PSYCHOANALYSIS TODAY
503
cally or nonmedically-are not exactly languishing. In fact, the
psychoanalytic profession seems evermore resolutely organized and
prepared to fight for its share of the psychotherapeutic dollar, indeed
has even mounted lobbying efforts in cognizance of the fact that the
state and third-party payers in general are playing an increasingly
important role in its economic future. One has even noted a short–
term resurgence of interest in psychoanalysis-both for its ideas and
as a mode of treatment. Nonetheless, the sagging fortune of psycho–
analysis is a reality-which leads us to the interesting question of
whether the creative atrophy of psychoanalysis and its economic
beleaguerment are in some way related to each other. Are the two
functional elements in some deeper historical contradiction which
possesses the psychoanalytic project as a whole?
I believe this to be the case; and since I am inclined to view such
things as a Marxist, I will begin exploring the contradiction as it
manifests itself economically. There are three ways in which psycho–
analysts might encounter a relatively decreasing demand for their
services. First there is the possibility that forms of neurosis only
marginally conducive to psychoanalysis are becoming pre–
ponderant-one thinks here of the increasing notice being given to
diffuse narcissistic disturbances as against the classical symptom
neurosis for which the technique was first developed. Then there are
those prospective patients who may have analyzable disturbances but
simply do not seek psychoanalytic help, either because they do not
define their emotional ills in a psychological way, or, if they do see
themselves as psychologically troubled, think in terms of another
therapeutic modality than psychoanalysis.
And~
finally, there are
those who could and want to be analyzed, but are dissuaded owing
to
lack of money and/ or time.
Now, these conditions point
to
something one but rarely finds
discussed in psychoanalytic writings, namely, that psychoanalysis is
a definite kind of relationship between individuals who have a real
historical function. In other words, the analyst is not someone
trained to handle a narrow technical problem but an agent engaged
in a particular social dialogue mediated by time and money. Simi–
larly, the analysand is not like the hypothetical medical patient who
brings his disease to tpe doctor-analyst, but rather the other agent in
the dialogue. Since dialogue implies a verbal exchange between two
consciousnesses, it is essentially an intersubjective process. Thus, for
psychoanalysis to take place there must be a psychoanalytic
subject-that is, a kind of person who is able
to
relate in a psychoan-
