Marilyn S. Jacobs, PhD

I will begin by thanking Ambassador Nowotny and her Embassy staff for arranging this wonderful and singular event. It is an honor and a privilege for me to be here today.

Earlier this year, an Op Ed column in the Los Angeles Times asked the reader to “…imagine a day without Freud …” (because) “… Freud is everywhere …” [1]

This is an apt conclusion and obviously not restricted to the vibrant community of psychoanalysis in Los Angeles.

A Google search this very morning of “Sigmund Freud” returned more than 800,000 results. “Sigmund Freud: 150^th Anniversary” returned more than 3800 results.

Amazon.com lists over 31,000 books on the subject of “Freud”.

Reflection upon the legacy of Sigmund Freud reveals a dichotomy. The legacy has been described as “the central imagination of our age” by Harold Bloom and “a whole climate of opinion” by W.H. Auden. Freud’s theories about human nature have been the cornerstone of clinical mental health practice for over 100 years. Yet, there has also been a powerful debunking of Freud’s ideas. As Peter Gay has noted “… there are no neutrals in the Freud wars”. Criticism has proliferated. This ranges from Wittgenstein’s view of psychoanalysis as “fanciful pseudo-explanation” to Janet Malcolm’s conclusion of the paradoxical “uselessness of its insights”.

As mental health professionals, the clinical problems we encounter in the 21^st century are increasingly more complex, complicated and intractable. We often feel powerless at the profound suffering we encounter. Although we benefit from breathtaking advances in science and technology, these advances often obfuscate our abilities and create new difficulties. We also face increasingly incomprehensible obstacles to human welfare. We struggle with the effects of globalization and economic instability, war, terrorism, ethnic strife, genocide, human rights abuses, social dislocations, environmental damage and unprecedented cultural shifts.

The biobehavioral and social sciences, the realms from which these problems can be solved, favor empiricist methodology, conscious control, symptom reduction and behavioral change. These approaches are not always helpful to the issues at hand. Understanding the unconscious, phenomenology, context, meaning structures intersubjectivity, non linear systems and relationality – approaches which could help -- are largely sidelined.

Thus, the challenge of clinical treatment in the 21^st century is to reintegrate psychoanalysis to the larger society. The four organizations represented here today have begun this task with considerable success. But there is a long way to go.

There is a great deal of optimism and a basis upon which to build. Psychoanalysis has undergone beneficial shifts since Freud and the first generations of psychoanalysts. A pluralism of rich ideas now informs psychoanalytic theory and practice. New roles have emerged. Many social institutions have taken notice. There is a revitalized creativity in understanding mental life.

I can speak personally to this undertaking. For the past 15 years, I have worked to integrate psychoanalytic thinking into a highly technological medical subspecialty at an academic medical center. While I was initially met with skepticism, wariness and unfamiliarity; (based largely on the absence of psychoanalysis from medical school curriculums), my efforts have been successful at gaining trust, interest and respect. My most compelling argument is the outcome; in the end, psychoanalysis is effective with medical patients.

We can foster renewal in the application of psychoanalysis to clinical work by redoubling our efforts at building bridges with the major social institutions. These would include of course medicine, but also education, child care and the legal system. We will want to stress how we do not want to replace other traditions (such as cognitive behavioral therapy) but add to them.

Our task is to build on the genius of Freud’s work while appreciating its limitations. We will also have to move beyond the Freud wars. We have the potential to make a change in our society and our world. We would be helped in this by thinking in terms of Karl Weik’s theory of “small wins” [2] insofar as psychoanalysis is concerned; and avoiding the hubris of ambition and overarching finalities.

Freud may be everywhere, but in clinical practice, he is not there nearly quite enough.

[1] Daum, M. (May 6, 2006) “Man of Our Dreams”, Los Angles Times.

[2] Weick, K.(1984). Small wins: Redefining the scale of social problems. American Psychologist 39(1), 40-49.