How did psychoanalysis come to define itself as being different from psychotherapy? How have racism, homophobia, misogyny and anti-Semitism converged in the creation of psychotherapy and psychoanalysis? Is psychoanalysis psychotherapy? Is psychoanalysis a “Jewish science”?

Inspired by the progressive and humanistic origins of psychoanalysis, Lewis Aron and Karen Starr pursue Freud’s call for psychoanalysis to be a “psychotherapy for the people.” They present a cultural history focusing on how psychoanalysis has always defined itself in relation to an “other.” At first, that other was hypnosis and suggestion; later it was psychotherapy. The authors trace a series of binary oppositions, each defined hierarchically, which have plagued the history of psychoanalysis. Tracing reverberations of racism, anti-Semitism, misogyny, and homophobia, they show that psychoanalysis, associated with phallic masculinity, penetration, heterosexuality, autonomy, and culture, was defined in opposition to suggestion and psychotherapy, which were seen as promoting dependence, feminine passivity, and relationality. Aron and Starr deconstruct these dichotomies, leading the way for a return to Freud’s progressive vision, in which psychoanalysis, defined broadly and flexibly, is revitalized for a new era.

Artwork by David Cabrera, 2016

Artwork by David Cabrera, 2016

In this article for Psychology of Aesthetics and Politics Magazine, Robert Frashure sits down with Dr. Lewis Aron to discuss his book “A Psychotherapy for the People: Towards a Progressive Psychoanalysis.” Dr. Aron, the Director of the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis and author of numerous articles and books on psychotherapy and psychoanalysis.

Robert: Thanks so much for taking the time to sit down and talk with me, Dr. Aron! Your work has been an inspiration to me for some time, and it is truly an honor to have the chance to speak with directly about the book.

Dr. Aron: It is a pleasure to talk with you, Robert. I thought the questions that you sent me before we talked were extremely well thought out.  Just from reading your questions, I felt like you had already organized a paper in your head.

Robert: I really appreciate that! I did feel as though I had been sitting on some of these questions for some time, and it felt great to find someone who found them interesting (laughs).

Dr. Aron: Yes, I know how that feels! And the truth is that I often prefer to write responses to questions instead of talking, in the sense that writing it really gives me the control to make sure that it’s exactly what I want to say.

Robert: Certainly, well we will try our best today then to be as precise as possible with our words. Which leads me to my first questions for you about the book: In your view, what might be the best approaches to integrate intersections of race and social class into contemporary psychoanalytic thought? Is it unfair to scapegoat psychoanalysis for the failures of a capitalist political system that often overlooks and discards the underprivileged?

Dr. Aron: I think that this is a very important question you are asking, and I think actually most people have not asked me such good questions, to be honest. A lot of the older people, I think the more established people, I think a lot of us, I include myself, are not sure what the next step is. It’s like, okay, in some ways, I’ve outlined the problem. But now what do we do?

Robert: Is this a question you get asked 1000 times?

Dr. Aron: Surprisingly, no. Yes, I’ve had a couple of people that come and walk to talk about diversity issues in psychoanalytic thought, but the questions I typically get depend on where people are coming to and from and what their interests are. And this particular book covers such a wide terrain that people have come to it from very different kinds of perspectives. But I would say that I found that younger people and particularly diverse younger people, many, many young, people from diverse backgrounds in all kinds of different ways, have responded very positively to the book.

Artwork by David Cabrera, 2016

Artwork by David Cabrera, 2016

Robert: Right, exactly. For me, I’m in the fourth year with my graduate Ph.D. program and there is a big emphasis on racial, socio-economic, gender, religious, and LGBTQ perspectives in my program. The reason why I especially wanted to talk with you about these issues is that I used to live in New York, on crazy old Christopher Street. And I actually began my psychology training working in the Bronx (Montefiore Hospital at Albert Einstein College of Medicine), which was a cross-section of most every category of diversity that you could imagine!

Living in New York confronted me with the realities of income disparity and poverty and I am curious how you process this. As you describe in the book: there often does seem to be a split between the social and the psychic, such that the overarching destructive impacts of the U.S. socioeconomic system are not adequately incorporated into therapy. For example, a middle-class clinician coming to work in an inner-city community must inevitably attempt to confront the inescapable sense of deprivation that can come with trying to live and raise children on a poverty level income.

Dr. Aron: I do think that there are several reasons as to why psychoanalysis has adopted such a cliched and privileged position in the imagination of American culture. I would emphasize that psychoanalysis was the establishment for many years in this country. Psychoanalysis was in power. After World War II, psychoanalysis really rose to the top of psychiatry and it was elitist. It was definitely elitist and it was not only elitist culturally but analysts purposely kept it elitist in order to charge higher fees, make more money, dominate the market. They dominated psychiatry departments. And when they do that, you pay a price for it. Once you’re thrown out of power, individuals who had not been included can become very happy with the fact that you’ve fallen from that kind of dominant position.

Robert: So are you saying that the misperceptions of psychoanalysis as taught in many graduate schools are correct then? For example, I cannot tell you how many times I have heard professors talk about psychoanalysis as if the last 100 years hadn’t occurred and Freud was the only important figure in the field. It always disappoints me how so many professors haven’t kept up at all with the development of psychoanalysis as a field.

Dr. Aron: Right, so I think that we created a lot of enemies and we created enemies especially among other kinds of therapists. Analysts have traditionally had a certain responsibility that we look down on other kinds of therapists and viewed what we were doing as deeper and better and more important. So I do think that we have to accept a certain amount of responsibility for that. And then the other side of it is just that to really understand how psychoanalysis has changed, at the very least, requires doing some serious reading. And I think most people that are in other schools, they haven’t put in the time to actually learn what the changes are and…some of it just ignorance.

Robert: Do you still feel as though the field of psychoanalysis is elitist at this point? I have heard so many times from students and teachers that psychoanalysis is only for the privileged and, by implication, white individuals. Do you think this is true, and why has this structure and image of psychoanalytic privilege been perpetuated into such a cliché among the lay public?

Artwork by Dana Schutz

Artwork by Dana Schutz

Dr. Aron: No. I think psychoanalysis has been brought down onto its knees. Psychoanalysis has so much lost its status. This began in the late 1960s and especially through the 70s and 80s with managed care, with psychopharmacology, and also with the rise of other kinds of therapies, CPT, short-term therapy, family therapy. And add to that the attacks of the women’s movement and feminism. I think psychoanalysis has really got cut down. And so I think these days psychoanalysis has been very much on the defensive. So is it elitist? I do think that like anyone else analysts probably have some secret feeling that their way of doing things is better than everyone else. But it’s no longer backed up by the institutions of power and by money.

So there was a time, after World War II there was a time when psychoanalysis was being funded, being supported by the Ford Foundation, the Rockefeller Foundation, and NIH grants. So on top of the fact that it was elitist, it had institutional, financial support, which it’s completely lost. Like you can’t get a grant now if you’re an analyst or doing analytic research.

Robert: How are psychoanalytic researchers like Dr. Beatrice Beebe been able to sustain their research for so long then?

Dr. Aron: Well, Dr. Beebe is quite exceptional and she frames her research very carefully as developmental research. And so she’s not writing a grant investigating psychoanalysis. She’s writing a grant with very, very precise kinds of behavioral measurements. And it’s seen as developmental psychology. So there’s funding for developmental psychology attachment theory, but that’s quite different from trying to get funding as an analyst supporting analytic research. So no, I think that analysts have kind of been brought down a peg or two.

Artwork by David Cabrera, 2016

Artwork by David Cabrera, 2016

Robert: I have a question regarding the possibility of psychoanalysis as a force for social change, as it is a recurring theme in your book. For me, I will never forget first encountering Freud’s writing as a repressed gay closeted teenager as I was so enraptured by his ideas that I thought to myself “ holy smokes, here is the secret to unlocking the miseries and passions of society, here is someone who finally understands me!.” As I have grown older and perhaps less repressed, my naïve enthusiasm has dimmed somewhat but I do still believe that psychoanalysis really could be a progressive force for positive societal change in American culture.

What are your views of psychoanalysis as a driving force for societal change on a larger level outside of the clinicians’ office, do you think it is still a relevant and vibrant discipline? Can it still be a liberation psychology? How can it be used not to further reinforce the individual and social status quo, but to further push forward the struggle for social justice and peace?

Dr. Aron: Well, let me say something about that because that’s actually crossing over into another area. Even when analysts were in elite space, there’s a long tradition in psychoanalysis going back to Freud that has provided low-cost treatment and free treatment to the poor. I think what’s not as well-known in the United States, because psychoanalysis was associated with the elites, what’s not as well known is that psychoanalysts in Europe were, at the very least, they were liberal democrats, they were liberal thinkers, and most of them were more radical than that. So you have many of the leading analysts that were communists and socialists, and active members in the Communist party, the Socialist party. There was a long tradition of trying to merge Freudian thinking and Marxian thinking.

And when they came to the United States after World War II, a lot of the immigrants left that behind because they were grateful to the United States for saving them from Hitler and they didn’t want to cause trouble in the United States. And in the 1950s, being a Marxist wasn’t so cool. But we now know that some of the leading analysts, actually a good number of the leading innovative analysts in America in the 1950s were secretly members of the Communist party. So there’s a very long tradition of psychoanalysis and progressive social democratic liberal movement. And from 1920 on, 1920…actually, Freud spoke about it in 1918. After World War I, there’s been an ongoing, continual tradition of psychoanalysis offering low-cost treatment to the poor.

Robert: I didn’t realize that. I read in your book about the history of psychoanalysis and social activism, in which psychoanalysis was seen as a social movement for reform and education and social policy. Which movements are you referring to?

Dr. Aron: Yeah, I think many people are probably not aware of it and I think it’s for the same reason. It’s that psychoanalysis became so associated with the establishment, with wealth, with charging high fees and private practice. And that was its public image in America post World War II. See, that’s a very short period. It’s just a blip in time. But the truth is, if you go back to the history of psychoanalysis from Freud on, what you’re gonna find is that, through most of its history, psychoanalysis was much more progressive. And the analysts in Europe routinely gave 10% or 20% of their time for free, for low-cost or free treatment. They all supported low-cost clinics for the poor. They even did things that in America weren’t considered so acceptable.

Like, in Europe, in order to treat more people, they cut the sessions down from six sessions a week to three. And they cut sessions down from a full hour, they cut them down to a half hour at first because they felt that that way they could provide treatment to four times as many people.

Robert: When I first read Freud, I was taking Harvard summer school classes and I was at an all-boys school and I was feeling very oppressed because I hadn’t come out yet as a gay man. And I’m reading “Civilization and its Discontents” and staring out the window in Harvard Square and thinking, “Wow, this guy’s onto something.” And he was so radical and you finally get in there and read what he has to say. And I don’t know. I always had that image of him as being a counterculture figure.

Scene from Game of Thrones.

Dr. Aron: He himself in his lifestyle was not particularly radical. He was a very typical Viennese liberal, social democrat liberal and always on the liberal side of things but not radical, not revolutionary. And I think, first of all, he was just a very stayed kind of person, but also I think that he was very conscious, very self-conscious that psychoanalysis be accepted as a science and that he felt that, if it was too connected with anything too radical or political, that it would lose its standing as a proper science. So I think Freud himself leaned in the direction of, hey, let’s not get too involved in politics and religion and all of this stuff. Let’s keep psychoanalysis as a clean science that doesn’t have political reverberations. But his followers were not nearly, because they didn’t have the same concern for the security of the discipline he developed, so his followers tended to be much more left-wing and radical than he was. The most important examples of that are probably Wilhelm Reich who he had the honor of being thrown out of both the Communist Party and the psychoanalytic movements.

Robert: Who are some of your other favorite, more radical psychoanalytic thinkers?

Dr. Aron: Besides Wilhelm Reich, Edith Jacobson is a very important figure. Erich Fromm, of course. But there were many that were really much more radical.

Robert: I know Ferenczi is a real interest of yours too, right?

Dr. Aron: Ferenczi is a real interest of mine. I don’t know that I would describe Ferenczi as so much of a radical. He wasn’t radical in terms of political activism, but he was radical in fighting for diversity and fighting for the protection of women. Especially early on in his work, he was fighting for the depathologizing of prostitutes.

Artwork by David Cabrera, 2016

Artwork by David Cabrera, 2016

Robert:  I didn’t know that.

Dr. Aron: Yes. He worked in a hospital. And Ferenczi is somebody that got along with most people. He was very well liked. But somehow the director of the hospital didn’t like him. And as a kind of punishment, he put Ferenczi to work, working with the prostitutes who were considered the lowest of the low. And Ferenczi was associated with  Magnus Hirschfeld who ran the Institute for Sexual Science, the first such facility in the world to offer medical and psychological counseling on sexual issues to heterosexual men and women, homosexuals, cross-dressers, and intersex individuals. It was at this institute that Hirschfeld and his colleagues pioneered some of the first sex-reassignment surgeries as well as primitive hormone treatments. His books were later burned by the Nazis, together with Freud’s, but he was the leading theorist of homosexuality and fighting for homosexual rights in Berlin. And Ferenczi, he was his representative in Budapest and he was fighting for the rights of homosexuals, prostitutes, all kinds of perversion, and arguing that this was not something that should be discriminated against. So he was socially progressive and active but not somebody that was politically active. But there were many others that were.

Robert: That’s interesting. I feel like we need him now. These are still issues coming up in our American politics, too, at this point. Which brings me to a question about psychoanalysis and LGBT issues. I was just remembering a transgender professor I had, female to male, who became very agitated when I told him I was interested in psychoanalysis. He had so much hostility due to, I think, the history of the field and its pathologizing of homosexual people.

So I was just curious what your thoughts on how Freud dealt with issues of sexual orientation?

Dr. Aron: Yeah, there’s a long history of this. Let me just see if I can say a few things about it. Freud on a personal level was treating homosexuality as perfectly normal and not pathologizing it at all on a personal level. His writing is contradictory. And you can find quotes in Freud to back up all kinds of different positions because he takes an inconsistent position. When he writes his most radical book, it’s called Three Essays on Sexuality. The Three Essays, the first edition of that was 1905 and he revised it many times afterwards. The first edition, he treats homosexuality as completely normal and he actually says directly that we have to wonder just as much why somebody would become heterosexual as wonder why they would become homosexual, that it’s just as puzzling to explain one as it is to explain the other.

Robert: That’s a good question!

Dr. Aron: Yeah, that’s where he starts. He starts with that. And why would anybody limit their choices? If you start out with bisexuality and if you can be attracted to your mother and father, if you can be attracted to men and women, why wouldn’t we think of it as something’s wrong with you that you would limit it to half of that, no matter which half? So that’s where he starts off in 1905. But then as, again, he wants psychoanalysis to be part of psychiatry. He wants it to be part of medicine. And so later he does take the position that it’s a developmental arrest, that something has gone wrong in the Oedipus complex. So there’s a contradiction between…so when a mother of a homosexual young man writes to him, he reassures her there’s no problem with this. But in his formal writings, he leans in the general direction of what psychiatry said at the time, which was that it was a deviation.

So there’s contradictions in Freud. But having said that about Freud, there’s no question that the mainstream psychoanalytic movement in America in the 40s and 50s became very conservative. They were in power, they took an establishment perspective, they aligned themselves with psychiatry, they became very conservative. So whatever Freud’s personal views, psychoanalysis in America in the 50s became very conservative and anti-gay, homophobic, and there’s no doubt your teacher had good reasons for feeling what he felt because for a long time there were no case histories in the analytic literature of trans-patients until the last 10 years, because they knew better than to go to an analyst, because they knew they were gonna be seen as pathological. So the fact is all of that’s changed. It’s all changed but the truth is that analysts were brought to that, I would say, kicking and screaming the whole way because they were reluctant to give up their more conservative views.

But the way it is now, if you go to an institute now, at least in New York, if you go to a psychoanalytic institute, you’re gonna have candidates in analysis who are…for sure you’re gonna have lots of gays, but you’re also gonna have transsexuals, you’re gonna have everything. So that’s really changed at this point.

Robert: Right.

Dr. Aron: There are significant numbers of transgender analysts writing analytic theory at this point. Transgender issues are very hot right now, and the theory is exploding very quickly. And I think it’s gonna take time for us to sort some of that out. Whatever gets sorted out, I think it’s very clear that the analytic community now is much more open to exploring without pathologizing it.

Robert: Well I hate to be the bearer of bad news Dr. Aron, but it looks like our 50 minute session is up! See what I did there?

Dr. Aron: Yes of course! It’s your turn to be the analyst and end the session, Ferenczi would be proud!

Robert: It was an honor to speak with you, and I look forward to exploring more topics as we sit down again in the second part of our interview.

Dr. Aron: Thank you very much, Robert! I appreciate the rigor and thoughtfulness of your questions. Talk to you then.

Artwork by David Cabrera, 2016

Artwork by David Cabrera, 2016