Freud's Free Clinics

1924
Psychoanalysis had become so popular in Vienna that the Rathaus politicians
turned over a city-owned building site at the lower end of the Berggasse,
the street on which Freud lived, to house further psychoanalytic endeavors.
The new building at Number 7, near both the medical school and urban
transportation, would bring together the society, the Ambulatorium, and the
Training Institute under one roof. But the building came without accompanying
construction funds, and the plans for a centralized psychoanalytic establishment
were set aside at least until 1936. In the meantime the thorny issue
of lay analysis recurred again and again. Julius Wagner-Jauregg had
reconvened the conservative Society of Physicians to examine the credentials
of Theodor Reik, then practicing on the strength of his academic scholarship
and psychoanalytic training with Freud. The challenge would draw Freud
into the political fray the next year and prompted him to write The Question
of Lay Analysis in 1927. But, more generally, as the programs of Red Vienna
prospered over the next eight years, then leveling off, the psychoanalysts carried
on the multiple clinical and educational functions of the Ambulatorium
with surprising equanimity concerning the political situation.
Wilhelm Reich, now assistant director of the Ambulatorium, found his
work with clinic patients to be mutually rewarding. The clinic allowed Reich
to further his social interests by treating the emotional problems of poor and
disenfranchised groups like laborers, farmers, students, and others with
wages too low to afford private treatment. As an analyst he brought to the
Ambulatorium a character well-versed in politics. “Material poverty and lack
of opportunities,” he believed, exacerbated the emotional suffering and neurotic
symptoms of poor people. 7 Because sexual disturbances, the rearing of
children, and family problems were inseparable from the larger context of social
and economic oppression, Reich would eventually broaden the scope of
psychoanalysis and add free sex counseling clinics to the outreach efforts already
underway. 8 While at the Ambulatorium, though, Reich deliberately
sought to treat difficult patients who had been diagnosed as “psychopaths,”
but were regarded as morally bad rather than “sick.” Frequently antisocial,
they showed tendencies to be destructive (of self and other) in the form of
criminality, addictions, rageful outbursts, or suicide attempts. Psychoanalysis,
Reich believed, would free them of rage and allow a more socially productive
motivation, or energy, to emerge naturally.
Only twenty-two years old and barely graduated from medical school, the
impassioned Wilhelm Reich assumed the position of first assistant chief to
Eduard Hitschmann at the Ambulatorium in 1924. Over the next six years the
two men, in many ways opposite in character, would work together as co-
137