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PARTISAN REVIEW
Wi lliam Ph illips:
T hank you . T here are three more. Pl ease announce
you rselves.
Chris Beals:
I had to do with training of p sychia tric residents formerly
a t Einstein and now a t Columbia, and it's about what's going on in
psychiatry and its rela tionship to p sychoanalysis tha t I want to talk
and, particul arl y, to disagree with Dr. Arlow in some of the things
tha t he finds going on in p sychia try.
Fi rs t of all , although those storefront cl ini cs tha t you feel have
almos t di sappeared have been funded on a lower level, they' re still
th riving. One of the things they' re necessary for is the trea tment of
ch ronic and acute p sychos is in the community, and tha t is some–
thing whi ch psychi a trists, parti cu larl y p sychi a trists in training, are
very much concerned with, and it doesn 't seem to have much to do
with psychoanalysis. T his is the kind of split tha t I think we need to
look at.
T he second thing I want to say is tha t residents coming in to
res idencies now are en ormously excited about wha t they are learn–
ing; thi s is a fantasti c time to be going into psychi a try. But the
excitement is in the social scien ces and biology. The curriculums are
exploding and the excitement is enormous.
It
certainl y is true, as you suggested, tha t the nonmedical
analys ts of all kinds are essenti all y findin g their clientele, both
because of econ omi cs and because of the o ther la rge social shifts and
changes in institution s tha t were mentioned earlier. But the ques ti on
is wha t is h appening to the p sychi a trists. I would like to suggest that
since the passing of the Mental H ealth Act in 1964, which made it
p rofitable to do so, they are graduall y and a t long last turning their
a ttenti on to the problems which had been cry ing out for their
a ttention : the schi zophreni as, the affective psychoses, and other
conditi ons on the borderline of p sychia try and medicine. T hese are
the conditi ons for whi ch you need a doctor who can make a
d iagnosis, prescribe med ication , order a social p rogram, possibl y
including involuntary h ospita li za tion . And the problem is, who are
the psychi atri sts who have been recruited to this crucial responsibil–
ity in our society? Well, if you look a t those over forty, they are
mos tl y a group of p eopl e who saw in p sychoan alysis a chance
to
make an excell ent li ving at a sedentary and refl ective profession with
long academic vacation s and time off for writing a few papers about
matters literary and philosophic. The delivery o f services to very sick
people was not wha t they had in mind, and, worse yet, it appears that
psychoanalysis as theory or as therap y is less and less appli cable
to
those problems.
