power and social control.
Psyche and Society
Freud gave us a simple but revolutionary concept: By talking to each other, we can explore dynamics outside of our consciousness to help people understand themselves internally and in relation to others and the world. When examining the interaction between psyche and society, Freud found that individuals absorb ideas from the outside and make them part of their internal world. Social forces (norms, expectations, rules) compose a structure inside the mind, a structure which can serve to maintain the status quo when people do not question these beliefs. Psychoanalysis can help soften these structures and support freedom in the psychologies of the oppressed through deep inquiry and curiosity.
The Early Days of Social Consciousness
In his early vision of the mental healthcare system, Freud was an advocate for medical care and psychoanalysis for all.
He believed that institutions should exist to serve all people, and treatment should be free. He wanted to move the practice away from just treating the individual, to treating larger social problems. “It is very conceivable that the sense of guilt produced by civilization is not perceived as such either, and remains to a large extent unconscious, or appears as a sort of malaise, a dissatisfaction, for which people seek other motivations,” wrote Freud. He saw the connection between mental health issues and social inequality, and he was concerned about the fact that treatment was only available to those who could afford it. This initial concern of Freud’s is still a problem today, with mental healthcare woefully underfunded by governments around the world.
In Practice
Psychoanalysts–both contemporaries of Freud and those who came after him–established free clinics to treat issues they saw in society. Between 1920 and 1938, free clinics formed across Europe to provide psychoanalysis for all. Socialist psychoanalyst Sándor Ferenczi founded a clinic in Budapest in 1929, where he sought to address the impact of societal repression and collective trauma on patients. Clinicians Francois Tosquelles and Frantz Fanon developed a radical approach to psychiatric care at their Saint-Alban hospital in France. The hospital was structured non-hierarchically; clinicians and patients shared roles, there were no uniforms, and walls were torn down. With this collectivist spirit, the clinic resisted the “soft extermination” of the Nazi-backed Vichy regime and protected the hospital patients from state violence. Fanon’s encounter with psychoanalysis at this time became central to his decolonial thought. The Lafargue Clinic in Harlem, New York City provided psychoanalysis to the community from 1945 to 1958, where clinicians interpreted the links between the conditions of one’s environment and one’s mental life. Sessions cost a quarter, but no one was turned away for lack of funds.
These were physical locations where experimentation and discovery in psychoanalysis took place. Clinicians asked themselves: How should the underfunded community clinic operate? How can we make mental healthcare accessible for all? What ways can patients be supported given conditions of repression and harm from governments and social forces? In these spaces, clinicians and patients found creative and effective adaptations despite all sorts of limitations. These are challenges that psychoanalysis and the mental health field at large continue to wrestle with today.
What We Can Learn
From Sigmund Freud to Frantz Fanon, there is a rich history of social justice within psychoanalysis that sometimes gets repressed. Psychoanalysis should honor its liberatory roots if it is to keep its position in the larger field of mental health. Like a good psychoanalyst would, we should look at kernels of the past to inform our next step.
References
Freud, S. (1930). Civilization and its discontents. Hogarth.
Retrieved From
1.) https://ia801503.us.archive.org/20/items/in.ernet.dli.2015.218475/2015.218475.Civilization-And_text.pdf
2.) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348439/#:~:text=Domestic%20funding%20for%20mental%20health%20by%20governments%20is%20low%20despite,physical%20and%20mental%20health%20services.&text=In%202013%2C%20WHO%20noted%20that,mental%20health%20was%20about%200.5%25.
3.) https://archive.wawhite.org/uploads/Journals/CPS-48-1.pdf
4.) https://blog.apaonline.org/2023/03/14/dis-alienating-theory-on-francois-tosquelles-frantz-fanon-and-political-theory-by-way-of-camille-robciss-disalienation/
5.) https://www.neh.gov/article/politics-and-psyche
6.) https://www.parapraxismagazine.com/articles/broke-psychoanalysis