A comment on Intrepid thought: psychoanalysis in the Soviet Union

29 June 1999

Dear Sir,

I have just completed reading Frank Brenner's articles on Freud (http://www.wsws.org/articles/1999/jun1999/freu-j11.shtml). I wish to extend my warmest thanks to him for writing them. I have been trying to piece together the common springs of Freud and Marx myself, and have been going nowhere really. It was a real revelation to find one's own half-thought-through conjectures and observations so adequately dealt with. I would also like to add a few points to the article to expand on certain points.

The attempted rooting out and destroying of Freud's influence on psychology was not limited to the Stalinist regimes. Hitler and Mussolini also attempted to destroy its influence. Freudian man knew no boundaries and could certainly not be racially defined. In all his works from Moses and Monotheism to Jokes and their Relation to the Unconscious, Freud deals with the commonality of mankind. His thinking was too threatening for Fascism.

Likewise in the capitalist countries, in the absence of book burnings, they had to call forth the schools of Watson and Skinner to counteract Freud's influence. This was successful to the extent that less than one percent of all patients receiving psychiatric care now receive analysis or Freudian based therapies. In the universities, schools and colleges that teach psychology or psychiatry, the little mention that is made of Freud is generally fraudulent and almost defamatory. This applies even to the training of psychiatrists. In the last round of budget cuts to Medicare in Australia the rebate on psychoanalysis was one of the most heavily pruned.

The dualism that Brenner speaks of prior to Freud is alive and well in the NSW [New South Wales] psychiatric system, so much so that the system is now called Mental Health. This is incorrect on two counts; firstly, the root cause of “mental illness” is the emotional world. Whether one sees schizophrenia as a emotional suicide in order to go on living, or neurosis as a desire to retreat from a frightening world to a world of maternal comfort no longer present, the cause lies in the reaction to the environment at an emotional level. And, secondly, as if human beings can have their emotional world so artificially separated from their living reality. The problem being, for the Health Dept., that emotional treatment takes care and time, both of which are in short supply.

Whereas in the old 5th Schedule system there was a training and emphasis on psychoanalytic frameworks, albeit limited by the very nature of bourgeois society, now the emphasis is entirely on pharmaceuticals. In my training 25 years ago, we were told that medication played only a small part in either maintenance or rehabilitation of the patient. While we were trained in Klein, Winnicot and Erikson, and the need for empathy and understanding; it is now chemicals for breakfast, lunch and dinner. It is much cheaper than providing all the needs of living, but it only treats the symptoms of the disorder. If we take schizophrenia, for example, the popular image is of someone talking to himself or seeing space ships or some such. These however are only the outward and communicable facets of the illness/disorder. The inner disorganisation of trust and the ability to live in the world are only visible from inference.

So giving them tablets is like giving someone with pneumonia, opium as an elixir. Certainly their coughing and hacking will stop, but the disease rages away unabated under the surface. Give someone with schizophrenia any of the slew of anti-psychotics and they will usually either cease to have these complaints or at least cease to report them. However, there are a number of patients who will not respond to this and they are labelled “Treatment Resistant”. What a slander. It is a truly Panglossian schema: “This is the best treatment available, in this the best of all possible worlds.” The inference is clear, if you don't respond to the treatment you are “resistant”—put into the same classification as Multi Resistant Staph Aureus, a rogue who could probably do a lot better if he really tried. I hear this a lot in case reviews: “We've tried everything...,” everything except giving the patient security and a sense of purpose.

Contrary to popular belief (mainly due to works such as One Flew Over the Cuckoos Nest, Angel at my Table and The Snake Pit, etc.), the patients in the older, more established, stand-alone hospitals, generally received much less medication than now. The reasons were simple—they had work, routine, love and play. Work is essential to proper human functioning; while the work may not have been as fulfilling as possible, it still served to give some sense of self-worth. Routine plays a large part in anybody's life, but when you are having some difficulty in ordering your existence and your world it serves to reduce anxiety considerably. The problem wasn't the routine for the patients; it was the content of the routine.

The patients were “held” (in the analytical sense) in sanctuary from the world that had created their illness and were only encouraged to leave once they had reached some form of self-provision. While they were in hospital it was taken as scripture that the three elements of life—work, love and play—were essential for recovery or stabilisation. And none of this took place in a vacuum; while there was some one-to-one work, the group was the foundation of most treatment. For if you couldn't function in a group, how were you to function in the world? All efforts were made to understand the nature of the illness and the individual response to it and how best to live within the society.

Being in a group situation also gave more opportunity for each to develop what was unique in himself. Nowadays it is more like the theme song from Rawhide, “no time to understand them, just rope, throw and brand them.” Patients are not treated anymore, merely serviced. It is a truly distressing sight to see people reduced to the state of barking madness, so undone have they become from the pressures of survival, surrounded on all sides by the hostile aspects of capitalism. I have known people for over 20 years, who were settled and productive in their own right, now destroyed by market forces and incapable of enjoying their life. People with a chronic mental illness should be afforded the choice of asylum until the world is a fit place for them to enter. Not one of the patients I knew in the old hospitals was asked if they wanted to leave when the Richmond Report was implemented. Many didn't, but to no avail, it was taken for granted that they didn't know what was good for them. They were, after all, “mad”.

I would like to make one final point regarding Erik Erikson's book, Childhood and Society. This book deals with the raising of children in markedly different societies, Plains Indian, Inuit, Yurok and American middle class. It shows how the needs of each society shape the early childhood of the children. For example, the Yurok salmon fishers have a boom and bust cycle of life; each season's haul of salmon is followed by the long wait for the next one. Teamwork and the ability to delay pleasures are therefore highly praised features of their life. How this is achieved, the dealing with Oedipal conflicts and weaning, show the plasticity of early childhood and the distortions that occur. (A somewhat magnified example is the caste which used to place babies' heads in misshapen plaster bowls in order that their heads might become grotesque, all the better for them to solicit alms as beggars. It was, the parents thought, the best way for the children to become self provident—a perversion of care which is none the less illuminative.)

Erikson is very astute when dealing with the “savage or simple” societies, but when he comes to the American childhood he loses sight. He sees things only as the needs of the democratic society. He does not see the needs of capitalism expressed. This is a pity because the book would have been all the stronger for it. But why was this? Why was Erikson unable to see the realities of life? Because any class analysis of the psychological and personality development of children, due to the destabilising and disorienting effects of Stalinism, had been obliterated. The recent review and the book have brought new light to these questions and can only bode well for the future of understanding the inner world of mankind.

I have posted copies of the review to every analyst I know, or don't know, and asked them to respond. I will send you their responses, if any.