Freud's Free Clinics

“THE CONSCIENCE OF SOCIETY”—INTRODUCTION
modern psychology, but it was, even so, the most complex and controversial.
At the Vienna Ambulatorium on Pelikangasse psychoanalysis was practiced
daily by clinicians closely linked to Red Vienna’s changing medical
and sociopolitical agenda. And on Potsdamerstrasse in Berlin the Poliklinik
offered the city’s psychiatric patients a compassionate alternative to the
Charité Hospital’s institutional care, taking in those whom the medical and
psychiatric establishments were ready to dismiss.
Although by 1938 the Nazis had so depleted psychoanalysis that one could
walk through the academic centers of Berlin or Vienna without meeting an
analyst, let alone a Jew, Otto Fenichel and his group of exiled colleagues argued
their beliefs more fiercely than ever. The Berlin clinic was ended in 1933,
Sex-Pol in 1934, the Vienna Ambulatorium in 1938. Even then Fenichel encouraged
his former colleagues to preserve a critical, political attitude even
though the Poliklinik had been aryanized (not technically closed) in 1933. In
the Rundbriefe, an extraordinary series of circular letters written to and
among his circle of activist analysts, Fenichel articulated the confrontation
between those who faithfully held to the humanist Freud and a new kind of
clinician aligned with ego psychology. Over the next ten years Fenichel
would come to view the ego psychologist Heinz Hartmann’s new theory of
adaptation as neo-Freudian at best and, at worst, conformist and eerily pre-
Freudian. Fenichel’s group argued consistently, along with their colleagues
in Ernst Simmel’s Association for Socialist Physicians, that the importance of
psychoanalysis lay precisely in its social, even Marxist, dimension. “We are
all convinced,” Fenichel wrote from Oslo in March of 1934, “that we recognize
in Freud’s Psychoanalysis the germ of the dialectical-materialist psychology
of the future, and therefore we desperately need to protect and extend
this knowledge.” 17
That the history of political activism in psychoanalysis has been consistently
withheld from public view is puzzling. The careers of the second generation
of psychoanalysts were exemplary. Freud’s students were leaders in
academia and medicine and even the military. Archival and oral history evidence,
fragmented as it is, confirms that the early psychoanalytic movement
was built around a progressive political core, closely allied to the cultural
context of central Europe from 1918 to 1933, and that the free outpatient clinics
were a practical implementation of that ideology. This narrative comes
into focus once psychoanalysis is located in relation to the twentieth century’s
alternately reformist and conformist social movements of modernism,
socialism, democracy, and fascism. Today Otto Fenichel’s 119 Rundbriefe survive
as eloquent documentation of the historical link between psychoanaly-
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