Psychiatry for Everything and Everybody:
The Present Vogue—and What Is Behind It
For a few years now we have been deep in a flood of Hollywood films and fictional and non-fictional best-sellers built around psychiatry and psychoanalysis; and there have been few days when the press has not featured a pronouncement by some governmental, welfare, educational, or military authority on similar themes. All these testify, if not to the fact that all Americans are mentally sick, to the presumption that most literate people in this country seem to think they are. How account for this psychiatric vogue? Siegfried Kracauer, who here attempts to explain the larger significance of this current mass preoccupation, has a distinguished record as a social psychologist.
Psychiatry and particularly psychoanalysis are now enjoying an amazing vogue in this country. In the prewar decades, the vogue was confined to intellectuals; today it has spread until it has become a mass phenomenon. In the words of Dr. C. Charles Burlingame, a leading psychiatrist: “Hundreds of thousands of persons, satiated with a superficial knowledge of the psychological implications of life and literally preoccupied with psychiatric terminology, are beginning to interpret every trivial thought and feeling in psychological terms.”
Particularly symptomatic of the fascination psychiatry exerts today are Hollywood’s psychological films—a trend that began around 1944 and remains unparalleled in other countries, with the exception perhaps of England, where it has made only a hesitant beginning. These films endow psychiatry with an illusionary glamor. As pictured by Hollywood, it is not so much a science as a superior system of magic practiced by a species of miracle worker. That on occasion one of these miracle workers misuses his magic for criminal ends only enhances its awe-inspiring uncanniness. In Spellbound the homicidal psychiatrist and his law-abiding colleagues engage in a struggle reminiscent of the contests between sorcerers in old fairy tales. Compared with these modem sorcerers, detectives have become rather dullwitted, as can be inferred from The Dark Mirror, in which the psychiatrist leaves the detective far behind in tracking down a smart murderess.
Thus, Sherlock Holmes has yielded to the analyst, common sense to the play of free associations, and the gun to the couch. But even the couch is no longer needed, for, unlike their counterparts in real life, most screen psychiatrists set aright the gravest mental derangements in six easy lessons. The very speed of their therapy adds to their stature as master-minds. (To be sure, in a silent film, Secrets of a Soul, made in 1926, the German director, G. W. Pabst, demonstrated that it was quite possible to impress upon spectators the slowness of psychoanalytical treatment and yet sustain dramatic suspense.) Once restored to normal, the patients usually return to the tasks of life and solve them with the greatest ease. The heroine of Lady in the Dark ends as a lady in the light, and the amnesia-stricken girl in Shock happily marries her lieutenant. Psychiatry, at least on the screen, appears able to solve anything.
How explain the average American’s infatuation with psychological procedures? Dr. William C. Menninger recently stated that “the neurotic patient represents a majority of all the patients who seek help from physicians” (New York Times, April 29, 1947). And patients of this kind are found not merely among the well-to-do. Military experience has shown “that the neurotic young man, as seen in army induction centers, came from the middle class as well as from the underprivileged,” Dr. Marynia F. Farnham states. People in all walks of life, then, are suffering from neuroses. And the most obvious conclusion that suggests itself is that the present-day attention to psychiatry must be accounted for by the existence of an unprecedented amount of mental maladjustment.1
In principle, however, most people, laymen and psychologists alike, agree in attributing the impressive spread of emotional disturbances to the heightened pressure of social factors. That we are mentally sick because the social structure is sick, is the opinion most frequently heard. One might expect, therefore, that popular imagination would turn from neurotic symptoms to social causes, and emphasize, not so much the importance of psychiatric cures as the necessity for environmental changes and the reform of society. Yet the spotlight remains unwaveringly focused on psychiatry.
The fact is, though most of us agree that society is at the bottom of many psychological maladjustments, we seem to act on the reverse principle that society is sick because we ourselves are sick. Dr. G. B. Chisholm, Canada’s Deputy Minister of National Health and formerly Director of General Medical Services for the Canadian Army, explains wars by the frequency of neurotic ills traceable to the immaturity of the masses: “The necessity to fight wars . . . is as much a pathological psychiatric symptom as is a phobia. . . . They are alike irrational behavior patterns resulting from unsuccessful development and failure to reach emotional maturity” (Psychiatry, February 1946). In this country many a psychologist thinks along similar lines. For instance, Dorothy W. Baruch considers proper child training the ideal antidote to race hatred.2
History teaches us that this shift of emphasis from outer to inner conditions is usually provoked by the impact of drastic social change and crisis. The vogue of psychiatry in my opinion owes its existence to two attitudes forced upon us by the present pressures of American civilization. One attitude amounts to an evasion. The other results from an attempt to compensate for the lack of what I would call emotional behavior patterns.
The evasive attitude is the outcome of the all-pervasive atmosphere of menace and danger arising from the impact of such dreaded social and political developments as “the coming depression,” war with Russia, and the atomic bomb. These threats fill the headlines of our newspapers and the recesses of our minds. It seems paradoxical, but the undeniable improvement of living conditions in this country has seen at the same time a steady decrease in emotional security. The naive optimism so characteristic of America, already shaken in the wake of depression, has definitely given way to widespread malaise. People are possessed by a haunting fear of what the future may have in store for them.
The fear is intensified by our awareness of how difficult it is for each of us as individuals to control or alter the course of events. Especially now that the United States has become such a dominant world power, public affairs assume giant dimensions that make it all but impossible to establish a meaningful relation between our immediate acts and the large but remote issues at stake. One act may have various incalculable effects, and one effect may be caused by several diametrically opposed acts. So the feeling grows that we are less than ever masters of our destinies. This is why many people—in particular middle-class people—have relinquished the attitude of active agents and become passive consumers who unhesitatingly buy whatever society hands down to them. This acknowledgment of social and political helplessness and the consequent adjustment to it inevitably deepen inner insecurity.
Perhaps this insecurity would be less acute were it not sustained by a spiritual crisis so profound that it affects the very roots of the American myth. Uncertainty as to the future wears away faith in attitudes and convictions held sacrosanct in the past. The present state of world affairs, along with our recent war experiences and our new international commitments, may have hastened this crisis. It is true that the average American repudiates Russian totalitarianism and looks distrustfully upon the socialist experiments in Europe; yet in a world becoming ever smaller the emergence into concrete action of hostile myths constitutes a troubling challenge to his own “American dream.”
The fact is that, much as he clings to his way of life, the average American is no longer in a position to take its fundamentals as much for granted as he used to. Individual freedom has become a matter of controversy rather than a live experience; and such ultimate issues as free enterprise vs. planned economy become slogans precisely because the issues involved can no longer be decided with certainty. Values that once formed implicit parts of our myth and therefore did not need to be mentioned are now being dragged into the arena of discussion.
The end of our way seems lost in a mist. To be sure, we improvise day-to-day decisions, but underneath there is always a gripping uncertainty about the system of values in which they may be rooted. Emotional insecurity grows as we are deprived of the psychological shelter that supreme, unquestioned values afford us. Most of us cannot stand being mentally shelterless, and we instinctively avoid any direct approach to social and political problems for fear lest our doubts about our traditional values be resolved into a negative certainty. Instead, we use the one escape route left: we retreat from society to the individual. The Stoics under the Roman Empire did more or less the same; and indeed all the great turning-points of history have witnessed similar phenomena.
The evasive attitude is well illustrated by the hero of Arthur Koestler’s novel, Arrival and Departure. A wartime refugee from a Nazi concentration camp, this young revolutionary has come to realize that he was wrong in siding with the Communists. He recants his faith in Russia without, however, coming to believe in the blessings of Western democracy. His beliefs are shaken, his mind is blank. Profoundly upset, he contracts an ailment—a lame leg. He consults a woman psychoanalyst, and she helps him identify his one-time Communist fervor as the aftermath of sinister childhood experiences. The whole process is a flight from the social to the private sphere.
This is a model case. Many people in a state of mental helplessness caused by external factors suffer intensely under their insecurity and more often than not develop neurotic symptoms like those of Koestler’s hero. But in the final analysis they prefer continued neurotic suffering to the necessity of confronting their fundamental doubts. Some emotional disturbances become useful simply because they enable us to escape the sharper, but in the end more efficacious, emotional disturbance that would result from modifying our values and beliefs to fit new situations. The very same evasion that prefers to call on psychiatry to remedy its aftereffects rather than face the facts, is to some extent responsible for the real difficulties that prompt the evasion. Cause and effect pursue each other in an endless circle.
It should be added that Koestler’s story continues on a note that reveals an even more dangerous tendency. Having won sufficient insight into himself, the hero is relieved of his ailment. But his cure only encourages him to explain all socially accepted beliefs as projections of psychological processes. His decision to fight for England, though made to appear an act of personal decency, is a transparent device. He eludes his torturing uncertainty about values by draining the values themselves of their objective significance: values are made to seem nothing more than temporary psychological solutions. Psychological argumentation thus supersedes the concern with content—a rather popular tendency at present, but one that strips life of its meaning.
The other impulse behind the current vogue of psychiatry is, as I have intimated at the beginning, our need for, and our present lack of, behavior patterns. This need, though by no means of recent origin, has of late become particularly urgent. Growing out of the situation of a young civilization, it has been strongly determined by three factors: the primitive habits of colonial life, the sloughing off by millions of immigrants to America of their “fettering” Old World traditions, and the circumstance that the major developments of this civilization happen to have coincided with the rise of industrialism.
All three factors have left their imprint on American life. Any society provides its members with a network of rules, codes, mores, and patterns enabling them to discharge their latent instinctive energies and faculties in various commonly understandable ways. But our society is historically conditioned to neglect the emotional for the rational, to cultivate utilitarian ends more intensely than emotional aspirations. This does not mean, of course, that we are less gifted emotionally than other peoples; on the contrary, if there is such a thing as a national character, then Americans should be credited with strong and generous impulses and an uninhibited readiness to translate ideals into actions. But it does mean that our civilization or culture has developed no system of communication lines that offers really satisfactory outlets to any large part of our potentialities.
The wide dependence in this country on the radio strikingly reveals the extent to which we depend on substitutes for self-expression. Even in small private gatherings the habit of listening to the inextricable blend of opera singers, news commentators, and commercials gets the better of conversation for its own sake—that free flow of improvised thoughts and suddenly emerging sympathies which involves all its participants to the full, uncovering their boldest dreams and remotest intellectual ties. We have come to prefer any intrusion of the outer world to the intimacy of such exchange, which seems to us a dangerous self-exposure rather than a welcome means of communication. The bar-and-grill, that last refuge of people who like to be together for no purpose at all, not even for fun-making, is being increasingly invaded by juke-boxes and television screens, which further thwart the possibility of really being together.
It is as if we were frightened by the prospect of emotional adventures. Everything becomes shapeless in this menacing terra incognita of our personal emotions. The ceremonial of courtship still confines itself to unguarded moments in the dark—alcohol still serves to fill in the gaps; and the Sam Dodsworths with their unsatisfied longings still visit Europe in search of more substantial fulfillment. But does not Hollywood offer guidance? All that it offers is empty glamor and infantile fantasy instead of mature experience, a dazzling make-up to make up for ugliness aglow from within.
For lack of proper outlets, deep-seated desires whose satisfaction is an end in itself flare up and fade away without leaving a trace. In contrast, the slightest effort that serves business interests has at its disposal a rich variety of channels in which to fulfill itself and gain recognition. The elaborate code governing our conduct within the commercial sphere contrasts strangely with the small set of standardized directives that try in vain to cover the vast neglected areas of our emotional life. These areas resemble those blank spots on the map that represent territories not yet explored.
At the same time our industrialist society, while explicitly disavowing the seemingly purposeless, tends to exploit it for purposes of its own. Commercial considerations encroach on human pleasures and ends, perverting them into means to economic ends. And as technological reasoning and the acquisitive instinct attempt to reduce our civilization to pure calculation and exclude any kind of activity that has only its own pleasure as end, the private jungle of stillborn passions, aimless drives, and unnamed conflicts within us expands; the result is that we find it very difficult to commune with each other, since all the personal elements that go to make up real communication are kept hidden away in many different such private jungles.
For a civilization that grew up in an age of revolutionary inventions and industrial conquests, it was quite natural to seize upon psychology for the sake of its practical implications.
A twofold use has been made of psychology. First, it has served, and continues to serve, as a technique or pseudo-technique of economic and social advancement: the search for opportunities breeds “how-to-achieve-success” literature. Thus personnel selection by business organizations has come to rely on psychological testing; and at the same time intensified competition leads concerns to resort to psychological techniques to squeeze the last ounce of work out of their employees. Human-relations research in factories now applies itself to streamlining workers’ mentality in the interest of higher efficiency. And since private sorrows may prevent some employee or other from giving his full, many an organization has hired psychologists whose function it is to lift production or step up sales by mending broken hearts. The relation between means and ends could not be reversed more drastically: happiness has now become a means to efficiency.
Secondly, psychology has been called upon in this country to facilitate self-expression and self-communication. It is noteworthy in this connection that psychoanalysis was adopted in America at an early date, and more readily than anywhere else. We seem to have been predisposed to it; in fact, for decades we have as a matter of course conceived of personal relations in terms of personality problems. This tendency pervades popular magazines and daily life. Schoolboys speak of their “inferiority complexes,” lovers discuss their “frustrations,” and mothers assume the attitudes of social workers. It is with the ease of an old habit that we dress personal urges in the terminology of psychological science.
That the urges for self-expression are often mixed with desires for wealth and power—“how to win friends and influence people”—should not prejudice one against their genuineness. People really wish and need to make friends, to shape and make manifest what they feel they have within themselves. But left in the lurch by our culture, they do not know how to formulate and express their personalities in spontaneous and accepted ways. And so, because of a shortage of socially recognized patterns for emotional exchange, they assign to psychology the task of defining their inner wants and engineering sufficient outlets.
It was only because the crises of the prewar years did not basically affect the central nervous system of American civilization that our interest in psychology as a vehicle of self-expression remained rather subdued. However, now that we are undergoing a crisis which threatens our most cherished ideals themselves—a crisis underscored rather than contradicted by the increasingly insistent appeals made to our way of life—this interest has developed from an undercurrent into a declared and almost spectacular preoccupation. The wavering of our fundamental beliefs has still further reduced the possibility, already weak enough, of real personal communication. What few communication routes do exist for the transfer of emotional currency rest on values and common assumptions that are now imperiled by an awareness that values once held absolute might be controversial after all.
How can one express one’s self when confusion as to ultimate values is added to the lack of the finer rules of conduct? Because of such difficulties many people remain, unaware, in a state of complete bewilderment. At least this is what might be inferred from the emergence of certain characters in recent Hollywood films that were rarely encountered before on the screen. I am thinking of the former flight officer in The Best Years of Our Lives, of the murder-suspect veteran in Crossfire, and of Henry Fonda’s Joe in The Long Night. All these ex-soldiers drift about in a visionless daze, at the mercy of every wind, benumbed even in their love-making. Perhaps they act this way under the shock of readjustment. On the other hand, if society itself were more articulate, the shock could hardly paralyze them so deeply.
The contrasts between American and French culture support these observations. France not only lost the war and endured German occupation; she now suffers from a prolonged crisis of her myth—a crisis so poignant that it divides the country into two opposite camps, with the prospect of civil war between them. Yet to all appearances this disintegration of values and beliefs has not yet succeeded in corroding the manifold traditions that control French life. There is, as no foreigner fails to notice, something Chinese about the abundance and rigidity of set conventions in France. They range from elaborate formulas for the complimentary closing in letters to suggestions for delicate love situations; from customs rhythmicizing the average existence to established literary models that qualify vague desires, anonymous moods. Many of these behavior patterns had originally practical functions, economic or otherwise; but with the passing of time they have outgrown these and, with a patina, now serve as means of emotional communication. Taken together, they form a dense texture that tends to perpetuate itself for its own sake, whether sustained by a basic national myth or not.
This texture has an objective character, strikingly illustrated, I submit, by a French colloquialism. Where we would say “I” or we,” the French more often than not use the impersonal “on”—“on s’arrange, on va se promener,” etc.—as if to indicate that private life evolves within a universal framework, a sphere of conventions to which all human beings are expected to conform. It is this participation in something objective that, despite their possession of a literature saturated with impressionistic psychological insight, immunizes the French against the encroachments upon personal life of applied psychology. They need not psychologize. Though aged and perhaps frayed, the texture of habits by which they live still protects them from sinking into the unfathomable abyss of ultra-personal subjectivity, from losing themselves in a maze of psychological relations unchecked by fixed meanings and images.
Even in this period of conflicting allegiances and intellectual despair, psychoanalysis is far from being a fashion in France (or, for that matter, anywhere else in Europe). The Existentialists, originally the vanguard of despair, now have turned activists; in an effort to compensate for the waning of the French myth, they insist that social and political decisions be made by the whole, integrated personality. Meanwhile French interest in psychology still confines itself to investigation for its own sake, as, for instance, in the poet Francois Ponge’s literary attempts to X-ray the personality structure of inanimate objects and plants. In contrast to this country, France makes no real demand upon psychology as a means of expediting emotional traffic or compensating for the absence of common beliefs.
Thus the vogue of psychiatry, as I have tried to show, not only originates in extreme uncertainty, but owes much to the fact that American civilization has not yet developed the compact texture of behavior patterns woven by older cultures. If such a texture existed in this country, many would not dream of so readily identifying their personal difficulties as emotional tangles to be untied with the aid of a psychoanalyst.
This is not said by any means to belittle the merits of psychoanalytical therapy. I wish only to describe a situation in which this therapy becomes a necessity because of a scarcity of meaningful alternatives. Wide areas of our world remain a vacuum. In that vacuum psychological mechanisms inevitably turn into independent entities and inner conflicts assume an existence of their own. Psychotherapy is a technique that deals with these mechanisms and conflicts by trying to regulate them, by straightening out maladjustments and removing inhibitions. The goal is to enable the patient to cope with reality and make the best use of his energies. Modern analysts logically define their task as emotional re-education.
However, even the most successful reeducation of this kind has its natural limits. It cannot alter the condition of our society, nor can it establish content and significance by itself alone. Indispensable as psychotherapy is, its cures do not fill the social void in which they evolve.
This is not generally recognized. On the contrary, there is a persistent tendency to exaggerate the functions of psychiatric practice. We expect its individual solutions to result in social solutions, and thus we burden it with responsibilities beyond its scope. The inherent danger of such an outlook, which is shared even by some misguided analysts, is that it sinks us ever deeper in sheer subjectivity.
And yet our fascination with psychiatry springs from a disquiet that in itself has elements of great hope. People seem to be increasingly aware of the vacuum around them. It is as if they could no longer bear the muddle of unchannelized, unqualified emotions, as if they finally wanted to move out of limbo into a realm in which impulses have a destination and sanctioned images articulate the infinity—evil only when unnamed—of inner processes. Behind the vogue—of psychiatry lies a nostalgia for making the deeper layers of the human being really communicable—those layers that till now have been shut off from circulation and light. The will to take these hidden things in ourselves into the open air would indicate that our civilization is beginning to come of age. Should it mature through suffering and experience, its growing wealth of forms, patterns, and imagery would halt our preoccupation with psychology and automatically consume the excesses of our present dependence on it.
1 Is the current ratio of neuroses higher than in the past? This question is difficult to answer, for what we have meanwhile learned to define as a neurosis may, prior to Charcot and Freud, have been diagnosed as a case of witchcraft, traced to organic diseases, or considered a moral deficiency.
2 Baruch: The Glass House of Prejudice (New York, William Morrow, 1946). At one point she says: “The ideal thing, obviously, would be if hostility could be recognized right in the family where it usually generates. If children could grow up learning to face themselves in their moments of anger, and bring the anger out directly, they would not have to repress it so that it would move out of their conscious minds, and, in consequence, out of control.”