I
It appears to me that the title of this treatise may require an
explanation. Let me, therefore, state that the problem of Lay-Analyses
expresses itself most succinctly in the question of whether medically
untrained laymen should be permitted to practise psychoanalysis.
This problem, timely in general, is subject to national laws.
It is a timely question, in so far as, up to now, apparently nobody ever
cared who was practising psychoanalysis. As a matter of fact, too little
attention was paid to the question into whose hands the employment of
this new science was entrusted, with unanimity prevailing only in
reference to a more or less strong tendency to wish that nobody at all
should practise psychoanalysis. There were different reasons for this
well-nigh general aversion.
The demand, then, now put before the legislatures of certain countries,
that only physicians be permitted to apply psychoanalysis proves that,
after all, a new, and apparently more tolerant opinion is becoming
prevalent, as regards the recognition of our science. This new trend of
putting the stamp of official and scientific approval on psychoanalysis,
by reserving the monopoly of its application to medically trained men,
must, however, first successfully clear itself of any and all suspicion
of being nothing other than just a modification of the resistance
hitherto shown towards psychoanalysis. Today, at last, it is admitted
that, under certain circumstances, psychoanalytical treatment is in
order. However, if it is to be applied, certain countries stand ready to
impose the restriction that licensed physicians only shall be permitted
to administer this treatment.
The problem before us right now, then, is why only physicians should be
permitted to practise psychoanalysis. This is a problem subject to
national laws. In the United States and Germany, for example, this
problem does not amount to more than just an academic discussion,
because in these countries a patient may receive treatment from anybody
he chooses. In these countries, anybody who feels the inclination may
treat, as a “quack” to be sure, “cases,” provided he stands ready to
assume full responsibility for the effect of his treatment. Not before
the authorities are actually appealed to to retaliate for such tangible
harm as a patient may have suffered from the hands of an unlicensed
practitioner of psychoanalysis, does the law interfere in the United
States, Germany and many other countries.
In Austria, however, where I am writing this treatise, bearing in mind
the special conditions which prevail there, in regard to the
administration of psychoanalytical treatment, the authorities employ the
law of the country as a preventive. In my country, without considering
ultimate results, the law, in sweeping restrictions, enjoins all and
sundry laymen from treating ailing people.
In the Republic of Austria, therefore, there is a very practical aspect
to the question of whether laymen should be permitted to treat ailing
people with psychoanalysis. As a matter of fact, under present
conditions, this question seems to be settled since it is already
answered by the wording of the law, now appearing on the statutes of my
country: Nervous people are unquestionably sick people; laymen are
doubtlessly no licensed physicians; psychoanalysis is a remedy for the
healing, or improvement, of nervous disorders. As in the eyes of the
law, the latter are considered diseases and the treatment of all such
ailments reserved for licensed physicians exclusively, laymen are liable
to severe punishment when employing psychoanalysis for the treatment of
nervous people.
In view of this plain state of affairs, one scarcely dares to approach
the question of permitting the laity to practise psychoanalysis in
Austria. However, in spite of the obviousness of the situation as a
whole, there are some additional aspects to the question which, albeit
the law does not take cognisance of them, should nevertheless be
considered.
It may develop that in connection with psychoanalysis, people in need of
treatment are not sick people, in the broad meaning of this term; laymen
not always to be considered laymen, nor physicians what physicians are
generally supposed to be—the very premise upon which these physicians
base their claims. If such a state of affairs becomes apparent, it would
be justifiable to insist upon a modification of the law, prohibiting the
unlicensed practise of medicine, as far as the application of
psychoanalytic treatment is concerned.