Freud's Free Clinics

1923–1932: THE MOST GRATIFYING YEARS
than “official.” These numbers alone indicate that males constituted at least
half the pool of clinic applicants. Once the sections of “independent professions
(12 percent), university students (9 percent), teachers (3 percent), soldiers,
servants, and school children” are added, the total number of males
would expand further. Moreover, what gives the males the real advantage in
this statistical picture is the third group of numbers, the psychoanalytic diagnoses
noted on admission. “Impotence” was, at 12 percent, the most frequent
primary psychological complaint registered in this year’s consultations. Impotence
weighs in three times as often as “frigidity.” There are two times
more diagnoses of “impotence” than of “hysteria,” the clinical diagnosis perhaps
most often associated with women. “Onanism” is diagnosed with the
same frequency as “psychopathia” (delusional depression).
For contemporaries of the Ambulatorium psychoanalysts, then, the men’s
numerical advantage over women in three major areas—number, occupation,
and diagnosis of applicants—did not imply male supremacy. It is difficult
to appreciate that men attended treatment at the Ambulatorium without
regard to the stigma of biased feminization and blame attached to psychoanalysis
today. Several explanations may be offered, but the most plausible is
the policy of universal access to care. For the last five years Red Vienna’s
health and welfare policies had ensured that, as Freud had said in 1918, “the
poor man should have just as much right to assistance for his mind as he now
has to the life-saving help offered by surgery.” Red Vienna’s urban planners
had intended to ease the lives of proletarian women (with labor-saving domestic
devices and community child care) and men (with onsite family supports
including the marriage consultation centers). True, Tandler’s maternalist
policies and the network of child-centered clinics focused on ready
access to mental health providers for mothers. But the clinics were built into
the overall sociospatial structure of the Gemeindebauten and, therefore, the
formerly private spaces of treatment rooms now became community areas.
Since mental health services were included in the array of social services, men
could approach treatment (for impotence, for instance) as a form of family
support. Another factor was popularity. Psychoanalysis was widely discussed
in fashionable newspapers read by men at their cafés. From pundits like Karl
Kraus to enormously popular poets like Rilke, the prominence of psychoanalysis
in the print media went far beyond the Social Democrats’ local periodicals.
Finally, a third consideration was the recent war and soldiers’ experience
with the psychoanalytic treatment of war neurosis. Impotence was one
of the most prevalent effects of shell shock. “‘Almost all’ the neurological patients
hospitalized in Budapest after World War I complained about ‘their
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