This essay on the middlebrow popularization of the role and influence of psychiatric ideas in the United States suggests that the world view variously described as the secular social gospel, progressivism, or (after about 1930) liberalism can best be understood in terms of the great influence that society's popularized medical models have had upon it. That is, liberal or progressive thinkers came to conceive of society as “a patient etherized upon a table,” an organism subject to illness but able to benefit from therapy as prescribed by trained experts. The popularization of psychiatric models also offered norms of health for the individual and (often by implication) for the group based upon the degree of adjustment to a reality external to the individual and subsuming smooth interpersonal relations and a variety of social norms. The most concrete institutional expression of this popular medical model of human nature and society was the network of local, state, and national societies for mental hygiene, and I have therefore used “mental hygiene” as a shorthand term for the concepts under discussion. However, it should be obvious that the fit between ideal-typical concepts and institutions is never perfect and that there is always a mix of ideas and motives among the individuals who constitute an institution at any one time. The concern here is with ideas and their diffusion, rather than with the close evolution of institutions or the development and effectiveness of therapeutic techniques. Furthermore, while this study is written from a viewpoint somewhat critical of the popular effects of a hygienic mentality, it should not be read as imputing either conscious self-interest or “bad faith” to the advocates of popular psychiatry, who appear to have been sincere, energetic individuals convinced that the diffusion of their own beliefs would have enormous social benefit. One of the regrettable tendencies of recent revisionist history has been a vulgar imputation of a conscious selfseeking or promotion of class interests to reformers and other actors who sought to change their environment—apparently from a Utopian view of what constitutes true sincerity and disinterestedness that finds only contamination in the mixed motives and unintended consequences of action in bourgeois society. A tragic or ironic view of history, obviously, avoids this naive faith and anger by assuming that consequences are rarely exact reflections of intentions, that action is as hazardous and morally ambiguous as it is necessary.
The early reactions by American intellectuals to the psychoanalytic ideas of Sigmund Freud offer an interesting case study in the ‘Americanization’ of ‘foreign’ ideas. While the heyday of Freudian influence on the lay intelligentsia came after the World War—probably in the 1920s—and the maximum penetration of specialized disciplines by Freudian concepts came after 1930, already by 1917 identifiable and influential groups of thinkers had discovered Freudian ideas, and had reacted to them. The reaction sometimes took the form of outright rejection, but more often that of some form of assimilation, some attempt to use Freudian doctrine in support of a pre-existing ideology, or even to recast present doctrine in the light of Freud's theories. These early reactions foreshadowed the kinds of polemical and ideological utility which psychoanalysis would have on a larger scale after 1920; these first adaptations and reworkings of Freudian ideas prefigured such latter accommodations of Freud to America as Neo-Freudianism and ‘adjustment psychology’. Psychoanalysis quickly became an accepted polemical tool in literary and political debate. To neoromantic radicals it offered a new method of personal salvation by sloughing off skins of civilized repression. On a more complex level of thought, it became one element in the construction of a positivist and determinist system of psychology. At the same time, and sometimes by the same men, it was used—and radically revised—in the ideological endeavour to assimilate deterministic psychology to the persistent optimistic, activist moral code, which many scholars were anxious to harmonize with their new science.
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