PSYCHOANALYSIS TODAY
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profession of psychoanalysis into a subdiscipline of medicine-or at
least made matters appear that way. The consequences of this self–
imposed prerequisite for certification were substantial. To my
knowledge, in no modern Western culture does the profession of
medicine enjoy a higher social esteem, reap larger economic rewards,
or find itself invested with a greater diversity and weight of authority
than that profession does in the United States. Primitive fantasies of
magical powers, priestly privileges and esoteric knowledge continue
to cloak our physicians even as those same physicians operate
increasingly as technologists, engineers, and applied chemists. There
are many reasons for the essential persistence of such beliefs among
Americans (although the quality of that persistence, and its periodic,
partial alternation from positive
to
negative, should also be noted),
and I cannot pause to discuss them in detail. Figuring largely among
them, however, was and probably still is the poignant and appar–
ently incorrigible American sentiment that there is nothing finally
that cannot be "fixed up" -including, it sometimes seems, life and
death themselves. And certainly including one's psychic, sexual and
personal life, one's career, one's difficulties with work, with mother,
husband, wife, children, lover, friends, enemies, acquaintances, and
pets, the pets of one's children, lover, friends, enemies, acquain–
tances, and so on. Many Americans were inclined to invest psycho–
analytic therapy (and other therapies as well) with the power to
fulfill such culturally supported aspirations, and although there is
little doubt that in the course of therapy such fantasies came in, as
they say, for due exploration and analysis, there is also little doubt
that the profession as a whole was the direct beneficiary of this
apparently ineradicable native impulse. And I must go on to say that
I cannot recall, during the years in question, coming across many
references in the professional literature to Freud's repeated admoni–
tions that the major contributions that psychoanalysis had to offer
would not finally be therapeutic in the accepted sense of the word.
Such contributions, he held, would be found ultimately in educa–
tion, in alterations of habits of child-rearing, in research and in
applications of psychoanalytic theory and methods in a variety of
cultural and scientific fields of endeavor.
An additional consequence of the official attachment of ortho–
dox psychoanalysis -to medicine was that it significantly limited the
pool of talent from which the profession could renew and reproduce
itself. Not only was this pool preselected in a particular manner; the
premedical and then medical educations that psychoanalytic candi-
