Freud's Free Clinics

1922
And, yes, Freud too treated patients for free. Freud analyzed Marianne Kris,
for example, at no cost intermittently from 1931 to 1938. “[Freud] treated me
for free,” Kris later informed the New York psychoanalyst Robert Grayson. 19
In the course of her analysis she questioned whether this gesture was more
than professional courtesy, although she had barely the money herself. When
Freud refused to let her pay for her analysis, she remembered that her father,
Oscar Rie, was not paid for his services as the Freud’s family pediatrician. But
“it was very generous because it’s very different,” she explained. “When a pediatrician
pay[s] a visit, he doesn’t lose another visit he could make; while if
one has somebody in analysis for that hour, you can’t take anybody else.”
Freud frequently interrupted Kris’s treatment because of illness or because he
determined to use her hour for another patient or as a clinical experiment in
fractionary analysis. Like Eva Rosenfeld in her own free analysis with Freud,
Kris admitted that at times she felt “a little envious . . . [though] grateful
enough. ... That I didn’t pay and that I had to interrupt . . . [did not] hinder
the analysis although it might have made it somewhat more difficult—But I
could express my feeling[s].” Freud’s career is strewn with stories of free
analyses: Marianne Kris, Eva Rosenfeld, the Wolfman, and Bruno Goetz are
just a few.
Unlike Wagner-Jauregg’s state-run psychiatric clinic or the municipal
consultation centers, the Ambulatorium was privately operated by the Vienna
Psychoanalytic Society in rented hospital quarters. Space and treatment
rooms were limited even when analysts treated some clinic patients in their
home-based offices. Their shared medical consulting rooms now had to meet
a dual set of needs, the psychoanalysts’ need for privacy and the Herzstation
cardiologists’ need for tranquil space. Grim conditions aside, the analysts relished
the chance to demonstrate that the success of psychoanalysis did not
depend on environment. These were stark surgical offices where the couch
was a metal examination table and the analytic patients had to climb up a
movable step ladder to reach the table top, then lie down on the thin springless
mattress. Patients alone did not have to sustain the austere makeshift
arrangements: their analyst sat angled behind the table on a simple bentwood
chair without armrests. “After five sessions [we] felt the effects of so long a
contact with the hard surface,” Sterba recalled. 20
Late one evening Grete Bibring was the last staff analyst about to leave the
clinic when her colleague from the neurology department, the hospital’s resident
expert in epilepsy, sauntered into the Ambulatorium with a handsome
nineteen-year-old law student. The young man’s seizures were so severe, the
neurologist said, that his ability to study was limited and, even worse, he felt
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