Bartlett's critique of Horney in this magazine [Science and Society] (Summer, 1945) seems to me to be basically correct and very welcome. It is precisely because Horney cast off some of the more flagrant errors of Freudianism that she has led so many people into another blind alley, perhaps more attractive than Freud's, but also more deceptive. Bartlett, like Horney, relates neurotic conflicts to the real world of social relationships, but unlike Horney, sees that the emotional forces behind these conflicts are bound to ideas which can be isolated and described. Bartlett also parts company with Horney when he recognizes that the patient's present system of relationships supports and maintains his conflict of ideas. From this Bartlett draws the conclusion that the task of the analyst is to expose these ideas, relate them to real situations and experiences—present as well as past—and guide the patient toward action which will resolve the conflicts or lift them to a more productive level. All this involves more than a reevaluation of analysis or mere shift of emphasis: it requires a fundamental change in the technique of analysis itself.

In a recent paper of mine ["Freudianism and The Psycho-analytic Tradition," American Journal of Psychiatry, Vol. XXV, May, 1945] I have attempted to show that the reactionary role of Freudianism consists essentially in the fact that it drives a wedge between the ideas of men and the material world which creates or maintains these ideas, and tries to split them apart. In spite of its materialist phraseology this is idealism, and psychoanalysis is a misguided contemporary form of idealism. Both Fromm and Horney form part of this tradition because their basic tendency is much the same, in spite of the fact that Fromm uses the language of Marxism and Horney the language of cultural anthropology.

How was it possible, we may ask, for both Freud and Horney to proceed from a position of professed materialism to an actually idealist position? Freud reached his idealist position by deriving ideas from biological experience—as instincts—instead of social experience. Horney achieves her idealist position by deriving ideas from childhood experience as opposed to adult experience. Fromm does the same. "There is no doubt whatever," wrote Horney in her New Ways in Psychoanalysis "that childhood experiences exert a decisive influence on development.…" Once the personality pattern congeals it is supposed to become more or less impervious to further influence from experience, unless an analysis effects an internal rearrangement of the parts. Idealism in one form or another is implicit in the whole concept of psychoanalytic therapy, which promises a man nothing less that the privilege of lifting himself by his boot-straps. For if it were conceded that neurotic conflicts are not only created, but also maintained or changed by experience, then the process of cure would have to take place out in the world of experience, away from the doctor's office.

There are many aspects to Freudianism and psychoanalysis and such is the complexity of the material that separate quotations in support of almost any point of view could be found in the psychoanalytic literature. We shall have to satisfy ourselves here with a discussion of the prevailing tendencies and errors, and insist that these must be regarded mainly as errors of emphasis, without complete exclusion of their opposites. Freud and his followers have each emphasized different aspects of the psychoanalytic structure and are not always in agreement as to what is basic and what secondary. Freud himself was not consistent in his enumeration of the basic propositions of psychoanalysis, and at times he seemed to believe that it was all basic.

It should be noted that Bartlett in his latest essay is much sharper in his attitude toward psychoanalysis than he was in his earlier writings. In his first penetrating analysis of Freudianism (Sigmund Freud: A Marxian Essay) he declared, for example, that Luria's experiments confirmed "almost word for word the three main assumptions upon which the entire mass of psychoanalytic observations depends. They confirm the fact that unconscious and active mental processes do exist; that these processes remain unconscious due to an economic mechanism of repression which manifests itself as resistence in the conflicting nature of the cure; and finally, that the free flow of associations is determined and in part derived from the subject's secret complexes." In addition, Bartlett spoke approvingly of the psychoanalytic therapeutic procedure which uses free association to reconstruct these unconscious complexes in consciousness "and very often thereby succeeding in bringing about those more stable reactions to which Luria refers." Bartlett finally concluded: "considering these circumstances and the degree of agreement on essentials, it is highly probable that the observations made by psychoanalysts are substantially correct."

In this earlier essay Bartlett thus accepted the following Freudian principles: (1) the dynamic unconscious; (2) repression and resistance; (3) psychoanalytic therapy. His essay on Horney indicates a considerable development of his views on these topics.

Our own attitude toward these principles may be briefly stated. In relation to (1), the question may be posed: Do we believe that unconscious forces motivate and affect behavior? The answer is, we do. Under (2): Do we believe that disagreeable memories can be displaced and forgotten and that it takes an effort to recall them? Here again, we do. Under (3): Do we believe that presentation or restoration to consciousness of these unconscious forces is helpful? Once more the answer is affirmative.

Yet our point of view is fundamentally opposed to Freud's in the following important ways:

(1) Though we believe, with Freud, that neuroses develop from conflicts, we do not believe that the conflict necessarily involves the opposition of the individual's unconscious drives to his conscious needs. All other types of unresolved conflict, including fully conscious conflicts, can engender neurotic symptoms.

(2) Our concept of unconscious drives is quite different from Freud's, who pictured them as originating from in-nate instincts or early childhood experiences. We reject his instinct theory, reduce the importance of childhood experiences, and emphasize the factor of ignorance in considering a drive unconscious. This means that a patient must not only be made to recognize the presence of a certain drive but must learn its origin, implications, and consequences. We can agree with Horney's statement in New Ways that the "main objective in therapy is, after having recognized neurotic trends, to discover in detail the functions they serve and the consequences they have on the patient's personality and on his life." Unlike Horney, however, we would regard many neurotic drives as expressions of certain social or class functions; we would emphasize the social consequences of their full expression; and we would relate them to the actual conflicting material needs and circumstances of the patient.

(3) In emphasizing the role of ignorance on the one hand and of actual material circumstances on the other, in the development of neurotic drives, the role of repression becomes less important, though it may still play a role. In the same way the chief sources of resistance to the analytic process appear to us to be ideological and material—but basically material. Actually the patient's resistance to a cautious, sympathetic and correct scientific analysis of his problem has been generally overrated.

(4) Inasmuch as neurotic conflicts are basically due to conflicts in material circumstances or social relationships, the analytic therapy, as we have elsewhere indicated, has mainly a preliminary value to the real therapeutic process, which involves changes in material and social relationships.

It can thus be seen that an acceptance of certain of Freud's principles by no means necessarily involves an acceptance of the Freudian structure, for important changes in emphasis and in relationships between these principles can impart altogether new meanings to them, or rob them of their old significance.

What has Horney done with the Freudian inheritance? In her first book, The Neurotic Personality of Our Time, she made a number of real contributions and advances, not the least of which was a refreshing simplicity of language. Yet in spite of a wholesome shift of emphasis to problems of real life and conduct, she declared herself fundamentally a believer in psychoanalytic treatment. "If … one believes," she wrote, "that the essentials of psychoanalysis lie in certain basic trends of thought concerning the role of the unconscious processes and the ways in which they find expression, and in a form of therapeutic treatment that brings these processes to awareness then what I present is psychoanalysis." Of the instinct theory she retained the instincts of sex and hunger. Though she wavered in her emphasis on childhood experiences she regarded them as the chief determinants of neurotic development. "It seems," she wrote, "that the person who is likely to become neurotic is one who has experienced the culturally determined difficulties in an accentuated form, mostly through the medium of childhood experiences, and who has consequently been unable to solve them or has solved them only at great cost to his personality." The question then arises: What is it that distinguishes the childhood of the neurotic from that of normal people? Horney replies by saying that the basic evil in the childhood of the neurotic "is invariably a lack of genuine warmth and affection." This is her explanation of the cause: "The main reason why a child does not receive enough warmth and affection lies in the parents' incapacity to give it on account of their own neuroses." Thus the vicious circle is created, apparently to be broken only by psychoanalysis.

Horney correctly saw that symptoms must be regarded as the expressions of fundamental difficulties of the personality as a whole. Under the slogan, "every neurosis is a character neurosis," she loosened the psychoanalytic procedure from a tangle of luxuriant detail, and treated her patients as anxious, insecure individuals involved in one or another typical personality conflict of our time, without paying undue attention to the particular symptoms through which they expressed their anxiety.

But even Horney's emphasis on social factors is distinctly one-sided. It is, to put it simply, completely middle-class. This, for example, is her concept of the abnormal individual: "We should be inclined to consider neurotic, for example, a girl who prefers to remain in the rank and file, refuses to accept an increased salary and does not wish to be identified with her superiors.…" Again: "In an individualistic culture," she writes elsewhere [New Ways in Psychoanalysis], "the individual is expected to stand on his own feet, assert himself, and if necessary, fight his way." There is not the remotest suggestion that complete identification with the rank and file, even at a sacrifice of salary, might be wholesome even in our society. She obviously pictures our culture as homogeneous, and regards the middle class character as universal. She moreover presents this character as derivative from an abstract cultural tradition, quite independent of the individual's adult experience. A worker whose loyalty to his fellow workers and to his union has been burned into him by harsh experience would be regarded as abnormal by these standards, for according to Horney, "A neurosis is a psychic disturbance … which deviates from the pattern common to the particular culture" [The Neurotic Personality of Our Time]. Where Horney recognizes the presence of conflict in our society, she sees it operating mainly through the medium of family life. Following Fromm, she pictures a continuity in which competitive hostility in the family circle engenders anxiety in the growing child, who in turn imposes his own anxiety and hostility upon his children when he grows up, without regard to the contingencies of his own later experience. The actual social relationships engendering the anxiety, in other words, are everywhere except in the present, and are hence not amenable to change. And since nothing can be done to change these factors, there is nothing left to do but understand.

Thus it is that Homey places understanding in a central position in her analytic treatment, almost completely neglecting the role of the patient's actual social situation and his real mode of existence. Bartlett has dealt adequately with this aspect of Horney's work. If it is protested that a depreciation of the role of understanding robs psychoanalytic treatment of a most essential feature, it must be acknowledged that this is true. It should be added, however, that by giving insight its proper preliminary place, and emphasizing action, we are also depriving analysis of its chief reactionary tool, and making it an instrument of progress.

But it is not enough to break with the Freudian tradition; a body of scientific fact and theory is needed to supplant it. The appeal of psychoanalysis to many thoughtful people cannot be glossed over and is based on some real attractions. Psychoanalysis conferred the dignity of scientific rank on psychology at a time when mechanical materialists refused to take psychology seriously. Some of the opposition to analysis still comes from this source. It was dialectical in its emphasis on conflict and change, and it satisfied the craving for scientific realism at a time when the prim bourgeois hypocrisies of the period were no longer tenable. Its concept of the unconscious, above all, satisfied the need for an understanding of drives that seemed so often to make an individual act against his own best interests. We now know that these conflicting ideas and drives originate in social forces. Freud mistakenly related them to instincts, but the urge to explain these obscure forces in terms of an unconscious that did not derive from the individual's rational interest remains the chief attraction of Freudianism, and is its most valuable commodity. The details of a new psychology of the unconscious based on an understanding of the individual as a social product now need to be elaborated.

In this connection the role of insight must be carefully evaluated. It must be recognized that psychoanalysis not only makes the analysts feel good: it often has the same effect on troubled patients too. The perplexed neurotic individual in our society is often at a loss when he tries to understand his plight or tries to treat himself. He cherishes the illusion that he is free and independent. If he is employed and has a family he will insist there are no objective reasons for his discontent. A theory which tells him that vague aboriginal instincts are disturbing him sounds plausible, because he does not feel all in one piece: he knows that he is torn by conflict. If the development of these conflicts can be traced back to childhood—as they often can—there is a real thrill of discovery and the plausibility of the theory is enhanced. The relationships to the analyst itself is usually pleasant. It is relaxing to be so honest and the analyst is nearly always friendly. Such relationships are both valuable and rare. The self-knowledge achieved is by no means nonsensical: much of it is valid and beneficial. (The fact is that the patient often feels better and recommends analysis to his friends.) In apparent opposition to our theory, these benefits are often derived before any change has taken place in the patient's formal mode of existence. It seems to me that Bartlett leaves himself open to misunderstanding by failing to concede this point. Let us, for the sake of clarity, assume that the analysis proceeds in a correct manner and gives the patient valid insights to his problem. We may list some of the immediate effects upon the patient as follows:

(1) Analytic insight tends to make neurotic problems more human. The neurotic patient is often possessed with the notion that his symptoms and problems are special and unique; they interfere with his capacity for social identification and tend therefore to discourage social activity. As the analysis reveals that fundamentally human drives lie at the basis of the symptoms, it becomes easier for the patient to see his resemblance to others and to recognize his identity of interests.

(2) Insight spares energy. Unresolved problems make constant demands on the patient's interest and attention, drain his energy, produce tension, and leave the patient with the constant dissatisfaction of a task undone. Correct insight allows the patient to clear the field for effective action and to turn his interest to other tasks. Mistaken insight gives temporary relief, but leads to extra trouble later on.

(3) Analytic work is an approximation to socially useful and socially acceptable work. Every analysis is an exercise in psychology. An interest in psychology—even though it be in one's own psychology—has a higher social value than an obsessive unproductive preoccupation with a personal problem. Analytic work thus facilitates the transition from mere personal preoccupation to social interests and activity.

(4) Analytic insight has educational and cultural value. Every analysis is bound to involve issues of general social and cultural interest. The analyst functions as a teacher and can exercise all the useful functions of a teacher in other spheres.

(5) Analytic insight is a social product. Analyst and patient work together to achieve it. Within its limits this is an important step toward socialization: The analyst is a valuable new and sympathetic friend—the relationship relieves the oppressive sense of loneliness felt by so many neurotics.

(6) Beyond the immediate benefits noted above, the analytic relationship has an important supportive function in the patient's transitional period. It affords encouragement, companionship, guidance, insight and fresh hope until the patient feels his strength emerging or reviving in the new situation created by his actions.

(7) Analytic insight prepares a program for action. This seems to me to be the main function of analytic insight. By understanding how his problem developed, the patient learns what line of action must be followed to relieve the problem. The prospect of useful action is as helpful to the neurotic as the promise of a good job to an unemployed individual. It is not the real thing, but it is close to it.

In summary, we can say that there are some features essential to the analytic procedure and also some incidental features. The essential features involve the acquisition of scientific insight to be used for a plan of action. The incidental features are the reassurance, friendliness, occupational activity and general educational advantages involved in an analysis. But the reassurance and friendliness cannot and should not be a substitute for the strength that comes from a broad social integration on the outside. For that reason the very relief the patient derives from the analytic relationship can prove to be a snare and an illusion, especially if it is overvalued and becomes the model for narrow and exclusive personal relationships later on. The chief value of an analysis is and should be, the scientific insight it provides.

There are a number of helpful auxiliary techniques for retaining the neurotic as a patient, teaching him effectively, influencing him, and so on. One must not be rude, over-critical, too dogmatic, too forward or eager; one must not make all decisions for the patient, nor make explanations for which the patient is inadequately prepared. All these rules, dressed up in technical language, comprise part of the method of analysis. A knowledge of psychological mechanisms is also necessary, but all these have too often served to obscure basic misconceptions or even to create the illusion that these "inner laws of movement" in psychology operate, like some sort of perpetual motion, without important influences from outside.

Practical considerations, however, make it altogether unlikely that individual psychoanalytic treatment will ever be regarded as a satisfactory method for alleviating the widespread neurotic discontent in our culture. Its chief danger lies in the fact that mistaken theories developed from individual treatment will be applied to general policies affecting social welfare. This is already taking place in the fields of social work and welfare, and in the social sciences.

In these areas current psychoanalytic theories are exerting a wider and more harmful influence on progressive thought than is generally realized and have tended always to confuse or divert decisive action. Wherever a theory of social action is blended with psychoanalysis, it is to the detriment of action. In spite of Freud's sharp opposition to Marxism, attempts are made repeatedly to unite the two. Fromm, who moved in the Social Democratic circle of Horkheimer in Frankfort before coming here, spoke quite frankly in his German writings of the "enrichment" of historical materialism by psychoanalysis. Wilhelm Reich in that period also made an attempt to synthesize Freud and Marx, with unhappy results, and has since given himself up completely to a hodgepodge of mysticism called sexo-economics. Osborn made another attempt a few years ago in his Freud and Marx, which carried a laudatory introduction by John Strachey. It is instructive, in retrospect, to read Strachey's plea, "Today, however, an increased emphasis should, surely, be laid on the subjective, dynamic factors innate in men." In addition the review of Horney's Self-Analysis in this magazine gave it almost unqualified praise. "Dr. Horney," the reviewer wrote (Science & Society, VI [1942]), "has tackled the problem of what the individual can do about himself, for himself and by himself with that same courage and originality that distinguished her first two books … [The present volume] offers a methodological approach which diligently pursued under favorable conditions, promises to help develop one to the full of his potentialities."

It is no accident that psychoanalysis never attracted a following in Soviet Russia. Dmitri Mirsky ridicules the Bloomsbury intellectuals who become intrigued by their own minutest inner experiences, and record their dreams every night, in his The Intelligentsia of Great Britain. Soviet psychology is oriented around the unity of activity and consciousness. "In concrete activity, in work, in adult social practice, in child-training and education, mental characteristics do not only appear, but are formed." This is the formulation of S. L. Rubinstein ["Soviet Psychology in War Time," Philosophy and Phenomenological Research, Vol. V, December, 1944].

Horney let the cat out of the bag when she declared in her New Ways that "analysis helps the patient to realize gradually that he is following the wrong path in expecting happiness to come to him from without, that the enjoyment of happiness is a faculty to be acquired from within.…" A progressive psychiatry, it seems to me, should teach on the contrary that the individual is nothing, and achieves nothing, by himself alone.