In 1923 the new city-state instituted a housing construction tax (the burden of which was on businesses and the diminishing middle class); 2,256 new residential units were built by the end of the year to redress the desperate housing shortage and to help clear the slums. Over the next decade, four hundred large communal housing blocks were built, planned around spacious courtyards, some of which spanned several city blocks. These increased the housing stock by 11 percent and housed 200,000 people, who were charged only token rents. The new “people’s apartment palaces,” as they were referred to, contained libraries, community centers, clinics, laundries, gyms, swimming pools, cinemas, and cooperative stores. The pride of these super-blocks, called the Karl-Marx-Hof, was built by a student of the architect Otto Wagner. Another was named after Freud.
These bastions were described by their Christian Social critics as “red fortresses,” suspected of being strategically sited and designed to be easily defendable in case of civil war. Vienna was hemmed in by the surrounding provinces from which it was now separated politically, and planners were therefore unable to enlarge the capital with garden city satellites. The historian Helmut Gruber describes the new housing blocks as reflecting the status of Vienna itself, a Social Democratic island in a national sea of Christian Socials: “Enclosed, isolated and defensive,” he writes, “they were enclaves within an enclave.”3
However, the Social Democratic politicians hoped that their form of “anticipatory socialism” would be infectious and serve as a springboard back to government. In 1923 their share of the national vote stood at 39 percent, but in Vienna they could count on a two-thirds majority in municipal elections. In Vienna, after the disillusionment of the immediate postwar years, the Social Democrats had managed to restore confidence in the revolutionary idea that modernism—reflected in the functional, streamlined forms of the architecture they sponsored—could reshape people’s lives for the better. The Social Democratic politician Otto Bauer claimed proudly that his party was “creating a revolution of souls.”4
As the Christian Socials grumbled about “tax sadism,” Vienna, like Weimar Berlin, became a model of social welfare, with not only excellent public housing but also enviable public health services. As city welfare councillor for Vienna, Julius Tandler, Reich’s former anatomy teacher, was responsible for the health and well-being of every citizen. The Social Democrats extended to everyone “cradle to-grave” care. Tandler was also in charge of early childhood education and initiated kindergartens and child welfare centers, and arranged for the building of numerous swimming pools and gyms. Under his tenure mortality rates dropped to 25 percent of prewar levels and, thanks to a government-sponsored proliferation of maternity clinics, the rate of child mortality halved.
Though it was not state-funded, the free psychoanalytic clinic, the Ambulatorium, that opened at Pelikangasse 18 in May 1922, offering free therapy for all, regardless of their capacity to pay, should be seen in the context of Tandler’s and the Social Democrats’ politics of benevolent paternalism. In September 1918, Sigmund Freud had given a speech at the Fifth International Congress of Psychoanalysis in Budapest. It was two months before the Armistice (Reich had just reached Vienna on leave), and almost all the forty-two analysts who attended appeared in military uniform, having been conscripted as army doctors to treat war neuroses, their success at which had won psychoanalysis begrudging respect from conventional psychiatry. But Freud looked to the future rather than dwelling on civilization’s obvious discontents, promising his audience, “The conscience of society will awake and remind it that the poorest man should have just as much right to assistance for his mind as he now has to life-saving help offered by surgery.”5 To this end, and sounding more like a health reformer than a psychoanalyst, Freud urged his followers to create “institutions or out-patient clinics…where treatment shall be free.” Keen to contribute to a better postwar world, Freud hoped that one day these charitable clinics would be state-funded. “The neuroses,” he insisted, “threaten public health no less than tuberculosis.”6
The psychoanalyst Max Eitingon, who came from a wealthy family of Galician fur traders and had funded the first of these clinics, established in Berlin in 1920, later wrote that Freud had spoken “half as prophecy and half as challenge.”7 Eitingon had directed the psychiatric divisions of several Hungarian military hospitals during the war. He set up the Berlin Poliklinik with Ernst Simmel, who had been director of a Prussian hospital for shell-shocked soldiers. The Poliklinik, which reflected a postwar spirit of practicality, might be seen as the psychoanalysts’ attempt to adapt the intensive treatment of war neuroses to shattered civilian life.
The Berlin Poliklinik was a chic but modest outpost for this military-style campaign against nervous disease; it occupied the fourth floor of an unassuming block and it had only five rooms. Freud’s son Ernst, an architect who had trained with Adolf Loos, designed the Spartan, minimalist interior. There was a large lecture hall–cum–waiting room with dark wooden floors, a blackboard, and forty chairs; four consulting rooms led off it through soundproofed double doors, and were tastefully furnished with heavy drapes, portraits of Freud, and simple cane couches. One patient was struck by the apparent lack of medical paraphernalia and walked out disappointed, muttering, “No ultraviolet lamps?”
We don’t tend to think of Freud as a militant social worker, and imagine he was more likely to be found excavating the minds of the idle and twitchy rich. The psychoanalyst Karl Abraham, who was to become director of the Berlin Poliklinik, complained of just such a clientele in a letter to Freud written before the outbreak of World War One: “My experience is that at the moment there is only one kind of patient who seeks treatment—unmarried men with inherited money.”8 But Abraham’s six Poliklinik staff were soon swamped with patients from all social backgrounds: they performed twenty analytic sessions on opening day. Though it was supposedly free, most patients did in fact make a modest contribution, evaluated on a sliding scale according to their means. Factory workers, office clerks, academics, artisans, domestic servants, a bandleader, an architect, and a general’s daughter were expected to pay, Eitingon explained, only “as much or as little as they can or think they can for treatment.” Freud praised Eitingon for initiating the drive to make psychoanalysis accessible to “the great multitude who are too poor themselves to repay an analyst for his laborious work.”9
The Berlin Poliklinik was always intended to be a flagship institution, and following its rapid success—350 people applied for treatment in its first year—a second free clinic was founded two years later in Freud’s native city (between the wars at least a dozen more were opened in seven countries and ten cities, from Paris to Moscow). According to Ernest Jones, who set up a clinic in West London in 1926, Freud was initially “lukewarm” about the idea of having a free clinic in Vienna, because he felt that only he could head it. However, the Berlin Poliklinik seemed to have turned its city into the new capital of psychoanalysis—Fenichel emigrated there in 1922, attracted by its vibrant reputation—and the Viennese analysts didn’t want to be upstaged. Paul Federn (then Reich’s analyst), Helene and Felix Deutsch, and Eduard Hitschmann pressed the idea upon Freud.
In May 1922 Hitschmann, a specialist in female frigidity (Reich had given Hitschmann’s book on the subject to Lia Laszky), was appointed the first director of Vienna’s Ambulatorium. Helene Deutsch later described Hitschmann, a resolute Social Democrat who had been practicing analysis since 1905, as “a cultured, witty man…200 percent ‘normal.’”10 Reich became Hitschmann’s first clinical assistant and would remain at the Ambulatorium for the rest of the decade. In 1924, he became the clinic’s deputy medical director with the job of interviewing and examining all prospective patients, sending off the ones he suspected of having a physical rather than a psychosomatic illness for X-rays and blood tests, and assigning the rest to an analyst. Each member of the Vienna Psychoanalytic Society promised to treat at least one patient for free to support the clinic, which repr
esented a fifth of their practice. If they couldn’t spare the time, Reich would collect the equivalent in monthly dues.
The Ambulatorium had been two years in the planning not only because of Freud’s initial intransigence but because the psychiatrist Julius Wagner-Jauregg, a member of the conservative Christian Social Party and the head of the Society of Physicians, had blocked the proposals to launch a free clinic connected to the Garrisons-Spital (military hospital). Wagner-Jauregg, the director of the University Clinic for Psychiatry and Nervous Diseases, was then Vienna’s most celebrated doctor and one of Freud’s most notorious and sarcastic critics—“His whole personality,” his onetime assistant Helene Deutsch wrote in describing his resistance to psychoanalysis, “was too deeply committed to the rational, conscious aspects of life.”11 With the support of other psychiatrists who were not well-disposed toward psychoanalysis, Wagner-Jauregg, who took an entire year to examine Hitschmann’s proposal for the free clinic before he rejected it, argued that the clinic was an unnecessary supplement to existing ones like his own and constituted a breach of trade.
Reich would no doubt have been aware of Wagner-Jauregg’s efforts to block the Ambulatorium when he began a two-year stint of postgraduate work in neuropsychiatry with Wagner-Jauregg and Paul Schilder, the doctor to whom Reich had referred Lore Kahn’s mother. When Reich studied under him, Wagner-Jauregg was experimenting with electrotherapy and insulin shock treatments, and with inducing malaria to cure the dementia associated with the final stages of syphilis. It was found that the resulting fever could kill all pathogenic bacteria; the innovation would win him the Nobel Prize in 1927.
Wagner-Jauregg had been a friend of Freud’s when they were students. He once carried him to bed after Freud blacked out from drink, and he was one of the few to use the familiar du to address him. However, the pair fell out in 1920 when Freud testified against Wagner-Jauregg before a parliamentary commission. Wagner-Jauregg had been accused of excessive use of force in treating the military “malingerers,” as he called those he felt were feigning illness as a form of desertion. At the beginning of the war he had treated war neurotics with isolation and a milk diet, but he soon found that a strong dose of electric shock therapy was the best method of getting “simulators” to return to active duty, a feat he claimed to have achieved after as little as one session of torture. Freud accused him of having used psychiatry like a machine gun to force sick soldiers back to the front. In his autobiography, Wagner-Jauregg wrote that he considered Freud’s public statement a “personal attack.”12
Reich received his first exposure to schizophrenic patients when he worked as an intern for a year on the “chronic ward” at the Steinhof State Lunatic Asylum in Vienna. There Wagner-Jauregg used bromides and barbiturates to sedate patients, which, Reich noticed critically, had no effect on their underlying psychotic symptoms. He wrote sympathetically of the inmates, “Each and every one of them experienced the inner collapse of his world and, in order to keep afloat, had constructed a new delusional world in which he could exist.”13 His own analyst, Paul Federn, claimed some success in penetrating and curing schizophrenic fantasies using psychoanalysis. Reich liked Wagner-Jauregg’s “rough peasant candour” and admired his impressive diagnostic skill, but working with him created split loyalties.14 Reich had already decided to give over his career to psychoanalysis, but to avoid being a target of his professor’s derisive wit, at Wagner-Jauregg’s clinic he made sure to exclude all mention of sexual symbolism from his patients’ case histories.
The Ambulatorium, which eventually opened at the General Hospital (where Felix Deutsch was a physician) just after Freud turned sixty-six, couldn’t have been more different from its sleek, modernist cousin in Berlin. Its shabby clapboard building was a carbuncle on the Beaux Arts architecture that surrounded it. The building was shared with the Society of Heart Specialists, whose physicians vacated it in the afternoons. The psychoanalysts used the emergency entrance for heart-attack victims as a meeting room, and the unit’s four ambulance garages made makeshift consulting rooms. A metal examination table with an uncomfortable springboard mattress doubled as a couch (patients had to use a stepladder to get onto it), and the analyst perched on a hard wooden stool. “After five sessions we felt the effects of so long a contact with the hard surface,” recalled the psychoanalyst Richard Sterba.15 He had occupied both the stool and the table, having been analyzed at the Ambulatorium for free by Hitschmann and later, with Reich’s help, having gotten his first job at the clinic.
There was nothing elitist about psychoanalysis as Reich practiced it at the Ambulatorium. According to a report published by Hitschmann in 1932, 22 percent of the clinic’s patients were either housewives or unemployed, and another 20 percent were laborers. In its first decade, 1,445 men and 800 women were treated in the Ambulatorium’s improvised space, more than the 1,955 people treated at the Berlin Poliklinik. “The consultation hours were jammed,” Reich recalled, “There were industrial workers, office clerks, students, and farmers from the country. The influx was so great that we were at a loss to deal with it.”16
These figures are especially impressive, considering the skeleton staff with which the institution operated, and show how accepted psychoanalysis was increasingly becoming among the general public. But they also show how far psychoanalysis was from providing what Eitingon ambitiously called “therapy for the masses.”17 Eitingon himself regretted that the clinics couldn’t reach more “authentic proletarian elements.” Yet it was specifically the ambition of the second-generation analysts to do this—to universalize psychoanalysis with the aim of treating the social causes of neurosis rather than merely patching up the mental health of individual sufferers—that led to ruptures that almost destroyed the profession.
Freud, in launching the radical social project that was the free clinics, inspired the “revolutionism” of the second generation of analysts, as one of their members, Helene Deutsch, termed it (echoing Otto Bauer’s idea of a “revolution of souls”). They were, she said, “drawn to everything that is newly formed, newly won, newly achieved.”18 These now legendary figures, who staffed the free clinics in Berlin and Vienna and came to believe that psychoanalysis could play a utopian role in liberating man from social and sexual repression, included Deutsch herself (who had been a lover of the socialist leader Herman Lieberman), Wilhelm and Annie Reich, Otto Fenichel, Edith Jacobson, Karen Horney, and Erich Fromm.
The year Reich joined the Ambulatorium staff, Fenichel instituted what became known as the children’s seminar for young psychoanalysts in Berlin, so called not because it was devoted to child analysis but because Fenichel liked to think of the rebellious analysts as “naughty children.”19 In Vienna there was a similar generational gap, and a corresponding rebellion of values. It is notable that in a photograph of the Ambulatorium’s volunteers taken in the mid-1920s, there were only two gray-haired members: Ludwig Jekels and Hitschmann, who were both about thirty years older than Reich. For the young recruits, even more than for their superiors, psychoanalysis was, as the historian Elizabeth Danto puts it, “a challenge to conventional political codes, a social mission more than a medical discipline.”20
Swamped with patients at the Ambulatorium, Reich felt he was “‘swimming’ in matters of technique,” at sea in trying to apply psychoanalytic theory to an inundated practice.21 He knew that he was supposed to break down the barrier of unconscious resistance with which the patient repressed any childhood sexual conflict so that the emotion-laden memory could break through and evaporate into consciousness, and he knew how to work with the transference so that it became a curative force in therapy. But what was one to do with uncooperative or catatonic analysands who refused to play the game of free association or did not want to have dreams? How to communicate with patients to whom the language of psychoanalysis was entirely foreign? When Reich told his uneducated patients, as he was supposed to, that they had a resistance or that they were defending themselves against their unconscious, they
just responded with vacant stares.
There was no training institute or organized curriculum where Reich could discuss these practical problems. When he expressed his concerns to more experienced analysts, he said, “the older colleagues never tired of repeating, ‘Just keep on analyzing!’…‘you’ll get there.’” Where one was supposed to “get,” Reich added, no one seemed to know.22 Reich would take particularly puzzling cases to Freud, to whom he seems to have had privileged access. One of the cases about which he sought advice was that of his first analysand, the impotent waiter Freud had referred to Reich who was still not cured three years later.
Reich had managed to trace the origin of the man’s problem to his having witnessed, at the age of two, the bloody scene of his mother’s giving birth to a second child. This had left his patient, Reich noted, with severe castration anxiety, “a feeling of ‘emptiness’ in his own genitals.”23 However, though he had theoretically solved the case by unearthing the unconscious root of his problem, an epiphany to which the patient displayed no obvious signs of resistance, the waiter remained uncured.24 Freud warned against too much “therapeutic ambitiousness” and advised Reich to be patient and not force things; he also suggested, “Just go ahead. Interpret.”25 However, Reich declared a stalemate and dismissed the patient a few months later. His first case was a defeat that would plague him.
Freud told his disciples only what not to do in therapy, preferring to leave what one should do, as he told Ferenczi, to “tact.” Freud later admitted that his more “docile” followers did not perceive the elasticity of his rules and obeyed them as if they were rigid taboos. According to Reich, Freud deemed only a handful of analysts to have truly mastered his technique. At the Seventh International Psychoanalytic Congress, in Berlin in 1922, where Freud gave a lecture that was the germ of the following year’s paper “The Ego and the Id,” he looked out at all the people in attendance and whispered conspiratorially to Reich, “See that crowd? How many do you think can analyse, can really analyse?”26 Freud held up only five fingers, even though there were 112 analysts present.
Adventures in the Orgasmatron: How the Sexual Revolution Came to America Page 8