A History of Psychoanalysis in America, by Clarence P. Oberndorf
A History of Psychoanalysis in America.
by Clarence P. Oberndorf.
Grune and Stratton. 280 pp. $5.
Contemporary psychoanalytic prose is a wasteland in which the parched reader falls on quotations from Freud as he would on ice-cold Coca-Cola in the middle of the Sahara. Hundreds of books on psychoanalysis repeat each other endlessly, but seldom offer any new ideas. On the surface, A History of Psychoanalysis in America is just another seminarish retelling of the same old story. But it would be a mistake to stop reading, because Dr. Oberndorf never hesitates to call a spade a spade. An “orthodox” Freudian who has little use for orthodoxy because he thinks people are more important than theories, Dr. Oberndorf is looked upon as something of a gadfly by his more metaphysically oriented colleagues. His book is the soul-searching of a man examining his way of life. Psychoanalysis has been his way of life and no one in America can examine it with more authority—if Robert A. Taft was Mr. Republican, Dr. Clarence P. Oberndorf is Mr. Psychoanalysis.
One of the first disciples of Freudianism in this country, Dr. Oberndorf learned psychoanalytic technique by rule of thumb before the days of institutes, formal courses, and compulsory training analyses. He was first attracted to psychoanalysis because it offered new hope for the cure of mental disease, and he did not question this fundamental purpose. In 1914, hoping to learn more about the technique of treatment, he had a few unsuccessful “didactic” sessions with Dr. Paul Federn, one of Freud’s associates. “I slumped on an uncomfortable sofa while Federn sat beside me. During our hour he would drone two or three times . . . ‘I’d say you do have a bit of neurosis.’ It seemed to console and reassure him that the analytic sessions were justified. Up to that time I had not encountered this question of making a jusification for analysis, for all the patients who came to me were suffering from urgent and distressing symptoms” (my italics). He did not, however, seriously question the superiority of psychoanalysis over other methods of psychiatric treatment.
Though loath to give up the idea of a personal analysis, he was still “reluctant to disclose his conscious and unconscious motivations to one of his friends and competitors. ‘There is something in the misfortunes of our friends which does not displease us. . . .’” His friends and competitors apparently felt the same way—it was the custom to go to Europe for didactic analysis or to wait for visiting European analysts.
Dr. Oberndorf soon tried analysis again in Zurich, this time with Dr. Alphons Moeder, who “did not seem concerned about the question of neurosis, but concentrated his psychoanalytic endeavor almost exclusively upon dream interpretation, in which he had a reputation for great skill.” The sessions ended abruptly when Dr. Oberndorf returned home because of World War I. These disappointing experiences led to his first doubts about the potentialities of the psychoanalytic method—doubts that had to be resolved. “In . . . twelve years of practice there had been numerous instances in which both the patient and I were content with the results obtained. Very probably I could have continued, as Brill and others did, without submitting to an analysis.” Although he was strongly advised against interrupting his flourishing practice, he made the pilgrimage to Vienna in 1921, to be analyzed by Freud. The experience seems to have jolted him—not because anything happened but because nothing happened.
Dr. Oberndorf went to Vienna full of youthful enthusiasm, hoping to improve himself in the arts of healing. He met a tired, sick, disillusioned old man envied by his war-impoverished colleagues more for his rich American students than for his worldwide fame. In describing his analysis with Freud, it is obvious—in spite of the usual pious utterances about the master—that he didn’t like Freud and Freud was unimpressed, if not bored, with him. “. . . the Professor remained consistently impersonal in his attitude, and this, I think, may have militated against the development of a feeling of warmth for him.” Freud on Oberndorf: “What shall I do with you—you have no neurosis.” (Imagine a modern analyst saying this to a patient! When Oberndorf repeated Freud’s remark to Dr. Federn years later, Federn exclaimed: “Just think, in those days we knew nothing of character analysis.” Nowadays it is not necessary to “justify” an analysis in terms of incapacitating symptoms. You don’t have to be incapacitated to be “maladjusted.” I have yet to hear of anyone being told he doesn’t need analysis. If you have the money it is felt you can always profit by a little psychotherapy.)
Dr. Oberndorf remained in analysis with Freud for 100 hours and seems to have experienced the classical post-analytic personal disappointment with the procedure. This aftereffect was described many times in the professional psychological journals of the 1920’s. Because most of these accounts were by “academic” psychologists who had submitted to treatment out of intellectual curiosity, they were—and are—largely discounted, although they remain the best methodological criticisms of the psychoanalytic technique yet written. (It is difficult to describe the post-analytic feeling. You expect something from an analysis; you’re not exactly sure what it is you do expect. You were damned unhappy when you started; you’re still unhappy now that it’s over. Most of those annoying or obnoxious personal habits persist. Depending on the kind of person you are, you’ll get sore at the analyst, or at the whole business, or at yourself, or just keep on changing analysts. But when it’s over you’re still the same old you. Anyone who has ever been psychoanalyzed will know what I’m talking about.)
Before he went to Vienna Dr. Oberndorf attributed his therapeutic failures to his own professional shortcomings, not to the limitations of the psychoanalytic method itself. If only he knew more, if only his skills were greater, he could help his patients more. In Vienna he was soon disabused of this notion. “The Viennese masters had not been able to avoid unsatisfactory outcomes any more than the relative novices in New York . . . it proved disquieting to my fond hope that psychoanalysis would invariably and unquestionably benefit appropriate cases.” Freud said goodbye to him with the words: “We harbor no hard feelings.”
Freud of course had already given up the curative aspects of psychoanalysis and was only interested in it as a theory of human behavior. Dr. Oberndorf still hasn’t quit on it. But his Viennese experience led him to question the practical therapeutic value of the rules of the classical procedure that are still regarded as sacred by many psychoanalysts—largely because they are a matter of custom. Freud insisted that a properly conducted analysis necessitated six hourly sessions a week. (The classical procedure in America now calls for five sessions a week—Americans are accustomed to the five-day work week.) Dr. Oberndorf believes that the treatment can be effective with fewer sessions a week. The non-orthodox schools have long since given up the five-times-a-week rule. There is at present no evidence to support the contention that five times a week is five times as effective as once a week, or that two years of analysis is twice as efficacious as one.
Dr. Oberndorf is still unconvinced that the famous “couch” is always advisable; he thinks that individual circumstances should determine whether the patient lies down or sits up. On this point, too, as indeed on all aspects of the procedure, there is no evidence pro or con. It is plain, however, that Dr. Oberndorf believes the rules ought to be flexible.
In discussing the question of whether or not psychoanalysts should be doctors, Dr. Oberndorf sides with the orthodox Freudians who frown on lay analysis. (Their failure to accredit Theodor Reik, one of Freud’s most famous lay associates, is still a source of embarrassment.)
On the point of lay analysis the orthodox Freudians alone are unorthodox. Freud himself was passionate in his conviction that psychoanalysts need not be doctors to be effective either as practitioners or as theoreticians, and was bitter about the stubbornness of the Americans on this question. The Europeans had to give way on the issue of analysis by non-doctors. The Americans were already the most solidly entrenched and highly organized of the psychoanalytic groups. Although they refused to recognize European lay analysts, the Americans did certify some European doctors who did not meet their own psychiatric training requirements. Many feel that the opposition of the American Freudians to lay analysis was as much due to economic self-interest as it was to a concern for professional standards. (Let me make clear that I believe all psychologists should be licensed. At present any crackpot who feels like it—and many do—can set himself up as a psychotherapist.)
Dr. Oberndorf has been a leading spirit in recent efforts to evaluate the practical results of psychoanalytic treatment. In a particularly revealing passage he conjectures that his early therapeutic successes may have been due more to his own enthusiasm than to the psychoanalytic method itself. Later he quotes a past president of the New York Psychoanalytic Society: “I wish that I might again have the good results with patients which I attained when I did not know so much psychoanalysis.” Dr. Oberndorf adds: “Perhaps any procedure, if it becomes too codified, leads to classification, receipts, and formulas which in turn tend to produce stagnation and routine.”
Nowadays it is as hard to think one’s way out of psychoanalytic categories as it was for medieval man to think his way into atheism—the climate of psychoanalysis is overpowering. Perhaps for this reason Dr. Oberndorf’s book has the effect of a gust of fresh air sweeping through a stuffy room. He obviously intended to reach a professional audience and this fact may partly explain his unusual candor. But Dr. Oberndorf is noted for his candor. While he still believes in the superiority of psychoanalysis over other methods of psychiatric treatment, he is bluntly critical of its present accomplishments—accomplishments which fall far short of original expectations.
If an institution can be said to have a conscience, then Dr. Oberndorf is the conscience of American psychoanalysis.