Freud's Free Clinics

1925
patients each week after school and in the early evening. Between forty and
seventy children yearly traveled daily by tram or bus for their analytic treatment,
a one-hour appointment maintained on at least five consecutive days,
for two to three months. This schedule suited both the children’s daily
timetable and the clinic’s arrangement for sharing space with the Herzstation.
But psychoanalysis was not always the treatment of choice for depressed
children and sometimes the clinic’s intake evaluator advised the family to
take a less intensive approach. One day each week was reserved for other
evaluations and consultations. An anxious child who excelled at sports activities
but claimed to hate reading might be helped more by a change of afterschool
milieu than by psychotherapy. Changing schools altogether or enlightening
the teacher might be an option for the phobic or obsessional child.
And teenagers, who often went to the clinic in pairs for advice on sex or work
options, formed a willing audience for evening consultations with Wilhelm
Reich, then deeply involved in questions of adolescent sexuality. Teachers
and parents were vital to the process; the Ambulatorium analysts largely subscribed
to Anna Freud’s belief that society’s repression of childhood sexuality
and “fear of immorality” interfered with the adult’s compassion for the
child. In her barely veiled criticism of Alfred Adler’s desexualized characterbuilding
practitioners for whom “child analysis might [be] some special form
of educational guidance,” Anna Freud outlined how the anxiety of parents
and teachers deprived the child of available help. 17 From there she advanced
some further family-based guidelines for handling disturbed children, not yet
as directive as family therapy but clearly involving parents in the assessment
of their children’s difficulties. In the friendly if chaotic atmosphere of the
Child Guidance Center, Editha Sterba (who had recently taken over the center
from Flora Kraus and the late Hermine Hug-Hellmuth) adopted Anna
Freud’s supportive approach. Anna Freud and Willi Hoffer were by then as
familiar with the needs of Vienna’s poor and working families as they were
with Tandler’s interventions. They had discussed child rearing with parents
at the workers’ education centers, and were known throughout Vienna’s
school and welfare districts. When social workers and district welfare workers
(who had attended these discussions) visited local family homes, they
found that families now viewed child analysis with fairly good will.
The year 1925 had started well at the Ambulatorium. The small staff was
galvanized by the Training Institute’s inauguration of its first class of fifteen
students. Helene Deutsch was the director, Siegfried Bernfeld the assistant director
temporarily, since he would soon move to Berlin, and Anna Freud the
secretary. 18 The arduous four-term course of study was modeled after the
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