Freud's Free Clinics

1932
“about sex.” Not that women were ignored. It was one of the accomplishments
of psychoanalysis to assert that women did have sexual responses. That women
of the “lower” classes also had sexual autonomy was an even more daring idea.
Whatever larger gender ethos facilitated men’s access to the Ambulatorium, the
clinic’s own disposition to treat women as equally sexual was avant-garde.
The two exceptions to the male plurality in Hitschmann’s tallies can be
found in the occupational categories of ”domestic service” and “no occupation.”
Here women (296) appear over four times more than men (66).
Women’s enrollment in Tandler’s maternal/child consultation centers or
other family assistance programs probably accounts for the increase. The
community lectures in child development, the support of the municipal social
workers, and the local newspaper articles were among most visible forms
of promotion for psychoanalysis, and many were targeted to women. Consequently,
poor women or those with “no occupation” sought assistance not
for hysteria but for relief from the same problems plaguing the men—depression,
lack of occupational satisfaction, and sexual dysfunction. By the
early 1930s an interesting and unexpected profile of the Ambulatorium’s patients
had emerged. For one, the male and female clients had largely the same
psychological complaints (and, presumably, the same sense of sexual dysfunction).
And, second, the clinic population was eclipsed by young adults
regardless of gender or social class. In the ten years covered by the report, the
twenty-one to thirty year olds were the only group that reached over one
thousand (1,083 specifically). They were by far the largest single classification
of consumers and the only group that came close, though a full 50 percent
smaller, were the thirty-one to forty year olds (537). At either end of the age
curve after that, children under age ten and elderly people ages sixty-one to
seventy were seen and counted, but represented only a small fraction of the
total patient population. In 1926 and 1927, peak years for children and seniors,
Hitschmann counted seven male and five female children and five seniors.
In contrast, no seniors and only a few children were counted in either
1922/23 and in 1928/29. It is possible that the child patients, who were treated
at the separate Child Guidance Center, were undercounted in this report.
Vienna’s Child Guidance Center was thriving, now that August Aichorn
had taken over, on a consulting basis, after retiring from public service. 5 The
Heitzing School had closed and, along with it, Aichorn’s periodic teaching
there, which he replaced by a solo practice of free short-term therapy, referrals,
and advice to children and their families. Aichorn remained an ambiguous
figure in the analytic community. Well-liked by both Sigmund and Anna
Freud, he came from a conservative Catholic family allied to the Christian
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