138

VII

“YOU have explained to me, at great
length, what psychoanalysis is, and
what knowledge is necessary to practise it with
a chance for success. It certainly could not
have hurt me to listen to you.

“However, I do not see how your informa-
tions are expected to influence my personal
view. Neuroses, it would appear, are a certain
form of disturbance, and psychoanalysis a cer-
tain method to treat such cases–a special med-
ical treatment, as it were.

“I understand that it is the rule that any
physician who intends to specialize in the one
phase or the other of his science is not satisfied
with the training he received before winning
his diploma, but rather goes on studying the
intricacies of his special field. This is es-
pecially a necessity, in case he intends to estab-
lish himself in a big city, the only place which
opens a satisfactory field for specialists. Any-
 

139

body who is going to specialize in surgical
work, will practise, for a few years, in the
surgical ward. Corresponding specialized
work will be taken up by the eye or the nose
and throat specialist, and the psychiatrist may
forever remain on the staff of a city or county
institution or a private sanitarium.

“The same method of development may be
expected of the psychoanalyst. Whoever de-
cides to take up this new medical specialty,
after finishing his studies proper, will have to
attend those institutes, for the duration of two
years, which you have mentioned before, pro-
vided it really takes as long as that to gain the
necessary knowledge. He will then also learn
that it would be to his advantage to join a psy-
choanalytical society, in order to remain in
contact with his colleagues.

“I really cannot understand why there is
any necessity for raising this question of lay-
analyses?”

Any physician, proceeding along the lines
you suggested, shall be welcome to us. As a
matter of fact, four-fifths of those whom I con-
sider my disciples, are physicians. However,

140

The Problem of Lay-Analyses

permit me to enlighten you as to relations, as
they actually developed between physicians
and psychoanalysis, and what development
they appear to be taking in the future.

Past developments do not give physicians
any right to claim a monopoly of psychoanaly-
sis. As a matter of fact, physicians, in the past,
have done about everything to damage psy-
choanalysis, beginning with superficial mock-
ery and going even so far as to indulge in seri-
ous defamation. Of course, you may correctly
say that all this belongs to the past, and should
not have any influence on the future. I fully
agree, but I am afraid that the future will not
live up to your expectations.

At this point, permit me to interpret for you
the term of “quack,” not in the way it is legally
employed, but rather in the sense in which it
should be logically applied. As far as the law
is concerned, a “quack” is an individual who
treats sick people, without being in the pos-
session of a diploma. I, however, would rather
qualify the term “quack” in this way: A
“quack” is anybody who undertakes the treat-
 

[141]

ment of a disease, without having the indis-
pensable knowledge and ability.

On the basis of this definition, I venture to
assert that–not only in the European coun-
tries–physicians, as far as psychoanalysis is
concerned, constitute the majority of “quacks.”
Frequently, physicians will employ psycho-
analysis, without having studied it, and with-
out sufficiently understanding it.

Do not tell me that this would display a
lack of conscience, which you would not sus-
pect in any physician. You might be tempted
to say that, after all, a physician ought to
know that a medical diploma does not con-
stitute a “Letter of Marque,” and that a sick
person should not be considered outlawed. As
far as a physician is concerned, it should be
taken for granted that he is proceeding in good
faith, even if he makes a mistake.

However, facts are facts. Let us hope that it
will be possible to explain these facts in a
manner, which you apparently wish. I, for
my part, shall try to explain to you how it is
possible that a physician, in matters of psycho-
 

142

analysis, takes liberties he would carefully
avoid in any other specialized field.

In the first place, it must be taken in con-
sideration that the training the medical stu-
dent received is almost the very opposite of
that which would be required of him, as a
preparation for psychoanalysis. His attention
has simply been focused upon facts which may
be objectively ascertained, such as present
themselves in anatomy, physics, and chemistry,
and which must be understood properly and
applied correctly, to achieve results.

As far as the psychological aspects of life
are concerned, no interest is created in the
medical student. The study of higher mental
achievements is not considered to belong with-
in the field of medicine, but rather into the
realm of another science. Psychiatry alone is
supposed to attend to disturbances of psycho-
logical functions, and it is only too well known
in which way, and with what objective in view
this is done: psychiatry simply tries to discover
the physical reasons for psychological disturb-
ances, treating them in turn like any other ail-
ment.

[143]

The Problem of Lay-Analyses

Psychiatry is correct in that respect, and
medical training apparently excellent. Should
it be maintained that psychiatry is one-sided,
it will be necessary to fix the point of view
from which such a reproach may arise.

Inherently, all science is one-sided, and
must be one-sided, inasmuch as any science is
limited to certain subjects, points of view, and
methods. It is a nonsense which I do not wish
to support that one science may be played
against any other. Physics after all, does not
minimize the value of chemistry; it cannot re-
place the latter nor be substituted for it. And,
surely, psychoanalysis is especially one-sided,
as the science of the psychological Uncon-
scious.

Thus, the right to one-sidedness should not
be denied to medicine.

However, a more practical point of view is
gained if observations are not made as to sci-
entific medicine, but rather as to practical
healing. Sick people, presenting complicated
problems, should impress upon us the fact that
psychological manifestations–be they ever so
hard to comprehend–cannot be simply elim-
 

144

inated from the picture. The neurotic, more
than any other patient, presents an undesir-
able complication. He offers a dilemma, not
less embarrassing to medicine than to law.
However, as long as such cases exist, they are
a responsibility especially of medicine. Never-
theless, medical training, sorry to say, is not
paying sufficient attention to such conditions,
–doing nothing for them. Absolutely nothing
at all!

As there are very close inter-relations be-
tween those things we consider physical and
those which we look upon as psychological, it
may be expected that the day will come when
organic biology and chemistry will finally ap-
proach the understanding of neurotic mani-
festations. This day, to be sure, seems to be in
the distant future. At present, such ailments
are still unapproachable, from a medical
angle.

If medical training would only deny in-
formation to the student in the field of neuro-
sis, this would be tolerable. But medical train-
ing is doing more. It implants into the young
student an incorrect and harmful point of

145

view. Physicians, whose interest for psycho-
logical facts has not been awakened, have
naturally a tendency of making little of such
facts, going even so far as to decry them as un-
scientific. Conditions of neurotic character
are hardly ever taken seriously by them, while
their lack of knowledge serves to breed disre-
spect for psychological research. Thus, neuro-
sis is not accorded sufficient attention.

Of course, these neurotics must be treated
when they consult physicians, and new discov-
eries must be tried out right along. But why
go in for a protracted period of preparation?
It can be done without that! After all, who
knows whether there is really any value to
that which is taught in psychoanalytical in-
stitutes?

Thus, as usual, lack of information results
in a most daring spirit of enterprise. Only true
initiates are modest, because they realize how
insufficient their knowledge is!

From all this, it follows that it is impossible
to draw upon a comparison of psychoanalysis
with other branches of medicine, as you at-
tempted to do

146

The Problem of Lay-Analyses

As far as surgery, and ophthalmology, are
concerned, medical schools and post graduate
courses offer sufficient opportunities for train-
ing. The psychoanalytical institutes are lim-
ited in number, young in years, and lack the
aureola of authority. Medical science has not
recognized them, nor does it give a hoot about
them. On the other hand, the young physician
who has been forced to believe his teachers, to
such a degree, that he hardly ever had a
chance to form his own judgment, will only be
too glad to try his hand at playing the critic,
in a field where there is no established author-
ity as yet.

There are still other circumstances which
favor the mushroom-like increase of young
physicians as psychoanalytical “quacks.”

If a physician would undertake cataract
operations, without sufficient training as an
eye specialist, he would soon enough lose his
patients. Compared to this, the application
of psychoanalysis hardly involves any danger.
The public, generally observing effective cata-
ract operations, expects results from a physi-
cian pretending to be an eye specialist. How-
 

147

ever, if a nerve specialist does not achieve
results, apparently nobody is surprised. We
surely have not been spoiled by the efficacy of
therapeutical treatment of nerve cases, and it
seems to suffice that the physician “tried every-
thing.” Nature must simply assert herself and
time exert its healing propensities.

If the patient happens to be a young girl, it
is first the menstruation which is expected to
work wonders, then marriage, and in later
years, change of life. In the end, death itself
may finally prove the great healer.

Moreover, whatever the medical analyst
employed in the treatment of such a case, is
so inconspicuous, as to offer no cause for re-
proach. After all, he did not resort to instru-
ments, nor did he write prescriptions. He just
talked and talked, trying either to talk some-
thing into the patient, or out of the patient.

How could such treatment do any damage,
especially as extreme care had been taken not
to touch upon painful or exciting matters?

The medical analyst, once he has thrown the
strict instructions overboard that were given to
him, will surely have tried to improve upon

148

The Problem of Lay-Analyses

psychoanalysis by extracting from it certain
features–poisonous fangs, as it were–to
make analysis more acceptable to the patient.
How splendid, if he really went only as far as
that and not so far as to awaken resistances
which he would be unable to cope with. He
would be apt to make himself disliked in such
a case!

Justice demands that it be admitted that an
untrained analyst cannot do as much harm to
a patient, as an untrained surgeon. The pos-
sible injury may amount to unnecessary ex-
penditure of money and time, and chances for
a cure may have either been destroyed, or else
spoilt to a certain degree. In addition to this,
the reputation of psychoanalytical therapy as
a whole would suffer. All this is quite unde-
sirable, but surely not as serious as the damage
that may arise from the knife of a surgical
“quack.” According to my observations, per-
manent aggravation of an ailment is not to be
expected from the incorrect application of
psychoanalysis. Reactions of an undesirable
nature disappear quickly. In comparison to
the traumata inflicted by life itself, which re-
 

[149]

sulted in the disturbances, a little incorrect
treatment does not amount to anything. The
unsuitable therapeutical attempt has simply
not benefited the patient.

“I have listened to your description of the
‘quack’ without interrupting you, and have
gained the impression that your position in
regard to physicians is barbed with hostility.
The reason for this enmity is obvious, from the
many hints you have dropped. At any rate, I
am of the opinion that as long as psychoanaly-
sis is to be employed, it should be only by such
persons as are thoroughly trained for it. But
it seems that you believe that even those phy-
sicians who may take up psychoanalysis, in
the course of time, will not go in for the neces-
sary thorough training?”

Exactly! As long as the relation between the
medical schools and the psychological insti-
tutes prevail as they do today, I do not think
that young physicians will resist the tempta-
tion of making things easy for themselves.

“It appears to me that you constantly avoid
making any direct statement in regard to the
problem of lay-analyses. Apparently, what

[150]

you wish me to surmise now is that it would be
your suggestion to withhold, as a means of re-
venge, as an act of punishment, so to speak,
the monopoly of practising psychoanalysis
from physicians, because such physicians as
employ analysis, are beyond control. You
would, however, permit the application of
such medical activity to laymen.”

I am not so sure that you surmised my mo-
tives correctly. Perhaps, I may later on be in
a position to prove to you that my point of
view is not as partial as all that. But be that
as it may, I strongly emphasize my demand
that nobody should be permitted to practise
psychoanalysis, unless he has obtained this
privilege on the basis of thorough training.
Whether such a person is a qualified physician
or not does not seem important to me.

“What, then, are your practical sugges-
tions?”

I am not as far as that yet. I don’t even know
whether I shall ever get that far. There is
some other question which I wish to take up
with you, and by way of introduction, touch
upon a certain point.

151

The Problem of Lay-Analyses

It is reported that the authorities, on the
strength of suggestions made by medical bod-
ies, may put a sweeping prohibition for the
practise of psychoanalysis by laymen on the
statute books. Such prohibition would natur-
ally also hit the non-medical members of psy-
choanalytical societies–men and women who
have undergone a very thorough training and
improved themselves greatly by practice.
Should such a sweeping prohibition become
an actual fact, the incongruous condition
would then present itself whereby people
really capable of applying psychoanalysis
properly, would be excluded from this prac-
tice, while on the other hand, this privilege
would be extended to individuals insuffi-
ciently informed, and not specially trained for
such work.

Of course, no legislature aims at so absurd
an effect.

But the dilemma that presents itself with
this piece of legislature, is neither important
nor difficult. It would concern only a handful
of people who would not even suffer appre-
ciably. Analogous to measures enacted by

152

monarchical Austria, republican Austria could
also resort to exception laws. Under the
Hapsburg régime, it happened that certain
“quacks” whose ability in the treatment of
certain diseases was convincing, were privi-
leged ad personam to treat sick people. These
were mostly cases of rustic healers, who en-
joyed the recommendation of one of those ex-
alted, once so plentiful, archduchesses. How-
ever, it should be possible to assume that the
benefit of such exception laws should also per-
tain to city inhabitants, who are recommended
by mere experts.

Of course, if the law is put on the statutes
in accordance with the wording of the bill
now pending, the Vienna Psychoanalytical In-
stitute, for example, would no longer be per-
mitted to accept students, unless they belonged
to the medical profession. All these endeavors
to restrict the application of psychoanalysis
hark back, more or less, to obsolete legislature,
dealing with quackery as such. This seems
anachronistic, inasmuch as at the time of the
enactment of these anti-quackery laws, the

153

The Problem of Lay-Analyses

particular nature of neurotic disturbances had
not yet been discovered and psychoanalysis did
not yet exist.

I am now approaching the question which
appears most essential to me: Is the practice
of psychoanalysis of such a nature as to lend
itself to the interference of legislative author-
ities, or would it not be much better to leave
psychoanalysis to its natural development?

Of course, I shall not decide this question,
but I am taking the liberty of submitting it
to you. It appears that in Austria, not unlike
other countries, by the way, there prevails a
real furor prohibendi, a veritable mania for
prohibition and general interference, a trend
which usually, as is only too well known,
makes for unsatisfactory results. According
to my own personal view, a superabundance of
ordinances and prohibitions will only serve to
injure the dignity of the law. It may usually
be observed that wherever there are just a
few laws, these laws are strictly adhered to,
whereas where laws exist in great numbers,
the temptation arises to break them.

[154]

Furthermore, a man cannot be considered
an anarchist, simply because he believes that
legislative statutes–in the view of their very
origin–cannot very well be regarded as some-
thing holy that must never be touched. Legis-
lative measures sometimes are insufficient, or
gradually become that, at the same time out-
raging our innate sense for justice and com-
mon sense. Then the time is on hand, where
there is no other means of correcting such
unbearable conditions than to simply trespass
against such laws. It seems advisable, for the
purpose of maintaining respect for laws and
ordinances, not to enact any which may be
difficult to enforce.

Much of what has been said here about the
application of psychoanalysis by physicians
would have to be repeated with regard to
lay-analyses proper, which the legislatures of
some countries are now prepared to prohibit.
In view of the fact that the application of the
analysis is a very simple procedure, consist-
ing merely of conversation without resorting
to instruments or prescriptions, it would be
rather difficult to prove that a layman actu-
 

155

ally employed psychoanalysis, if he stoutly
maintained that he had merely benefited a
person by administering a good “talking to.”
Such assistance, to a person in need of it,
could not very well be prohibited simply be-
cause a physician may once in a while resort
to the identical thing!
 

In English speaking countries, Christian
Science has gained tremendous popularity. To
my mind, it constitutes a dialectic abnegation
of such evils as life presents, by resorting to
the teaching of Christian religion. I do not
hesitate to state that such measures strike me
as a regrettable fallacy of the human mind.
But who in the United States or England
would ever think of prohibiting Christian
Science or seek to punish its followers?
 

Generally speaking, is governmental au-
thority always so certain to be on the right
side? Assumed even that many, left to their
own devices, would encounter danger and ex-
perience harm, would it not just the same be
much better if governmental authority would
merely indicate dangerous ground, but on
the whole leave it to the individual to be
 

[156]

taught by experience and mutual influence?
Psychoanalysis is so new, the broad masses
so insufficiently informed about it, the offi-
cial view of science still so vacillating, that it
appears to me as premature to impede its
progress by legislative measures.

Why not leave it to the patients themselves
to learn that it is dangerous for them to apply
for psychological assistance to persons who
are not sufficiently informed?

If people are sufficiently enlightened and
warned, prohibition will surely prove super-
fluous.

On Italian highways, poles, carrying high
tension electric power, display this warning:
“Chi tocca, muore!” Which has proven per-
fectly sufficient. In contrast to this, in other
countries, for example Austria and Germany,
this warning is of an insulting verbosity:–
“Inasmuch as touching these high-tension
wires is dangerous to life, it is herewith
strictly prohibited to meddle with them!”
Why this prohibition? Whoever cherishes his
life will not touch them, and whoever wants

[157]

to commit suicide will surely not be detained
by the warning.

“But there are cases which may be quoted
as precedent for the prohibition of lay-analy-
ses. For example, the law against the practice
of hypnosis by laymen, and another enacted
against occult séances and the organization of
spiritualistic societies.”^*

I must admit that it is beyond me to admire
these measures. As far as the last mentioned
prohibition is concerned, it surely constitutes
a case of grave over-officiousness, encroaching
upon intellectual freedom. As far as I am
personally concerned, I do not think that any-
body would suspect me of having faith in oc-
cult phenomena, or of being interested in its
general acceptance. However, such prohibi-
tive measures will never serve to stifle the in-
terest that some people manifest for the al-
leged secrets of an occult world. Such offi-
cious interference may do a lot of damage by
preventing impartial seekers for truth to ar-
rive at a finding which would do away with

^*These laws are on the statutes of the Austrian Republic.

[158]

occult misconceptions. Here also, we observe
the fact that other countries do not interfere
with so-called “parapsychic” research, but
only Austria.

As far as hypnosis is concerned, it is some-
what different from analysis. Hypnosis is
nothing else but induction of an abnormal
condition of the soul, serving the layman
merely as a means of entertainment. Had hyp-
notic therapy fulfilled its early promise, con-
ditions would have evolved similar to those
now prevailing in psychoanalysis.

Aside from this, the history of hypnosis con-
tributes another precedent for the fate of psy-
choanalysis. When I was still a young instruc-
tor of neuropathology, physicians fervently
fought against hypnosis, claiming it to be
nothing but a fake, an infernal delusion, a
most dangerous practice. Today, this same
hypnosis has been monopolized by them. They
are resorting to it as a method of examination.
For some nerve specialists, hypnosis is their
most important stock in trade.

However, I have already told you that I

[159]

The Problem of Lay-Analyses

do not intend to discuss whether restriction by
law or a hands-off policy would be the most
correct procedure, concerning psychoanaly-
sis. I know very well that this is a question
of principle which will be decided by the
inclination of influential people rather than
by strict argumentation. What seems to me to
suggest a policy of laissez faire I have already
mentioned. But if the decision should be one
for active interference, then, to be sure, it
would appear to me as a one-sided and un-
just measure to enact a sweeping prohibition
against the practice of psychoanalysis by lay-
men. Then, it would be up to the legislature
to fix the conditions under which the appli-
cation of psychoanalysis would be permissible
for those who would be privileged to employ
it. It would also be necessary to appoint an
authority who could be appealed to for infor-
mation, who would decide what constitutes
psychoanalysis, what the training would be,
and how to administer it.

Thus, things must either be left alone or
else order must be created and the situation,

[160]

The Problem of Lay-Analyses

in general, clarified. But there is no use in
simply interfering with a complicated situ-
ation, by means of a prohibition, which is
based without much discretion, upon obsolete
acts of an antiquated legislature.