Free Shrinks by Jeffrey A. Lieberman

feelings that Jung professed. And of course, in Freud’s eyes, sexual conflict was the sina qua non of psychoanalysis.
    Freud became increasingly concerned that Jung’s endorsement of unscientific ideas would harm the movement (ironic, as there were no plans to develop scientific support for Freud’s ideas either). Finally, in November of 1912, Jung and Freud met for the last time at a gathering of Freud’s inner circle in Munich. Over lunch, the group was discussing a recent psychoanalytic paper about the ancient Egyptian pharaoh Amenhotep. Jung commented that too much had been made of the fact that Amenhotep had ordered his father’s name erased from all inscriptions. Freud took this personally, denouncing Jung for leaving Freud’s name off his recent publications, working himself into such a frenzy that he fell to the floor in a dead faint. Not long after, the two colleagues parted ways for good, Jung abandoning psychoanalytic theory entirely for his own form of psychiatry, which he called, with an obvious debt to Freud, “analytical psychology.”
    Despite the tensions within the fracturing psychoanalytic movement, by 1910 psychoanalysis had become the traitement du jour in continental Europe and established itself as one of the most popular forms of therapy among the upper and middle classes, especially among affluent Jews. Psychoanalytic theory also became highly influential in the arts, shaping the work of novelists, painters, and playwrights. But although by 1920 every educated European had heard of Freud, psychoanalysis never wholly dominated European psychiatry. Even at its high-water mark in Europe, psychoanalysis competed with several other approaches to mental illness, including Gestalt theory, phenomenological psychiatry, and social psychiatry, while in the United States, psychoanalysis failed to gain any traction at all.

    Sigmund Freud’s inner circle of the Psychoanalytic Society. From left to right are Otto Rank, Freud, Karl Abraham, Max Eitingon, Sándor Ferenczi, Ernest Jones, Hanns Sachs. (HIP/Art Resource, NY)
    Then, in the late 1930s, a sudden twist of history obliterated psychoanalysis from the face of continental Europe. After the rise of the Nazis, Freud and his theory would never regain their standing on the Continent they had enjoyed in the early decades of the twentieth century. At the same time, the chain of events initiated by German fascism roused psychoanalysis from its American slumber and invigorated a new Freudian force in North America that would systematically take over every institution of American psychiatry—and soon beget the shrink.
    A Plague upon America
    While nineteenth-century European psychiatry oscillated like a metronome between psychodynamic and biological theories, before the arrival of Freud there was precious little that could be mistaken for progress in American psychiatry. American medicine had benefited, by varying degrees, from advances in surgery, vaccines, antiseptic principles, nursing, and germ theory coming from European medical schools, but the medicine of mental health remained in hibernation.
    The origins of American psychiatry are traditionally traced to Benjamin Rush, one of the signers of the Declaration of Independence. He is considered a Founding Father of the United States, and through the sepia mists of time he has acquired another paternal appellation: Father of American Psychiatry. Rush was considered the “New World” Pinel for advocating that mental illness and addictions were medical illnesses, not moral failings, and for unshackling the inmates of the Pennsylvania Hospital in 1780.
    However, while Rush did publish the first textbook on mental illness in the United States, the 1812 tome Medical Inquiries and Observations upon the Diseases of the Mind , he did not encourage or pursue experimentation and evidence-gathering to support his thesis and organized his descriptions of mental illness around theories he found personally compelling.