March 5, 1999

By Rodrigo Muņoz, M.D.
APA President

Sigmund Freud and Emil Kraepelin were both born in 1856 in not-too-distant cities in central Europe. Eugene Bleuler and Nobel Prize-laureate psychiatrist Julius Wagner-Jauregg were born one year later, in 1857, in the same area. These men had parallel and intersecting lives that brought enormous richness to our field.

Freud studied individuals, Kraepelin studied diseases. They may have been looking at different aspects of the same processes. Wagner-Jauregg was the empiricist who could plan for results. Bleuler was a unifying force that could see good in the work of many and a teacher to many whose names are still with us. Hermann Rorschach worked on his inkblots while studying under Bleuler.

The year of the creation of the first formal psychoanalytic society-1907-was also the year when Freud met Carl Jung, Karl Abraham, and Max Eitington, all Bleuler's students. Eitington was the first psychiatrist to undertake training analysis under Freud.

These developments in Europe did not go unnoticed in America, so that as early as 1906, James J. Putnam, a professor of neurology at Harvard University, published the first paper in English specifically on psychoanalysis. Starting in 1908, when A.A. Brill was a guest of the Psychoanalytic Society in Vienna, Freud showed a keen interest in developments on this continent through correspondence with Drs. Putnam, Brill, and Ernest Jones. One year later, 90 years ago, Freud, Jung, and Ferenczi were central figures at the conference at Clark University celebrating the 20th anniversary of its foundation. This conference attracted such figures as Adolf Meyer and William James.

The emergence of psychoanalysis as a socially accepted discipline in the America of the following decades produced a surprising change in the attitude of many toward psychiatry: Psychiatrists progressively went from "alienists" in charge of those suffering incomprehensible illnesses to physicians capable of handling the fears, anxieties, depressions, and unusual behaviors of productive members of the community.

Historians of the 20th century will certainly examine the gradual emergence of psychoanalytic-thinking America as a product of psychiatrists' effort at understanding and controlling major medical, social, and economic phenomena. In this, much is owed to the Menninger brothers, to those around Franz Alexander in Chicago, to groups that followed the thinking of Harry Stack Sullivan, and to many more. At the very least it can be argued that they brought psychiatry out of the hospitals for chronic patients and into the community and medical practice. They changed the image of psychiatry so that it became appealing and humane. They also provided evidence that we psychiatrists could communicate with our patients and even teach others to do the same.

Could all of this have happened without Freud and the psychoanalysts? I personally doubt it. There is evidence of the opposite: We are permanently in danger of being controlled by reductionistic forces that minimize psychiatric interventions, try to challenge the value of verbal therapies, and push toward denying the individuality of each patient.

In American psychiatry today, leaders like Drs. Norman Clemens, Robert Pyles, Glen Gabbard, Silvia Olarte, and many others continue to advocate for our patients in ways reminiscent of the seminal writings of early psychoanalysts. Dr. Otto Kernberg, a distinguished American psychiatrist, is president of the International Psychoanalytic Association.

Ernest Jones, in his biography of Sigmund Freud, contends that it was in the last decade of the last century when Freud was the most original. This may then be the best time to commemorate and honor him.