By Michael Darer
Mental illness and the treatment surrounding it has always had a complicated place in American society. The spectre of madness–as some might have called it– has been around for centuries, going by numbers of informal names, and treated through numbers of untested methods. Despite periods of misunderstanding, fear, and disinterest, however, questions of sanity and mental health have long had a position in American culture.
In the mid-20th century, however, that position solidified.
As bedlam spread throughout the European continent in the 1910s and 1920s, increasing numbers of emigrants made their way over to the United States. Among them, were many practitioners of psychoanalysis, which had taken off in Europe under the auspices of professionals such as Freud and Jung. Years later, as the Second World War raged, psychoanalysis further entered the public consciousness as a medical necessity for those subject to the immense violence of combat. With each new application, notions of mental healthcare, mental illness became increasingly embedded in the fabric of literature and art. In 1940s New York City, this was especially true. Hordes of authors, scholars, and medical professionals helped hone and explore the discipline, and–as a result–the increasing influence of psychoanalysis became clearer in Manhattan than anywhere else in the country. There, the discussion was sharpest, motivated by artistic, political, and social conversation. The chaos of the early 20th century was crucial to the development of an American mental healthcare system, which grew alongside the political and cultural concerns of the nation itself, becoming simultaneously more popular and more culturally scrutinized in the wake of the second World War.
Part I: Psychoanalysis, Psychiatry, and the Interwar Years
It was in the 1920s that psychoanalysis first truly gained cultural traction in America. The study of psychiatry had been around for years, at this point, practiced with various techniques and results. The American Psychiatric Association had been founded in 1844. But this old American psychiatry was more often than not ignored. For many, it was by turns barbaric and boring. Even as the field grew it remained within its niche, a medical focus for medical men dealing the uncomfortable incurable realities of “madness.”
Alternatively, psychoanalysis was something new and glamorous. In its language and its iconography it seemed far more civilized, lively, and urbane. For the past two decades, Sigmund Freud–as well as many others, including his protege Carl Jung–had helped establish the field of study in Vienna. By 1910, psychoanalytic institutes had begun springing up across the continent, including in Moscow. America, for the most part, was experiencing an economic boom in the wake of the first World War, and wealthy Americans now had the opportunity to indulge in all sectors of their lives, and psychoanalysis–so far removed from the violent dingy images of old American psychiatry–seemed like the headiest of indulgences.
For wealthy Americans, psychoanalysis (a term first used by Freud in 1895) was now seen as a cosmopolitan luxury, a fascinating indulgence that carried with it both supposed medical benefit and the aura of culture. There was a “sheer passion” for the study now in the states, argues Lawrence Samuel in his history Shrink.According to Samuel, by the 1920s, Freud was the most famous scientist alive, with the possible exception of Albert Einstein, and for many, the 1920s was an “age of psychology,” a turning point in the social currents of human history. “The belief that human history could now be divided into pre-Freud and post-Freud was almost universal,” Samuel continues. “Many believed that Freud’s cracking of the psychic code was every bit as significant as any prior breakthrough in biology, chemistry, physics, or astronomy.”
This excitement was only heightened by the growth of psychology that accompanied its spread. The psychology that captivated America after World War I was being referred to as a “new psychology,” and encompassed a significantly broader range of interests than early excursions into the workings of the mind, even those of Freud himself. Certainly, Freud’s writings on sexuality, and Jung’s on free-will were much of the basis for psychology’s initial jolting appeal, but the public conception of psychoanalysis was no bigger than it had ever been before. Freud and Jung, themselves, had visited Massachusetts’ Clark University back in 1909, but despite the momentous response to their lectures, it wasn’t until a decade later that their study moved from academic interest to cultural fascination.
Part of this was due to the time it had taken for psychoanalysis to gestate and expand in American culture, but part of it was very much of the moment. “In the 1920s, the new psychology was of great interest because of its relationship to the cult of the self in which Jazz Age Americans were caught up,” posits historian John C. Burnham. The exuberance and extravagance of 1920s America was founded on the primacy of the individual: his or her victories, desires, and celebrations. As such, the self was the lens through which much of America saw itself. Now, it wasn’t just the patient on the couch being analyzed, but the world at large: films, literature, music, the living, and the dead. In 1920, Van Wyck Brooks published his Ordeal of Mark Twain, in which he held the works of the author under the psychoanalytic lens, using them to draw conclusions about Samuel Clemens’ relationship with his mother. Three years later in The New York Times, writer Thomas L. Masson wondered how the teachings of Freud might have informed the work of writers in the past: “We cannot help but wonder what would have been the effect on Charles Dickens if…he had taken a course in Freud, or how…Shakespeare would have dealt with the character of Hamlet.” For many, psychoanalysis was now as fundamental as any in physics. It was the newest element, the way by things would always move, or, failing that, how they would have if they had been blessed with the insight of this new Viennese sorcery.
This fascination was, of course, not without its opponents. Throughout its history, psychoanalysis was dogged by a whole swarm of criticisms. Some saw it as godless, or impure. Freud’s fascination with sexual mores was off-putting to many in Europe and America, alike. In the States, others still thought that to attempt to penetrate the psyche was a sort of heresy–a privileging of the mortal mind over the immortal soul. As psychoanalysis became more and more prominent, and more and more intellectuals joined the flock, the certainty among detractors that there was an implicit if not explicit arrogance in the cataloguing and unpacking of human compulsion and desire became ever stronger. It was indulgent. It was immoderate. It was lascivious. The charges went on and on.
These criticisms only gained traction when, in 1929, the American Stock Market crashed, plunging the nation into the Great Depression. As businesses rapidly closed, souplines wound down sidewalks and around corners, and rumors of brokers plunging from upper-story windows spread through cities, Americans looked left and right for something to blame. For many, the culprit was overindulgence. Citizens in urban and rural communities alike considered the Stock Market Crash to be the fault of the wealthy, who has spent frivolously. The glitz and excitement that had been lusted after by many in the ‘20s was now scorned and disowned.
Of course, then, those charges against the fancy new European treatment, exported to intellectuals and urbanites could now take hold. Often repeated was the story of Stanley McCormick, the millionaire heir to International Harvester whose mental illness was undented by the waves of psychoanalysts hired to help in. In 1930, his family hired a traditional psychiatrist, and McCormick was said to quickly improve. Stories such as this brought increasing waves of criticism from the psychiatric community, much of which believed that psychoanalysis was the style-over-scientific-substance cousin of their own field. George H. Kirby, the then-president of the American Psychiatric Association said in 1934 that, while he respected the field of psychoanalysis and its value, its application was limited beyond investigation. Kirby was wary of “parlor psychologists,” who he believed obscured and drowned any of the scientific utility of the practice with enticing flair and empty showmanship, as a “way of entertaining suburban ladies.”
This concern was especially potent when directed at the way in which the terminology of psychoanalysis had been appropriated outside of the field. In 1924, in response to a New York Times pan of the Boston Symphony Orchestra’s performance of Igor Stravinsky’s “The Rites of Spring,” the paper was sent a response from a reader in Franklin, Massachusetts, who explained to the reviewer that Stravinsky had meant “to draw the thing out of the unconscious,” but that the critic musn’t worry, for certainly others, too, had missed the point. Exchanges such as this one were demonstrative of how, over the past decade, the language of psychotherapy had tried to commandeer nearly all aspects of American life through its wanton analysis. In the wake of the Crash, that just seemed foolish and arrogant. In 1931, one of the nation’s top psychoanalysts read at the American Psychiatric Institute from a paper entitled, “Lincoln as a Humorist.” Brill determined that Lincoln had been a “schizoid manic personality.” He argued that Honest Abe was split between the brutish cruelty of his father and the soft kindness of his mother. The fact that the president occasionally told dirty jokes demonstrated that he was latently sexually aggressive. It was a disaster.
Jacob Moreno of Vienna deemed the paper “necroanalysis” and argued that the psychoanalytic field did not have the ability to draw the conclusions that Brill had with any degree of certainty. Many in the almost riotous crowd at the reading deemed Brill’s paper insulting: psychoanalysis as slander. More so than that, however–with the field so under fire from those who were repulsed by its tendency for seeming pretension and lewdness–it was psychoanalysis as self self-parody. The ultimate proof that this field was simply another empty arrogant luxury, divorced from the actual needs, wants, and struggles of Americans.
At the same time, psychoanalysis faced threats from within its own fold, as medical professionals attempted to reshape the ways in which doctors went about understanding the individual. In 1932, Adolf Meyer of John Hopkins University gave a lecture at the New York Academy of Medicine in which he proposed an adherence to the “broad psychobiological principle of considering the whole man…rather than the elusive subconscious.” Meyer’s psychobiology spoke to many of the same concerns that Moreno has voiced in the wake of Brill’s reading, albeit from a slightly different angle. Many believed it was time to end the fascination with the limited abilities of psychoanalysis, and to integrate it back into a more complete medical understanding of the human creature. Psychoanalysis on its own looked to be overstepping its boundaries, forgetting its place. Meyer and his comrades were more interested in the scientific benefit than the cultural currency, and so psychoanalysis cast no spell for them.
If Americans were privy to these internal concerns, though, most paid no mind. Even though far fewer could afford psychoanalysis in the clutches of the Depression, the fascination still lingered. In the pages of the New York Times, writers battled against one another over the prominence of the phenomenon. Was it good for America? Was it simply a fancy chased for far too long? Either way, psychoanalysis captivated the nation well past the point at which it seemed as though the fancy had been thrown aside.
It was not just in America, however, that the values and mechanisms of psychoanalysis were being examined and upended. In Europe, massive governmental shifts had been underway since the late 1910s, and the social fabric of these changes spread generously into the study of the mind. As Eli Zaretsky writes in his text Secrets of the Soul, “fascism and communism challenged the liberal separation of the public from the private, albeit from opposite directions.” As the Russian Revolution brought the Bolsheviks to power in 1917, and World War I brought about the rise of fascism in Italy and Hungary, psychoanalysis became an unwitting political battleground.
Under the auspices of fascism, psychoanalysis became the fascination of another cult of the individual, far different from that of the American Jazz Age. In countries such as Germany, which saw the proliferation of Nazism beginning in 1933, psychoanalysis gestured towards the greatness of a single mind. It was a celebration of the genius and individuality of the leader, the crowning supreme self. In Freud’s writing, this harkened back to the image of the hypnotist, and those living within increasingly fascist nations began to use the psychoanalytic current for both conformity and rebellion: the ruler as the deceiver and manipulator; the ruler as the psychological ideal.
In those nations that underwent communist revolutions, psychoanalysis was equally prized. For many, it codified the notion of the individual as set upon by the outside world, shaped by and subject to the forces of trauma. In those countries where public and private separation was seen as an outdated oppression, psychoanalysis was used to explain the long complacency of the abused populace. The hypnotist was capitalist. The hypnotist was the social, political, and economic voices that kept the proletariat under the boot of their slavemasters. Psychoanalysis was explanation and liberation.
Of course, despite this integration, not all of psychoanalysis was welcome, nor were all its practitioners. When the Nazis took control of Germany in 1933, Freud’s books were among the first burned. Meanwhile, the state decried the “Sexual Bolshevism” is saw in some strains of psychoanalysis. In 1938, when the German state annexed Austria, Freud was forced to flee to England, where he lived until his death, roughly a year later. The communists were no more accepting of some of psychoanalysis’ more controversial theories. Across Europe, it was consistently seen as a field of immense power, necessary to both harness and suppress. This stood in stark contrast to the debate across the Atlantic, where is seemed as though America struggled to decided whether psychoanalysis was a study to respected at all, much less feared. Still, as intellectuals fled to America from fascist and communist regimes, they brought with them the academic developments of their study, and sometimes the seeds of a paranoia that would in later years further complicate the American relationship with the European fascination.
For the remainder of the 1930s, though, America seemed content to squabble professionally and privately about whether psychoanalysis was a fad, while psychoanalysis quietly proved its adaptability and endurance. In fact, it seemed that the very versatility that had made so many uncomfortable with psychoanalytic discussion of art and politics, was what allowed the study to endure all of the criticism and professional restructuring that was rained down in the Depression years. The language of psychoanalysis quietly made its way over to the other most recent American fancy: film. Meanwhile, across the country a number of psychoanalytic centers of study were erected, including one in Chicago in 1932, and many others following. In 1936, Bellevue Hospital in New York City conducted a moderately successful program of group-psychoanalysis, in hopes that the results would be strong enough to support a sort of psychiatric New Deal. Only eleven of the fifty-one were deemed “cured,” but an additional sixteen were, “relieved.” The New York Times reported the results as a cause for celebration.
In coordination with these victories, psychoanalysts turned further towards popular writing, publishing volumes and volumes of psychoanalytic takes on everyday problems and questions. Karen Horney–a prominent analyst and author of the day–wrote about things such as “boy fever” and even confronted and debated many of Freud’s original ideas and principles, particularly in her 1939 text, New Ways in Psychoanalysis. For Horney, psychoanalysis was new and American, and destined to endure and evolve.
But there were still those who seemed determined to undermine the tenuous hold that psychoanalysis had managed to reclaim. A number of American psychiatrists became increasingly brazen in their criticism of the study as foreign, European, and un-American. Others still seemed concerned that the methods used were, at best, unsuccessful and, at most, harmful. Gert V. Gontard, a European journalist, was critical of the old-world trickery he saw infiltrating his new home. He railed against psychoanalysts for turning virile American men into neutered boys, and claimed that psychoanalysis had–packed within it–all the evils of fascism and communism, exported from a crumbling Europe to the shores of an unsuspecting America. While others did not take their concerns quite so far, in 1941 The Chicago Tribune called psychoanalysis the “fashionable refuge of neurotics for the past decade. Chiming in, many psychiatrists wanted their rival to know it had worn out its welcome.
At the same time, the psychiatric institution began to suffer, even as it continued to criticize its fellows. Just like psychoanalysis, psychiatry was less affordable in the wake of the Depression, and seemed considerably less profitable to those young men and women who were or had considered college. As psychoanalysis had eclipsed psychiatry in the 20s, and the Depression stifled both in the 30s, it became harder and harder for even established psychiatrists to find work, especially within university systems. Still, the number of PhD psychiatrists had managed to increase in the 20s, and that only intensified the struggle to find employment. Most turned to nonacademic posting. Furthermore, this led to a total restructuring of the process of receiving a PhD in psychiatry, as professionals attempted to slow the flow of newly licensed young men desperate for work. Over the course of the decade, numerous professionals closed their practices, some choosing not to return even as the field rebooted in the 1940s. Even as the field made in-roads on new and improved treatments (including the use of insulin as opposed to electricity in shock treatments in 1936), the economic conditions made it hard to achieve a major turnaround. Despite its institutional history and self-certainty, psychiatry fared little better than psychoanalysis during the Depression years. While psychiatry remained established and respected, it proved increasingly unpopular in the cultural imagination, not nearly as adaptable as psychoanalysis, which–on the other hand–accomplished far less in treatment, while still remaining a lively part of discussion. As it turns out, however, both would be rescued, along with America, by the same great cataclysm.
Part II: World War II and the Revitalization of Psychotherapy in America
In May of 1939, a reunion was held in New York City, attended by a number of prominent psychologists. These men had all served in the first World War, and the gala was meant to commemorate the demobilization of its guests twenty years earlier. The organizer of the party, Walter Bingham–who was also the president of the New York Association for Applied Psychology–had been looking to rebuild the military psychology network for years, and this seemed like the perfect occasion. The army sent a lieutenant colonel from the Adjutant General’s Office to the gathering, possibly interested in the exact same cause.
By the time the second World War broke out in Europe, the forces that powered it had already upended psychoanalysis in Europe. Jewish professionals had been forced to flee their homes or face the unknown wrath of the German state. The Soviet Union had made sure that only very specific types of psychoanalytic material could be published. Across the continent, it seemed as though the practice might very well have to start once more from the ground up once the rubble from the war was cleared away, and yet no one knew when or how this new Great War would end.
Four months after Walter Bingham’s gala reunion, the American Psychological Association (not to be confused with the American Psychiatric Association, this APA was founded much later, in 1892) and the American Association for Applied Psychology held their joint meeting. Just the previous day, Britain and France had declared war on Hitler’s Germany in retaliation for the Reich’s invasion of Poland. The men gathered at this meeting appointed emergency committees, and waited for the call to national service. Within the next five months, the two bodies had merged.
In contrast to those working in fields of study such as physics, psychologists and psychiatrists were always some of the last to be approached in war time, and never quite got the same level of comprehensive government support. The reasons for this were somewhat obvious to the members of the profession, whose specialities were not nearly as concrete or seemingly applicable as those other scientists who would later be enlisted to work on projects such as the Atomic Bomb. Still, the psychiatric and psychological profession had what no other scientific discipline did: a claim on the mindstate of the soldier, and this would always eventually bring military personnel looking for support. In the meantime, psychologists, psychiatrists, psychoanalysts all had the chance to organize and mobilize their profession while they waited, better than any other collective. By the time they were sought out, they were always ready to go: structured, disciplined, and committed to the task.
Starting as early as 1939, psychiatrists and psychologists were being contacted and contracted by the military. In the summer of that year, the American military had a standing army of 174,000 men, which President Roosevelt quickly increased to 227,000 as a provision of a limited state of emergency. Following this increase, it became immediately clear to the military that they would most likely find themselves adding many more troops and personnel in the months to come, and as such, would need to revamp their testing procedure, which had not changed since the demobilization following World War I. Walter Bingham and others were quickly approached, and soon found themselves employees of the United States Military, once more.
Part of the main task given to psychologists at the time, was the development and reformation of the Army General Classification Test, which was used to determine the intelligence, psychological fitness, and general military aptitude of commanders within the United States Military. At the time, military brass believed that–because of the storm of psychoanalytic and psychiatric fascination in the last decade–the test could and should be updated. One of the major developments in those interwar years had been the growing popularity of Intelligence Quotients (I.Q.s), and so this became quickly integrated into the AGCT, as well as other examinations re-assessed by the military in the next two years.
Until 1942, the general use for the military psychologist remained administrative. Professionals were distributed to each branch of the United States military, including the Air Force, which had yet to achieve the sort of rigor and standardization of those more established branches. There, a number of psychologists, once again, went about overseeing the development of qualifying examinations.
By the time the United States entered World War II, the psychiatric and psychological establishments were well-entrenched in the military fabric, and organized to optimize treatment for soldiers and assessment of recruits. Professionals were distributed to hospitals and bases, while others remained in the country, assisting with the notification of casualties and limited counseling of newly made war widows. All the while, they worked to hone their study, working with the military to develop increasingly new ways to distribute information, attend to soldiers, and refine the field.
Psychology for the Fighting Man appeared in the summer of 1943, and quickly spread throughout the nation and the world. It was popular in New York bookstores and Allied post-exchanges alike, and offered an overview of the study as it applied to the American combatant. For the soldier, it offered twenty short chapters–designed to be read in any order–focusing on things such as “Morale,” “Sight as a Weapon,” “The Right Soldier in the Right Job,” and “The Differences among Races and People.” For the reader back home, it seized upon that old fascination, now reenergized through the growing zeitgeist of the American war effort. The book was a hit, selling 400,000 copies by the end of the war. Publications such as The New York Times gave it positive, if bland reviews, perhaps still sore from the deluge of pop psychology books that had inundated bookstores in the last two decades.
Perhaps one of the most exciting professional developments of the war, though, was the refinement of clinical psychology, which, until the mid-1940s had yet to achieve any sort of secure place in academic psychology. Certainly, in the 1930s, the study was beginning to be codified in textbooks and graduate programs, but it was widely regarded (along with social psychology) as a lesser division of the practice. This all changed with the war, however.
In June of 1941, the National Research Council recommended the use of a number of clinical psychologists by the Army Medical Department. It would be another year until these men were actually assigned–6 in all–to the Sanitary Corps, but they were immediately sent to hospitals around the country. In 1943, when psychoanalyst William Menninger of the Menninger Foundation in Kansas was appointed chief of the Neuropsychiatry Branch in the Office of the Surgeon General, he ensured that the numbers increased. Using funding and personnel from his own facilities, Menninger to reorganize the military divisions, adding clinical psychology to the official roster, alongside psychiatry, neurology, and preventative psychiatry. By August of 1944, 8 months following his appointment, Menninger received requests for 213 additional clinical psychologists in the field.
This is not to say that World War II was devoid of any professional tensions. When Menninger was originally appointed there was a small but potent outrage among psychiatrists who believed that the chief of the Neuropsychiatry Branch should be an actual psychiatrist. At the time, the professional divisions between psychiatrists and psychoanalysts remained potent, only perhaps mitigated by the fact that the army had had very little interest in hiring many psychoanalysts to begin with. These tensions were further eased by the few working psychoanalysts who seemed to treat patients without causing any irreparable harm. Perhaps it was a tolerance more than a peace, but after a while it seemed as though psychiatrists became disinterested in harassing the few employed analysts, and worked quietly alongside them, professional resentment and all.
The best examples of this partnership across professional lines came with the study and the treatment of “shell shock.” As a diagnosis, “shell shock” was difficult to pin down. In modern terms, it relates most closely to Post-Traumatic Stress Disorder, distanced from its contemporary sibling “battle fatigue” by the presence of intense and petrifying visual and auditory hallucinations. Still, it seems as though the terms were used somewhat interchangeably by both soldiers and commanders, for whom both quickly became a type of vernacular. This was only complicated by a third term, “postconcussional syndrome,” which was employed by the British military, after they chose to ban “shell shock” in favor of something more clinical.
In cases of shell shock, psychoanalytic treatment was relatively routine. The patient would be sedated, and then asked to describe their experience, as well as whatever entered their head. When they came around, the analyst would read his notes back, and explain to the soldier how he had painted his experience, and how he had answered additional questions in light of the memory. The conclusions drawn from these sessions were undoubtedly psychoanalytic, but they were far different from those that might have been offered by the Freudians of the 20s and 30s. British physician and psychoanalyst Roland D. Fairbairn, for instance, likened the traumatic results of shell shock to an intense homesickness: he claimed they were caused by separation anxiety. For Fairbairn, this was the explanation behind some of the memory loss and violence that followed in the wake of shell shock. Soldiers, trapped in their subconscious were trying desperately to escape the hostile world of war, and return to their families in the peaceful past. Hence the forgetting of regiment numbers, and the names of war buddies. Hence, the desertions. Hence, the tragic suicides. Supplementing this psychoanalytic approach, psychiatric professionals worked tirelessly to figure out how to treat these traumatized soldiers, chemically. The sedatives used in session were carefully chosen by psychiatrists, and military psychopharmacologists strove to perfect treatments, even as to this day drug therapies remain imperfect for sufferers of PTSD.
Still, the results of this treatment were often cause for celebration, and as a result psychoanalysis seemed back on the rise. In 1944, Columbia University established both a psychoanalytic and psychosomatic clinics, continuing to establish New York as the center of the psychiatric and psychoanalytic worlds. A year later, in 1945, the New York Psychoanalytic Institute organized a fundraiser with the aim of accumulating three hundred thousand dollars to help veterans “affected by neuroses” who could not afford treatment. The gala dinner at the Waldorf-Astoria attracted more than six hundred generous donors, who quickly helped the NYPI surpass its goal.
By the time World War II began to draw to a close, it seemed as the whole of psychotherapy had been revitalized. Psychiatrists and psychoanalysts alike returned to practices overflowing with prospective clients. Once more, the American appetite for the psychological loomed wide, but now that appetite was slightly different. In the years during and following the second World War, Americans seemed more attuned to the questions that psychotherapy dealt with. While, in the past, psychoanalysis had seemed to exist in a vacuum for the wealthy and the curious, the psychiatric profession was now inextricable from the visible psychological violence, wrought by the second World War. For every heroic erudite analyst, there were one hundred broken and terrified men, back home, trying to adjust to the new chaos of victory. The fascination was back, but it was a more critical and keen fascination than before, one that seemed interested in mental illness and mental healthcare far more so than the Freud fanboys of the 20s and 30s. Now, the stakes, the discussions, and the culture seemed more real than ever.
Part III: Trauma, Literature, and The Hospital in Postwar New York
By the end of the Second World War, the psychiatric profession was subject to a whole new litany of praise, and a new species of scrutiny. Certainly, some of the old criticisms still applied, and the Catholic Church, in particular, had continued to beat the drum of psychoanalytic indecency. Many families were uncomfortable with the idea that their sons would be subject to the questionable morals of psychoanalysis while overseas, fighting for God and country. They echoed the sermons of Gert Gontard, demanding that psychoanalysis not make boys of America’s men.
For many, this last claim took on dark resonance when veterans returned home. Many families who now greeted their sons had never seen the toll that war took on the mind. The psychoanalytic institute braced for the next wave of criticism, but it didn’t quite come. Catholic leaders still railed against the indecency of Freud’s oversexed writing, but their criticisms were overcome by both the celebrations of V-E and V-J Day, and the mourning for the losses that settled in soon after.
In the years following the war, combat trauma became one of the most discussed aspects of the psychiatric profession. It became the way in to the discussion of mental illness that much of the country had long lacked, and New York, which now positioned itself as a Mecca for mental health–crowded with private practices, hospitals, and research centers–became an artistic centerpiece for that discussion. In many ways, Manhattan was the floorplan for the New America in the wake of the war. Architecturally, culturally, and politically the city moved dynamically forward, trumpeting its own battle cry into the next half-century. The same was now true for psychology. In the 1940s, Leopold Kleiner, a Manhattan architect advertised that he would be designing homes specific for introverts and extroverts. “Unless the places in which people live and work are designed to conform to their psychological make-up,” he said in 1949, “they will be unhappy.” Kleiner called this “psychodesigning.” Architecturally and culturally, it was the new force at work in Manhattan.
If Leopold Kleiner strove to remake New York in the image of postwar sanity, author J.D. Salinger was the perfect example of the postwar insanities that haunted many of Manhattan’s citizens. In the spring of 1942, at age 23, Salinger was drafted into the army. Over the course of his time, he saw combat at the Battle of Hurtgen Forest, Utah Beach, and the Battle of the Bulge with the 12th Infantry Regiment, 4th Infantry Division. In 1945, Salinger was transferred to a counter-intelligence division where his proficiency in French and German might be put to work. That year, he and a detachment entered and liberated one of the sub-camps of Dachau.
After Germany was defeated, Salinger was hospitalized for what he later described as combat stress reactions. It is unclear what he was officially diagnosed with, but his own frequent allusions to sensory hallucinations have led scholars consider shell shock, or modern-day PTSD. Reportedly, Salinger told his daughter, “You never really get the smell of burning flesh out of your nose entirely, no matter how long you live.”
In his biography of Salinger, Kenneth Slawenski argues that much of Salinger’s writing was affected by his experience in the war. Before being drafted, Slawenski notes, Salinger had written a short story titled “Slight Rebellion off Madison,” which he had submitted to The New Yorker in December of 1941. The story revolved around a disaffected teenager in New York City named Holden Caulfield, who, at one point, alludes to his “pre-war jitters.” Though the magazine had originally accepted the story, they declined to run it once America entered the war. It was only published in 1946.
For Slawenski, this anecdote provides an interesting bracket for Salinger’s war-writings. Here, Holden becomes a token of anticipatory trauma. It then, makes additional sense to read Holden’s reappearance in Catcher in the Rye (1951) as loaded with postwar trauma. Holden is Salinger, for Slawenski: in both his appearances, an object beset by the anxieties of respective American eras. Of course, Catcher is unsubtley loaded with allusions to trauma and stress. It is an almost ostentatious parable of it.
Catcher finds Holden Caulfield wandering New York City, after leaving school early for vacation. In his time on the street, he encounters classmates, professors, and a smattering of New Yorkers. The two greatest presences in the novel, however, are those of his older brother Allie, who died of leukemia; and James Castle, an ex-classmate who leapt to his death as a result of incessant harassment. Both of these deaths haunt Holden and appear to him viscerally over the course of the novel. At one point, Holden is assaulted by a pimp named Maurice, who socks him in the stomach. Holden, doubled over, goes into a long fantasy about being shot, saying “I’d hold onto the banister and all, with this blood trickling out of the side of my mouth a little at a time. What I’d do [is], I’d walk down a few floors–holding onto my guts, blood leaking all over the place”. It’s an intensely detailed and visceral fantasy that only gets darker when Holden remembers James Castle, whose body he had seen after it hit the ground:
“What I really felt like, though, was committing suicide. I felt like jumping out the window. I probably would’ve done it, too, if I’d been sure somebody’d cover me up as soon as I landed. I didn’t want a bunch of stupid rubbernecks looking at me when I was all gory.”
Holden is haunted by trauma, and by the visuals of his classmate’s body. The idea that there were crowds around, happy to gawk at the corpse of this poor boy, horrifies Holden. It isn’t hard, then, to see how this might resonate with Salinger’s own experience, as a young man tramping through the belly of the German death machine, where the emaciated, twisted bodies of Jewish families were left in mass open graves, or used to festoon the fences and walls of the concentration camps. Much of what haunted the American psyche in the wake of the Holocaust were the visuals. It was the photos and the videos of the concentration camps–the horrors of Auschwitz, and Dachau, and Bergen-Belsen made flesh–that brought the evil home. What terrified and disgusted America was the desanctification of the body, inherent in those images. This is what Salinger witnessed first hand, and what Holden finds himself so torn up about, is a cousin of that memory.
Later in the novel, Holden experiences something similar with his memories of Allie. Crossing the street, he prays to his brother for some sort of protection between blocks: “I’d say to him, ‘Allie, don’t let me disappear. Please, Allie.’ And then when I’d reach the other side, I’d thank him. Then it would start all over again as soon as I got to the next corner.” For Holden, the memory of Allie is something physical, something sensory. His incredulity over his willingness to thank his dead brother affirms this. He knows he’s not reaching out to Allie in the same way some reach out to passed relatives for support. There is some sort of exchange and conversation going on for Holden, something dissociative.
Holden was not the only character Salinger used to explore these sorts of stressors, however. A whole year before Catcher in the Rye was published, The New Yorker featured the short story “For Esme–With Love and Squalor,” which would later be anthologized in Salinger’s Nine Stories collection in 1953. “Esme” is divided into two episodes, centering around Sergeant X (only named in the second episode) and his communication with the title character. In the first of the episodes, Sergeant X encounters Esme in a church in Devon, England, as a member of a children’s choir. The two converse, and Esme reveals that she is an orphan, her father having been killed in North Africa, and her mother in the Blitz. In the second episode of the story, Sergeant X is stationed in Bavaria, suffering from some variant of battle stress, for which another soldier mocks him, saying: “‘nobody gets a breakdown from just the war and all…you probably were unstable like, your whole goddamn life.’”
As the story concludes, Esme sends Sergeant X a package, containing her father’s old wristwatch, which she had showed him when they first met. Incredibly moved, he muses, “You take a really sleepy man, Esme, and he al-ways stands a chance of again becoming a man with all his fac–with all his f-a-c-u-l-t-i-e-s intact.” It’s a far more uplifting ending that that of Catcher, which concludes with Holden in the hospital, wondering whether opening up was worth the pain it caused him. “Esme” on the other hand, is the opposing narrative of trauma: the man who is able to overcome the physical and mental handicaps of war based on the love and support of those around him. For many, that was the postwar narrative that felt most acceptable, if not always most true.
As much as they could, Americans wanted to believe that this new psychology could save veterans from the damage the war had inflicted, and New York City seemed to be the metropolis most suited for this. With the new boom in the popularity of psychiatry, funds flooded facilities and departments at Columbia. Psychoanalysts began publishing more and more, with Karen Horney once again making a splash with her Are You Considering Psychoanalysis?. Horney’s book promised to demystify the process of analysis for its readers, and asserted that psychoanalysis was not just for those suffering from severe trauma, or mood disorders. Psychoanalysis was, once again, becoming a cure-all, the gift of a gradually unimpeachable institution that saved everyone from suicidal manic-depressives to the housewife who was just too disorganized to get anything done. If Are You Considering… positioned itself as a test to see whether psychoanalysis was for you, it was a test with quite a curve. Psychoanalysis was once again for everybody, according to the likes of Horney.
Just as psychoanalysis was reestablishing itself as the people’s therapy, other professionals were arguing that there were greater things to be done with the profession, greater minds to be vetted. Harold D. Lasswell of Yale Law School went before the Association for the Advancement of Psychoanalysis in 1946, and proposed that psychoanalysis be used to vet world leaders, in the same way that it had been used to test military commanders. For Lasswell, psychoanalysis could provide a peek into the minds of all those who held the reigns of the American state, a perhaps invaluable security. Lasswell further argued that as the social taboos of seeing an analyst dissipated, leaders would be far less unwilling to undergo such testing.
While Lasswell was correct that the “middle-classing” of psychotherapy was making an analyst’s appointment far less frowned upon. he failed to recognize the ways in which that was occurring for Americans, and the slant at which it did. In Paths into American Culture John Burnham points out that, while seeing a therapist was becoming an increasingly smaller deal, the American public still clutched dutifully on to the taboos of actual mental illness. For middle-class Americans, it seemed as though mental illness and psychoanalysis were still largely divorced, especially outside of the realm of war trauma, which many believed ultimately curable. As much as treatment began to advance, the popular opinion of treatment seemed to progress catacorner. There were two faces to psychotherapy now: the palatable face of analysis, and the undiscussed face of madness. While the former increasingly became a point of fashion and culture, the latter still remained mysterious and sometimes terrifying.
Perhaps the contrast between these two postwar therapies is best illustrated in the work of Mary McCarthy, who encounters and diagrams both. In her collection of connected short stories The Company She Keeps (1942), Meg Sargent–a transparent stand-in for the author–visits a psychoanalyst, who she picks apart as frustratingly predictable, boring, uninsightful, and bourgeoisie:
“Sometimes it seemed to her that her analysis could never be finished until he could purge himself of the maple furniture in his waiting room, the etching of the cathedral at Chartres that hung above his desk, the subscription to Newsweek that never ran out. Someone had once suggested to her that all this was a matter of policy, that a psychoanalyst in the decoration of his professional quarters aimed deliberately at that colorless objectivity, that rigorous job-lot asceticism that can be seen in its purest form in the residential hotel room.”
McCarthy finds something false in the trappings of the analysts office, which seem to speak more a uniform culture than any sort of personality. To her, they offer no insight, simply giving worried husbands or bored housewives the illusion of peace of mind. They are just as George Kirby had envisioned them.
Starkly on the other hand, is what could colloquially be referred to as the institution, or the hospital. This was the second face of psychotherapy whose taboos had yet to be lifted. In The Group, which McCarthy published in 1963, one of her characters is committed to a psychiatric hospital against her will, by her husband. The novel, which is autobiographical in numerous sections suggests that McCarthy herself was the victim of this sort of treatment.
In The Group, which traces the experience of a group of friends and Vassar graduates (McCarthy’s own alma mater) the character of Kay is the closest McCarthy stand-in, whose husband Harald shares a name (spelling intact) with that of Kay’s husband in the novel. Late in the book, Kay’s friend Polly, a nurse at the Payne Whitney Clinic, Women’s Division is called upon to care for a new patient, who turns out to be Kay. They encounter each other as Kay lies in bed “with a huge black eye and contusions on her bare arms.” According to Kay, Harald was a drunk who was frequently violent and abusive. Kay explains:
“‘Harald said he was tired of my dirty mind, and he hit me. You know, I saw stars the way they do in the funny papers. It was silly, but I hit him back. Then he knocked me down and kicked me in the stomach. What should I have done, Polly? Picked myself up and waited for him to be sorry the next day? I know that’s the right technique, but I haven’t got the patience. I jumped up and ran into the kitchen. He ran after me, and I picked up the bread knife. I purposely didn’t take the carving knife because he’d just sharpened it and I didn’t want to scare him too much…He knocked it out of my hand. Then he pushed me into the dressing room and locked the door.”
The next morning, Harald calls the police, and claims Kay was violent towards him. He has her committed. Though Harald told Kay that she was going to a regular hospital, Polly explains the purpose and the rules of Whitney: “‘They take away everybody’s belt and wedding ring. I’m surprised they let you keep yours.’” Kay is horrified by the levels of surveillance, exclaiming, “‘I gather…that they think I want to commit suicide. They keep peering at me through those slats in the door. Did they expect me to hang myself with my belt?’”
At the end of the novel, Kay is released, but returns a changed person. She dies, falling from a twentieth story window in the Vassar Club, though it is unclear whether she slipped, airplane spotting, or jumped, traumatized by her time in the hospital, and the violence of her home life:
“Kay had been airplane spotting, it seemed, from her window at the Vassar Club, when somehow she lost her balance and fell. She had had two cocktails before dinner, which might have slightly affected her motor reactions. To those who had been seeing her regularly since she had come back this spring, the manner of her death was a shock but not a complete surprise. She had become very war conscious, like many single women. As her friends could testify, she talked a great deal about air raids and preparedness. Ever since the invasion of the Lowlands, she had been saying that it was just a matter of days before America would be in the war. She was convinced it would begin with a surprise enemy air attack; Hitler would not wait for Roosevelt to arm and declare war on him. He would send the Luftwaffe over one night to wipe out New York or Washington…This new craze of Kay’s had amused her friends when it had not saddened them.”
For McCarthy, the experience of the psychiatric hospital was a trauma, akin to the war. There is a dread of destruction in her writing, a tension between Kay’s earlier incredulity over how sure the doctors are that she will kill herself, and how certain she is later that America will be destroyed by Hitler’s forces. Writing in the wake of America’s survival and victory, McCarthy hones in on the anxieties of one who couldn’t survive, and whose death orbited around the image of the psychiatric institution, so easily and quietly abused.
McCarthy was not the only New York author who delved into such anxieties about the darker edges of psychotherapy. In his play A Streetcar Named Desire, Tennessee Williams also paints the psychiatric hospital as a dead end, a place where many may go against their will, if deemed unfit to play a pre-assigned role. After Blanche DuBois is sexually assaulted by her brother-in-law Stanley Kowalski at the play’s end, she is institutionalized at the behest of Stanley and her set-upon sister Stella. Williams describes the agents of state in stage direction: “A Doctor and a Matron have appeared around the corner of the building and climbed the steps to the porch. The gravity of their profession is exaggerated–the unmistakable aura of the state institution with its cynical detachment.”
Just like in McCarthy, Williams paints the institution as discompassionate, cold and business like. It emerges under the official guise of protection and healing but exercises its power in a world where that power is ultimately abusive. Blanche is not being taken off to be healed. She is being taken off in order to be silenced.
In their text Mental Hospitalization Charles A. Kiesler and Amy E. Sibulkin offer a snapshot of institutionalization in the 1940s and 1950s. Though, they argue, the abuse of the mental hospital was not nearly as widespread as culture would have individuals believe, to pretend that there were no cases in which patients were wrongly committed, or held inappropriately would be dishonest. Kiesler and Sibulkin explain that, since the psychiatric hospital was in a period of reorganization in the 1940s and 1950s, it was more easily exploited. Further complicating this is the way in which certain behaviors were treated at the time. For a long period, homosexuality was considered a mental disorder for a which a number of individuals were committed. In the 1950s, as the Red Scare spread through the country, it was not uncommon for a suspected communist to be committed in order to hopefully cure him or her of his or her “traitorous disorder.” This, of course, was somewhat practiced in the case of Ezra Pound, who was committed on account of his Nazism, in an attempt to “cure” him of his seditious thinking.
Part IV: To The Fifties And Beyond
As the 40s moved into the 50s, questions such as these would become increasingly important. With the growing fear of the Soviet Union and the blooming anxieties of the Cold War at work in America, psychotherapy would take on yet another “wartime” jolt. As Lawrence Samuel writes in Shrink, psychoanalysis would become both a force for conformity and rebellion: a calculated balm to the terror of annihilation, and an indulgence of what some now feared once more to be over-sexed, and foreign.
Still, in New York City, psychoanalysis remained in power, still growing in influence. A radio show called Psychoanalysis in Daily Living played every morning. Women’s magazines published articles explaining how various tenants of the profession might make readers into better wives and mothers. What had once been seen almost universally as a European entity had transformed into something wholly American: a way to steel oneself against the Communist threat, a way to strengthen the American family, a continued push for America’s scientific superiority. Even the level of criticism that psychotherapy at times received from writers and professionals was a demonstration of this. Psychotherapy was entrenched: as an institution and as a talking point. It fascinated politicians, and artists, and military leaders, and average Joes. If not ubiquitous, it was pervasive. It was influential. It was in films, on the radio, in books, and in the paper. Even those who were infuriated by it, could no longer argue that psychoanalysis and its brothers were simply a fad.
In 1949, the World Health Organization published the sixth edition of its International Classification of Diseases, the first edition to include mental illnesses. In 1952, the American Psychiatric Association published the first edition of the Diagnostic and Statistical Manual of Mental Disorders, which, in 2013, would see its fifth edition. Both of these texts further gestured towards the growth and entrenchment of psychotherapy, codifying the language, intent, and authenticity of the field in America, and around the world.
The history of psychotherapy in America is diverse, expansive and complex. Rooted in early colonial practices, psychiatry and psychology grew slowly and quietly through the 18th and 19th centuries. By the 20th century, however, the whole makeup of American psychology was changed. Through psychoanalysis, questions of the individual mind became a scientific interest of the masses. Even as the professions that pursued them were disparaged in the wake of the Depression, the public fascination with the topic and its luminaries was incontrovertible.
With World War II, psychoanalysis and psychiatry experienced a recodification, scientifically and culturally. With that, came new waves of interest and criticism alike. In the 1940s, psychotherapy cemented itself both through its proponents, and its detractors. With the work of writers like Salinger on the mental health conditions present in returning veterans, to the writings of McCarthy on the neutering of psychoanalysis and the manipulations of state hospitals, it became increasingly clear that the way in which the mind works, and the way in which the mind is treated, were of crucial interest to Americans. As New York City continued to emerge as a template for a postwar America–a cultural, political, and scientific hub–the discussions of mental health and institutional administration that occurred there carried immense weight for the rest of Americans. Those prominent New Yorkers who did criticize psychiatry, helped it grow, giving it a cultural position to be accountable to, and a narrative to be in conversation with.
Through the Jazz Age, the Depression, the Second World War, and the restructuring of America the followed in its wake, psychotherapy served as a microcosm for the country. As Americans strove to decide how to remake their new Superpower, psychotherapy became a battleground for the values, positions, and anxieties of Americans. That it evolved to so closely mirror national sentiments is no accident. Since psychotherapy began growing on American shores, it was destined to be wound into the strange, self-conscious DNA of the nation, failings, over-reachings, and all.
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