The Question of Lay Analysis
Freud wrote The Question of Lay Analysis as an occasional piece in support of one of his friends, Theodor Reik, who had been accused of practicing medicine illegally (he was not a physician). He cast it in the form of an informal conversation with an "impartial interlocutor," probably Julius Tandler, the Viennese city councilor for welfare, with whom he had in fact discussed the Reik case.
The question of "lay" analysis had been of concern to Freud and his students for a long time because not all of them were physicians. The gap had progressively widened between those who, like Freud, felt that sound training as an analyst was all that mattered, regardless of any previously acquired diplomas, and those (particularly Abraham A. Brill and the Americans) who, considering analysis to be a medical discipline, wanted to prohibit non-physicians from practicing. Ernest Jones launched a major survey of the analytic community before the Innsbruck International Congress in September 1927, at which twenty-eight contributions on the subject were discussed without any agreement being reached. Freud wrote a "Postscript" for the occasion, maintaining his claim that analysis could be practiced by non-physicians.
Freud opens the imaginary conversation of The Question of Lay Analysis by describing disorders for which the ordinary physician can offer no real help, then proceeds to outline the methods of free association, dream analysis and so on, which seek to shed light on unconscious processes. He provides his putative interlocutor, whose supposed criticisms and questions frequently punctuate the exchange, with some notion, from the dynamic point of view, of his structural theory of the mind, of the instincts and, from the economic point of view, of repression and anxiety, of childhood sexuality, of the Oedipus complex, and so on. This metapsychological overview is followed by an account of the procedures of analytic therapy (transference, resistance, and the art of interpretation). Neither general medicine nor psychiatry prepares the physician for any of this, Freud declares; they may even constitute an obstacle. Special training is required, beginning with a personal analysis, without which even a physician may be no more than a quack. Any legislation on the subject would therefore be more of a hindrance than a help. Freud therefore concludes that analysis may perfectly well be practiced by non-physicians. Such an analyst would nevertheless need the help of a physician, prior to the analysis, in order to settle diagnostic questions or, in the course of the analysis, to take over in the case of disorders beyond the scope of the analyst: but the same holds for the physician analyst. Freud concludes by tracing the program of what the ideal analytical training might involve (p. 246).
This work has had considerable influence on the debates that continue to this day on the "question of lay analysis" and the training of analysts. On the whole—though with noticeable variations from country to country—the International Psychoanalytical Association has adopted Freud's position.
- Freud, Sigmund. (1926e). Die Frage der Laienanalyse. Unterredungen mit einem Unparteiischen. Leipzig-Vienna-Zurich, Internationaler Psychoanalytischer Verlag]]
- GW, 14: 207-286
- [[The question of lay analysis. SE, 20: 177-250.
- ——. (1927a). Nachwort zur Frage der Laienanalyse (1926e). Internationale Zeitschrift für Psychoanalyse, 13: 326-332]]
- GW, 14: 287-296
- [[Postscript: The question of lay analysis. SE, 20: 251-258.