Horney, Karen Clementine

1885–1952

GERMAN PSYCHIATRIST, PSYCHOANALYST, PROFESSOR

UNIVERSITY OF FREIBURG; UNIVERSITY OF BERLIN

BRIEF OVERVIEW

The study of mental health and the feminist movement are deeply indebted to Karen Horney for offering the world innovative and alternative views of psychodynamic theories. She influenced society and the treatment of the mentally ill in the late nineteenth and early twentieth centuries. Ironically, Horney never perceived herself as a feminist, and many aspects of her lifestyle—especially her dependence on having a man in her life—appear to make that label problematic. In Europe, where Horney was born and began her career, the study of the mind was completely male-dominated, and came to be firmly under the sway of three men that were her contemporaries: Sigmund Freud, Carl Jung, and Alfred Adler. Yet despite these three disparate voices, Karen Horney was also able to make her voice heard.

Horney is often described as a neo-Freudian, but her view of neurosis is markedly different from Freud's. She became convinced that neurosis was much more a normal component of life than it was in Freud's universe. Where Freud perceived neurotics made sick by forces beyond their control in the subconscious, Horney saw people termed neurotic attempting to make their lives bearable. She called their symptoms a means of "interpersonal and intrapsychic control and coping." Where Freud viewed culture as the necessary bulwark for survival pitted against the primitive desires of the id, Horney saw culture as the problem. Culture provided bad environments that caused frustration of people's emotional needs and created hostility, fear, and insecurity, leading to neurosis.

Freud believed that sick patients could be saved by healthy doctors. Horney, however, came to believe something that was anathema to Freud and the rest of the psychological community of her time: People suffering from mental illness could take responsibility for the illness and help themselves. The concept that people dealing with minor problems caused by neurosis could be their own psychiatrists was far from a popular view among the providers of psychiatric care. Though the concept of self-help is not consistently given credence by mental health professionals today, self-help programs for a wide variety of emotional, social, and physical problems have become a standard facet of treatment. Karen Horney was far ahead of her time when, in 1942, she published Self-Analysis, one of the earliest self-help books ever written. Much of her work was based upon her own terribly personal and painful experiences, and yet from that pain she gave birth to optimism. Karen Horney was, in herself, living proof that human beings, even neurotic, depressed human beings, can do great things. Her honesty and unflinching ability to look inward and use that vision became the tools that she used to help others. Sadly, for most of her life, she was unable to help herself.

Horney's unique vision of the treatment of mental illness didn't stop with self-help. One of the leading feminist thinkers in the psychological world of her time, Horney was an early critic of Freud's penis envy and Oedipus complex hypotheses. One of her earliest published works, a collection of essays titled Feminine Psychology, went into print in 1936. Though she agreed that such a phenomena as penis envy could and did exist among little girls, she was convinced that it was far less significant an issue among adult women than Freud and his followers believed. Horney could accept that it was possible for penis envy to be a component of some neurotic females' psyches, but adamantly disputed that it was as universal as Freud believed. Much of her early writings suggest that what Freud called penis envy may instead be the justified resentment that women feel as they attempt to survive as second-class citizens of a male-dominated world.

It is unclear if Horney was thumbing her nose at Freud when she developed a premise that indeed there may be a male version of penis envy. Horney called this "womb envy." Womb envy, she stated, was the unexpressed inadequacy some men felt because they could not bear children. She suggested that womb envy manifests itself in two ways: men trying to dominate women, and in over-achievement and the drive to succeed.

In reviewing Horney's theories over the span of her life, there are marked changes in those beliefs. It could be said that she was inconsistent—at first espousing Freud's theories regarding childhood sexual conflict and transference and later attacking them. But this change demonstrates one of Horney's great abilities: to hold nothing sacrosanct. Horney seems to have received this gift from living with a fanatically religious father and a sanctimonious mother. It gave her a unique aptitude to critically look at her own ideas as well as the viewpoints of others, and to revise her own tenets as they needed changing, due her life experiences. This open-mindedness—this refusal to become rigidly orthodox—it appears, was for Horney the reason her beliefs and approach to psychoanalysis have remained a part of mental health treatment decades after her death.

Horney's critics also called her politically incorrect. There is some evidence to support that criticism. Surely her ongoing attacks against Freud within months after his death might have been avoided by a more circumspect person. Her statements about the "pious Jew thanking his God. . .that he was not created a woman," made in Germany in the years that the Nazis were fighting to gain control of the country, sound anti-Semitic and inflammatory. Yet early on, Horney equally expressed anger at her family's discrimination against (the first of several) Jewish lovers. In her decades-long battle with Freud and his followers, Horney certainly wore no velvet gloves. Neither did her critics. However, for all the evidence of political incorrectness, there is at least as much substantiation that Horney was among the most courageous, honest, and forthright of the analysts of her time.

BIOGRAPHY

Horney's family of origin and early years

Eilbek was a bustling small town on the outskirts of the port of Hamburg, Germany, when Karen Clementine Danielsen was born there on September 15th, 1885. She was the second (and last) child born to Berndt (Wackels) Danielsen, a Norwegian sea captain and his young wife, Sonni. Captain Danielsen had been married before, and had four grown children before he fell in love with this woman 20 years his junior. Clothilde Sonni Van Ronzelen Danielsen was an unusual woman for her time. Described as beautiful, well-educated, sophisticated, and liberal, Sonni was the daughter of a well-known Amsterdam architect. Sonni came to the marriage an independent woman in an era when men were the unquestioned masters of their homes. From early childhood, Karen's mother confided the unhappy details of her married life to her children. As a young girl Karen already knew that her mother had married Wackels Danielsen in 1880 less because of love than the fear that she might not marry at all. She also came to know that her mother wished Captain Danielsen dead. In 1881, their first child, a son also named Berndt had been born, but it did little to stop the already-looming battle between the poorly educated, overly religious Wackels Danielsen and his freethinking, urbane wife. Karen's birth four years later was equally ineffective in uniting the unhappy couple. Throughout their marriage, Wackels Danielsen would continue to go into frequent angry tirades. Equally, Sonni would persist in looking in disdain upon him, considering him far beneath her in life-station.

Horney wrote of her father,

He delivers conversion sermons, says endless, rather stupid prayers every morning.... I cannot listen to his sensuous, materialistic, illogical, intolerant views of everything high and holy. He is simply a low, ordinary, stupid character who cannot rise to higher things.

This excerpt from Horney's diary that she began to keep at age 13 is quite telling. Karen and young Berndt Danielsen called their father "the Bible thrower." Apparently Wackels Danielsen's interactions with the family when he was not at sea fluctuated between brief periods of quiet interspersed with terrible arguments with Sonni and severe punitive measures aimed at his children. He was given to rages during which it was not uncommon for him to throw his ever-present Bible across the room. Karen alternately feared and hated her father both for his religious hypocrisy and harsh, authoritarian ways. But perhaps his greatest sin, in her eyes, sprang from her belief that he favored her older brother over her simply because she was a girl.

PRINCIPAL PUBLICATIONS

• Feminine Psychology. New York: W. W. Norton Co., Inc. 1936.
• The Neurotic Personality of Our Time. New York: W. W. Norton Co., Inc. 1937.
• "New Ways in Psychoanalysis." Psychological Review. New York: W. W. Norton Co., Inc., 1939.
• "Self-Analysis." Psychological Review. New York: W. W. Norton Co., Inc., 1942.
• "Our Inner Conflicts." Psychological Review. New York: W. W. Norton Co., Inc., 1945.
• "Are You Considering Psychoanalysis?" Psychological Review. New York: W. W. Norton Co., Inc., 1946.
• "Neurosis and Human Growth." Psychological Review. New York: W. W. Norton Co., Inc., 1950.

Captain Danielsen, for all the negatives attributed to him, is also described as having brought young Karen on three of his voyages, something rarely done by sea captains in the late 1800s. He also reportedly brought her presents from all over the world. Those trips with her father remained some of Karen's better childhood memories. Even as an adult, she still remembered hearing the Norwegian sailors read aloud on these journeys. In her writings and lectures, she quoted passages from Kierkegaard and other Norwegian writers that they had read. Despite the sea voyages and the gifts, Karen viewed her father as a hypocrite fixated on religion, and invariably sided with her mother in the frequent battles that disrupted the Danielsen household. Even with the healing passage of time, Karen's recollections of her early years were conflicted and painful, replete with conflict of a cold, uncaring father battling with a mother she came to view as smothering.

Despite her overwhelming possessiveness, Sonni seemed to truly love Karen and in childhood often referred to her as "my little lamb." Yet she often gave the appearance of being closer to, and confiding more in, her son Berndt. That closeness between mother and son, along with Sonni's beauty and grace, seem to have made Karen feel alienated and to view herself as an ugly duckling. The resultant bitter, rebellious, and angry little girl seems to have tried to gain her brother Berndt's affection in lieu of her parents' love. There apparently was some sexual play between them as children, and Karen, with characteristic candor, describes childhood incestuous feelings toward her older brother. When young Berndt reached adolescence and turned his back on her, Karen was for some time devastated by his rejection.

"If I couldn't be pretty, I decided I would be smart." A childhood picture of Karen Danielsen shows a blonde-haired little girl that clearly is at least attractive. Yet it seems that Karen never perceived herself that way. Much of her memories suggest that instead she felt awkward, unwanted, and valued less than her brother because she was a girl. Despite emotional problems that were already clearly in evidence (Karen's first depression, she states, was at the age of nine), she found an escape from her unhappiness in her studies. By the time she was 13, she already was determined to become a doctor. When she decided that she wanted to transfer from the church-run school that she had been attending to a newly opened gymnasium in Hamburg to prepare girls for university, the struggle between her parents reached new heights. Captain Danielsen, tight-fisted and not a believer in higher education for girls, as might be expected saw the move as foolish and a waste of money. He apparently wanted Karen to stay at home and help out, making it possible for the family to dispense with the services of their maid. But Sonni prevailed, and in 1901, Karen, then 16, began high school in preparation for attending the university, paid for by her father.

Schooling and marriage

In those high school years, Karen expanded her education in more than academics. She was a gifted student, but while still in her teens, she began a series of affairs with an unending parade of men. Such liaisons would characterize most of her life. In the diary she began to keep at age 13, Karen noted, "Being in love displaced all other worries: for if he is my thought day and night, how then should others have room?" Her first love was an unnamed actor, followed by an equally anonymous friend of her older brother's in 1903, but these liaisons were brief. A longer affair with a Jewish musician named Rolf soon followed. It was during this relationship with Rolf that Karen discovered and railed against her mother's and brother Berndt's condescension and anti-Semitism. In 1904, a momentous event happened that would change many things for Karen Horney. She was still involved with Rolf when nearly a quarter century of marital discord between Sonni and Berndt Danielsen came to an end. Sonni separated from her husband, moved out of the Danielsen home, and joined Karen in Hamburg.

Sonni's departure also signaled the end of financial support for both she and Karen. It is at least arguable that in addition to fears of being left on the shelf, Sonni had married Berndt Danielsen for his money. It is clear that at least at the end of her marriage, she had no financial resources of her own. To make ends meet after Sonni left her husband, she began to take in boarders and Karen began to tutor. Her parent's separation made Karen increasingly conscious that the mother she had defended all of her life might not be a model of perfection after all. Earlier, Karen had made cutting remarks about her father, saying that "mother is our greatest happiness" and "we are so unspeakably happy when you are not here." Karen now began to describe Sonni as "depressed, irritable, and domineering." Karen quickly became involved with one of her mother's boarders, a man only referred to as "Ernst." With equal speed, Sonni made it known to her daughter that she did not approve. This led to even more tension between mother and daughter.

In 1906, at the age of 21, Karen began medical school at Freiburg University. Once more she was free of her parents, who had caused so many conflicting feelings in her young life. Inevitably, she met and began a liaison with a fellow medical student named Louis Grote Losch. For once, Sonni approved of the relationship and in what was beginning to be a pattern, moved to Freiburg to be near Karen. Sonni even took in Losch and another of his friends as lodgers. By then, Karen was beginning to see her relationship with Sonni as too close, overwhelming. She described feeling "as if I would suffocate under all the love and care surrounding me." In the autumn of 1906, in a move rampant with rebellion and reminiscent of a Freudian case study in which a woman "marries her father," Karen began an affair with one of Losch's friends, a young law student named Oskar Horney. Passing her medical examinations the next year, Karen moved to Gottingen to begin her medical internship. But the affair with Oskar Horney continued unabated.

"In Oskar," she said in a letter at the time, "I found everything I consciously wished for." By all accounts, Oskar Horney's political beliefs could minimally be called right wing while Karen, though never overly involved in politics, was rather liberal. But in October of 1909 these two opposites were married and moved to Berlin. It would soon be evident that she had indeed "married her father." Oskar Horney was every bit as harsh a disciplinarian and as unfeeling a man as her father had been. In Berlin her new husband quickly found employment with a man named Stinnes. Stinnes owned a giant German industrial conglomerate most noted at the time for its cruel squashing of a strike in the Stinnes coalmines the year before. The newlyweds initially lived in a boarding house, but soon, thanks to Oskar's early and frequent promotions, they were able to upgrade their living accommodations to their own apartment in a middle-class section of Lankwitz, a suburb of Berlin. They quickly began to lead an upper-class lifestyle. She and Oskar almost immediately became part of the freewheeling culture that pervaded Berlin just prior to the onset of World War I. That milieu was replete with sexual abandon, and by 1912 their marriage was what is commonly today called an open marriage, with both partners blatantly having affairs outside of their marriage.

Karen continued her studies at the Berlin Medical School during this time, affiliating at the school's neuropsychiatric clinic. Sometime during this period of time, Karen became depressed once more. The reason given was discouragement at being excluded from dissection classes as medical school because she was female. It was also during this time that she first met Berlin's premier psychoanalyst, Karl Abraham, a rigid adherent of Sigmund Freud.

In a pattern that would emerge over and over in her life, things did not continue to go well for Karen. The next year, she continued to become even more depressed, experiencing something new with her feelings of hopelessness—sexual difficulties. In 1910 she began psychoanalysis with Karl Abraham. Her melancholy was compounded that same year in May when her father, the source of much of her internal conflict, died. Even more depressed by summer, and now also pregnant, she stopped psychoanalysis. She would later try psychoanalysis again with Hans Sachs in the 1920s, but it would never help her to any appreciable degree. In Mothers of Psychoanalysis, Janet Sayers describes Horney's reaction to the pregnancy. It was remarkable for both its uniqueness and honesty: She feared it would "interfere with her affairs and vagabonding." Yet the thought of becoming a mother made her "happy and proud." In February of 1911, Karen's mother Sonni suffered a stroke and died, missing by one month the arrival of her first granddaughter, Brigitte.

In 1911 with her depression once more on the wane, Horney began to attend meetings of the Berlin Psychoanalytic Society. The next year, she presented there a paper on the sexual education of children. Horney was still, at that point, sufficiently a Freudian that Karl Abraham wrote to Freud in Vienna recommending Horney's paper as "showing a real understanding." In 1915, with so many men away at war, she was elected secretary of the Berlin Society. Oskar's continued affiliation with the Stinnes businesses became even more profitable with the inception of World War I. In 1913 the Horneys' second daughter, Marianne had been born, followed in 1916 by a third daughter, Renate. They bought a home in a wealthy town, Zehlendorf, and vacationed along the Baltic coast and in the mountains around Berchtesgaden, where Adolph Hitler would later locate his vacation home.

Horney seems to have been determined not to suffocate her children as her mother had once smothered her. Early in life, her first-born, Brigitte, contracted tuberculosis, an illness common even in developed countries in the early part of the twentieth century. Karen promptly shipped Brigitte, then six years old, and her younger sister, four-year-old Marianne, off to Switzerland. They were sent without her and stayed for several months, Karen said, because she wanted them to become independent. Her children—especially her middle daughter Marianne—would experience Karen as both benignly neglectful and often unavailable. She impulsively sent them to a number of experimental schools and began sending all three of her daughters to fellow analyst Melanie Klein for therapy in 1923 when the eldest, Brigitte was 11. Apparently neither the stay in Switzerland nor therapy with Melanie Klein was designed to protect her children. Though the girls would remember their father as playing with them more than their mother did, he would also be remembered as a harsh disciplinarian. In an ironic replay of her own childhood, Karen Horney was already allowing her husband Oskar to inflict the same type of verbal and physical abuse of her daughters that she and her brother had once endured. With characteristic honesty, she would later say that at the time she had believed that she should not interfere, that the discipline was good for her children, and that it would foster their independence. It was a belief that she would later come to see as incorrect.

In 1920, the prestigious Berlin Psychoanalytic Clinic and Institute, the first clinic that made psychoanalysis available to the public, opened its doors. Its ahead-of-its-time mindset would give Horney her first feminist victories: She would become both the Institute's first female member and its first female instructor. Once more she attempted psychoanalysis, this time with Vienna-born Hans Sachs. Her mothering experience in the previous decade had led Horney to insights regarding feminine sexuality and psychology that were beginning to clash with Freud's theories. Adding insult to injury, her first therapist, Karl Abraham, at a conference in The Hague that year opined that women really wanted to be men. He based this belief upon Freud's penis envy theory. That same year, for the first time, Horney wrote a paper expressing psychoanalytical criticism of Freud's male-domination philosophy. It was not destined to be her last.

Though many of her male, Freudian colleagues soon began to openly disagree with her increasingly antagonistic perception of Freud's psychosexual theories, especially those involving women, Horney did encounter some triumphs in her work. Her 1922 appearance at the Berlin Psychoanalytic Congress in which she dismissed Freud and Abraham's beliefs as nothing more than "masculine narcissism" drew a larger audience than any other speaker. She lectured on female sexuality, drawing large crowds, and even was covered in Berlin newspapers. But the price for this success was high. More and more the members of the Institute saw her as a heretic from orthodox Freudian psychology, and in another parody of her childhood, Horney felt increasingly alone and estranged from everyone around her. Increasingly she expanded on thinking begun in the prior decade, in the times of her own pregnancies, about the unexplored importance of motherhood. In a letter to another therapist she noted, "I consider it rather one-sided that the (Freudian) emphasis is always on the attitude toward the father. . .always explaining that for simplicity's sake only the attitude toward the father is mentioned but it would also apply to the attitude toward the mother. But it does not."

World War I's end left a vanquished Germany awash in economic chaos. Even a man as ruthless as Stinnes was not able to avoid financial collapse, and Oskar lost his job. In 1923, Oskar also came down with meningitis, which was soon followed by his own financial failure and bankruptcy. Never a particularly pleasant man, Oskar became progressively more depressed and aggressive after his illness and business failures. In 1926 the Horneys had to sell their home in Zehlendorf. The straw that broke the camel's back occurred that same year when Karen's 42-year-old brother Berndt developed pneumonia and died. After Berndt's death, she felt unable to cope. While on vacation at the Baltic seashore that summer, she contemplated suicide by drowning, but did not. She continued work at an increasingly hostile Berlin Institute and remained in an increasingly unhappy marriage with Oskar. Three years later, in 1927, 42-year old Horney and her three children moved out of that house, never again to return. They relocated to a Berlin apartment, and like her mother, Horney took in lodgers. In 1936, Horney returned to Nazi Germany on one of her many visits and began divorce proceedings against Oskar. He would eventually marry his secretary, with whom he had become romantically involved.

There were those who said Horney only married Oskar Horney for his money. The same suspicion had been raised regarding Horney's mother Sonni years before. There is no way of knowing. What is known is that despite her reduced financial status, Karen Horney seemed to blossom after she left her marriage. Though she had written and lectured on feminist themes even in the early twenties, in 1932 she published two essays that clearly set forth her views on men, women, and Freud: "The Problems of Marriage," and "The Dread of Women." Adolph Hitler and his National Socialist Party were rapidly replacing Germany's anarchy and turmoil, and clearly would soon be in power. Horney, though apolitical, was never an admirer of the Nazis. When a former student, Hungarian analyst Franz Alexander offered her a position in the United States as Assistant Director of the Chicago Psychoanalytic Institute in 1932. Horney jumped at the chance to leave Germany. Now 47 years old, she and her youngest daughter Renate moved to the United States. They arrived in Chicago on September 22nd of that year, leaving behind in Germany Brigitte, now 21 and already an up-and-coming movie actress, and Marianne, studying to be a doctor.

The early years in the United States

Horney passed her U.S. medical board examinations the next year and applied for U.S. citizenship. She also began her practice in the Chicago area and an affair with a younger man she was supervising in analysis, Leon Saul. Horney's experience treating American neurotics increased an already burgeoning belief that Freud's tenets had depended too heavily on constitutional factors and not enough on the social. The next year, when Erich Fromm came to lecture at the Chicago Institute, Horney renewed an acquaintance that was to change her life. Fromm, a 34-year-old psychoanalyst from Frankfurt, Germany, and recent escapee from Nazi Germany, had, like Franz Alexander, previously been one of her students at the German Psychoanalytic Institute. Though he was 15 years her junior, Horney and Fromm began an affair that would go on for several years.

If Freud's theories could be broken down to a belief that biology shaped us, it was Fromm's conviction that society made us who we are. Fromm's ideas would validate and enhance the theories Horney was already developing, as her ideas would nourish and enhance Fromm's work. Fromm is often described as a melding of Marx and Freud, and indeed, both men were his mentors. Fromm was born in Frankfurt, Germany, of Orthodox Jewish parents. Like Horney, his childhood memories were less than idyllic, containing a moody, business-obsessed father and a depressed mother. The suicide of a beautiful woman, a friend of the Fromm family, and the insanity he perceived in Germany related to World War I were the motivations for Erich to become interested in the workings of the human mind. By 1922, he, like Horney, was working as a psychotherapist. But by 1934, Fromm could see what lay ahead for Germany as well as both Jews and Communists, the two identities he shared. He came to the United States as a refugee, as did so many other intellectuals from Germany and Central Europe.

In 1934, Horney resigned from the Chicago Psychoanalytic Institute and took a teaching position at the Washington-Baltimore Society for Psychoanalysis. The main motivation for this job change seems to have been her desire to be closer to Erich Fromm. When Fromm moved to Brooklyn, New York, then a cultural center for Europe's earliest refugees from the Nazis, Horney followed him there, requiring her to commute from New York to Washington and Baltimore to teach. Marianne had completed her studies, left Germany, and begun an internship in Chicago. In 1935, Renate, now 19, chose to drop out of school and return to Nazi Germany to marry her childhood sweetheart rather than remaining in the United States with her mother. Yet for all these changes within her family, this was a happy and prolific time for Horney. She was elected a member of the New York Psychoanalytic Society and began to teach at the New School for Social Research, part of the University of Exile, a school developed by the vast number of intellectuals being driven out of Europe. She published the first of her many books, the collection of her essays and lectures entitled Feminine Psychology in 1936. She eventually published seven major works on neurosis, psychotherapy and self-help, as well as more layman-oriented, "pop" versions of these books.

Karen Horney and the Nazis

Horney made several trips back and forth to Germany in the 1930s, both to see her daughters and to lecture. As an expatriate, she was more welcome than one might have expected, perhaps due to her anti-Freud stance over the years. A full-scale Nazi attack on Freudian thought, calling it "Jewish Science," was underway in Germany at the time. (Ironically, Carl Jung, who had been Freud's collaborator and later, like Horney, one of those that disagreed with his psychosexual theories, was also welcomed by the Nazis. Though he was said to disagree privately with the Nazis, Jung never offered any audible disagreement with the Nazis' anti-Freud stance. Jung in fact served as the head of the German Medical Society for Psychotherapy, an early breakaway group defecting from Freud's tenets. Horney was a member and supporter of the group.) While attending one of Brigitte's plays one evening, Horney was even mistaken for a Nazi party official. Her trips to Germany invariably included giving lectures. On a bittersweet note, one of these lectures was at her alma mater, the Berlin Institute, now commonly called the Goering Institute, after the relative of Hermann Goering, Deputy Führer, who was now in charge there, and where discussion of Freudian principles was no longer allowed. This cousin of Goering's so enjoyed Horney's address (which apparently complied with the ban on mentioning Freud) that he requested a copy of one of her books, which she later sent him.

Horney was never involved to any degree in politics, and unlike other intellectuals of that time who constantly spoke out during World War II, she kept her thoughts her own. Her only known reference to the war concerned mothers and mothering, and how such an event as World War II caused stress to mothers. Horney knew something of that stress: she, too, had the added concern of still having two daughters living in Germany in the 1930s. But on the eve of World War II, in 1939, she did relate her long-held theories to the rise of fascism in Europe. She stated that on an individual level, her parental lack of approval for any kind of dissent on her part was instrumental in keeping her from becoming politically active. On a larger scale, she speculated that this early fear of losing acceptance conditioned people to "uncritically adore one parent. . .or become subservient to the demands of a self-sacrificing mother." Horney believed that this early conditioning made people ready targets for fascism, easily agreeing to blindly obey in return for "promises to fulfill all their needs." She saw Adolph Hitler as the consummate patriarchal figure, ready to dispense whatever was needed by the German people in return for their absolute obedience. The only defense against dictators, she believed, was for people to "become stronger in their self-resolve and individual capacity for forming judgments and making decisions."

In 1941, there were marriages on both sides of the Atlantic for Horney's family. Marianne, in analysis with Fromm for some time, married in New York while Brigitte married in Germany, in Berlin. Brigitte was growing increasingly unhappy with life in Nazi Germany, however. When a close friend of hers, Joachim Gottschalk, committed suicide along with his (Jewish) wife and child rather than be arrested by the Gestapo, Brigitte desperately wanted to leave her native land. However before that could happen, she had a recurrence of the tuberculosis that had plagued her in her childhood. She spent most of the war in a sanitarium in Switzerland.

Later years

Horney and Fromm's affair had been at its height during the 1930s. They lived well and seemed to be good for each other. Their love affair was far more than physical attraction. It was a meeting of the minds, a sharing of Horney's view of psychoanalysis and Fromm's of both sociology and psychotherapy that was mutually beneficial. Despite Fromm's socialist views, they hosted lavish parties replete with the finest gourmet dining, roulette parties, or even being serenaded by Erich Fromm and Hasidic choruses. These affairs were attended by most of the luminaries of the time. Among the regular attendees were Karl Menninger, Harry Stack Sullivan, and Margaret Mead. Up until the onset of World War II, Horney and Fromm took frequent vacations to France and Switzerland. Karen Horney had arrived. Thanks to her psychoanalytic practice, her books, and her lectures, money was no longer a problem. She enjoyed the good life, and bought several homes, including a vacation home at Croton-on-Hudson. The last of Horney's homes were located on Fire Island and Wildwood Hills, Long Island.

It was a basic tenet of Horney's life, however, that things never went well for any great length of time. She had always, dating back to her years in Berlin, been tremendously popular with her students, and this adoration continued at the New York Institute. In June of that year, though, New York Institute students submitted a petition to the school asking that Horney's work be included in the school's curriculum, a request met with hostility by the institute's administration. In September of 1939, as World War II was beginning, Sigmund Freud died in London. His death did nothing to diminish Horney's continuing outspoken, anti-Freud stance. Once more it would make her a lightning-rod for her colleagues' censure. Her teaching position was downgraded to sporadic lecturing and a senior year elective course. An October 1939 address, one month after Freud's death, added insult to injury. Once more Horney assailed the prominence Freud had given childhood psychosexual experience in creating neurosis. This time Horney's anti-Freud message was greeted with stony silence or derision. Mystified by the response and in tears, Horney asked, "Why can't we have different opinions and still be friends?"

The next year, the school required several of her students' papers to be revised, causing these students to feel that attending Horney's classes doomed them to unfair grading and prejudice. A special inquiry into this incident, including a student questionnaire the next year supported their belief, but it made no difference to the New York Institute. In April of 1941, Horney's teaching status was further downgraded to infrequent lecturer. At that point, Horney and several of her supporters (including the 14 students who believed themselves discriminated against) resigned from the New York Institute. She, together with Fromm, Harry Stack Sullivan, William Silverberg, Clara Thompson, and others, soon formed the Association for the Advancement of Psychoanalysis (AAP) in late 1941. The association seemed to get off to a good start, initiating its own training program and a publication, The American Journal of Psychoanalysis.

During this stressful time, Horney's relationship with Erich Fromm had been deteriorating as well. Self Analysis, her work advocating that neurotic people could aid in their own therapy, was published in 1942. It received lukewarm reviews at best from the psychoanalytic community, and for the most part, was completely ignored. Fromm, too, had published a book the previous year: the landmark Escape From Freedom, which had been far better received. A summer vacation at Monhegan the previous year proved to be their last as a couple. It was Fromm that left the relationship, but it is believed that their breakup was mostly related to her jealousy over the recognition his book received. The fact that he continued to teach at the New York Institute after the institute's treatment of her and that Fromm, too, was a highly popular teacher, apparently added to her resentment. Always the survivor, Horney threw herself into her work. Her private practice was thriving, and she remained actively involved in the AAP. At least in some ways, the AAP proved a freewheeling group. (At its first annual conference, the association began a tradition: the toasting of "luxurious and lecherous living.") Karen had also become editor of the group's journal, The American Journal of Psychoanalysis.

During her years of analysis with Fromm, Horney's daughter Marianne had come to realize the hostility she felt toward her mother. In spite of this, she, now also a psychoanalyst, joined Horney's new psychoanalytic association. As this antagonism surfaced, Horney seems to have blamed her former lover for Marianne's feelings. This quickly became another cause of the rift between them. Horney and Fromm managed to put aside their differences, and both remained in the new organization for several months. In 1943, in a parody of the situation Horney had just put behind her at the New York Institute, a request by students for Fromm to teach both clinical and theoretical subjects was blocked by Horney. Soon after, his teaching privileges were revoked. The reason given was Fromm's lack of a medical degree, but most saw it as the vengeful reaction of a rejected and bitter woman. When Fromm resigned from the AAP in April of 1943, several others, including Harry Stack Sullivan and Clara Thompson, followed. One of the most painful defections for Horney was her daughter, Marianne. Six further defectors later that year, including William Silverberg, assured that Horney's AAP would not receive the acceptance of recognized psychoanalytic organizations.

Following these bitter disappointments, she once more looked to another younger man, her trainee Harold Kelman, to become her lover. Kelman would not be the last. She never remarried, though there were several relationships, often with admiring younger men, over the ensuing years. There continued to be turbulence in her life due to her outspoken disagreement with Freudian teachings, her poor relationships with many of her colleagues, and her penchant for getting into relationships with the wrong men. She was described by many as "imperious" in her management style. Yet she remained the dean of the American Institute for Psychoanalysis for another decade. Her private life remained replete with dinner parties and social activities with artists and existentialist philosophers from both sides of the Atlantic. Among her friends was a wealthy manufacturer, Cornelius Crane, who introduced her to a Zen Buddhist scholar named Suzuki. That meeting would lead to a later fascination with Zen Buddhism.

In those later years, when Horney was in her late 60s, it seems that she finally began to make some personal progress toward the self-realization she had sought for others for most of her life. Though she continued to work hard, seeing patients from early morning until late in the day, she also seemed to find more enjoyment in her private life. She took up painting, traveled a good deal, and the bond with her daughters improved as she visited Brigitte in Switzerland and Renate in Mexico. They accompanied her on trips and spent pleasant summers vacationing together. She published her last book, Neurosis and Human Growth, in 1950. Her earlier contact with Suzuki led to an expanding interest in Zen philosophy. In pursuit of that interest, she traveled to Japan with Suzuki and her daughter Brigitte, now divorced, in 1952. Shortly after she returned from Japan, she was diagnosed with stomach cancer, already quite advanced. She died on December 4th of that year.

THEORIES

Horney's Freudian beginnings

No discussion of the philosophy of Horney is possible without first elaborating on the ideas that initially formed her theories—the work of Sigmund Freud. More than Alfred Adler and Carl Jung, whose breaks with Freud in the early twentieth century were well documented and publicized, Horney initially seemed to agree with Freud. It is for this reason that she is so often characterized as being a neo-Freudian, and why Horney would always, even after tremendous differences developed between them, express great appreciation for Freud's ground-breaking discoveries. It was the material that Horney would build on.

Freud discovered that he could bring relief to patients suffering from neurosis by encouraging them to talk with him about their feelings. This free-talking method, called free association by Freud, gave rise to the treatment modality Sigmund Freud is famous for: psychoanalysis. The famed Viennese psychiatrist and his disciple Carl Jung introduced this concept in the United States in 1909. Freud's work with patients using free association and dream analysis created experience that helped him to map what soon became known as the unconscious. Freud defined portions of the human mind as the id (the primitive, undisciplined part of the mind), the superego (the conscience), and the ego (the self-concept that regulates and integrates all the rest). Freud hypothesized that unconscious processes and their relationship to early childhood experiences were the primary factors in determining personality adjustment or maladjustment in adulthood. He also came to believe that sexual conflict was the principal reason for neurosis.

Freud's ideas were the first and most famous theories in psychology. Most of the leading mental health professionals of his time began to follow him. At certain junctures after that early acceptance, opinions would split, and at each of these divisions, some of Freud's followers took different paths. Carl Jung, along with another follower, Alfred Adler, were the first separate from Freud's road and begin the journey on their own paths. Horney would soon fill one of the vacancies in the Freudian ranks—but only for a brief time.

Horney spent three decades bringing the world innovative psychiatric and psychological theories that have led the way for many schools of psychological thought and are still considered to hold great relevance today. Her contributions in many ways match the decades of her life as a psychiatrist, with each decade highlighting a separate portion of her theory development:

• Early essays on feminist psychology in the 1920s. These are said to be the actual beginnings of Horney's break from standard Freudian thought. Because of her feminist stance in those years, she is often credited with being the founder of feminine psychology, creating its original political and theoretical philosophy. She saw penis envy, Oedipal complexes, and the lack of focus on motherhood and mothering as the flaws in Freud's patriarchal-based beliefs, and set out to remedy these deficiencies.
• Psychoanalytic experience supported her growing belief that the society people live in and relationships that they experience are far more important in the development of neurosis than Freud's predetermined instinctual and biological causation. The development of these convictions by Horney make her one of the founders of humanist psychology.
• Her work in the last decade of her life culminated in the development of what she termed interpersonal defenses and intrapsychic defenses, and her hypothesis of how these defenses develop as a means of dealing with anxiety.

Horney and feminist thought

Explanation

She is said to be at home only in the realm of Eros. Spiritual matters are alien to her innermost being, and she is at odds with cultural trends. She therefore is, as Asians frankly state, a second-rate being. She is prevented from real accomplishments by the deplorable, bloody tragedies of menstruation and childbirth. And so every man silently thanks his God, just as the pious Jew does in his prayers, that he was not created a woman.

These words, from Horney's first book, Feminine Psychology published in 1936, are echoes of earlier essays written in the 1920s, soon after Freud first published his theories of female sexuality. Horney believed that classic Freudian psychoanalysis (which she had then recently undergone with Freud disciple Karl Abraham) inherently perceived women as imperfect because it was the work of a male (Freud) in a male-dominated society. Horney saw Freud's hypotheses regarding female sexuality were nothing more than an attempt to curb the "power struggle between the sexes." Horney made every effort to stimulate debate on this difference between Freud and feminists during her years at the Berlin Psychoanalytic Institute, but was unsuccessful. Both Freud in Vienna and her male colleagues at the Institute in Berlin allowed the issue to die a natural death by simply ignoring it. For Horney, though, it did not die.

Horney's disagreement with Freud's penis envy theory

When Freud disciple Karl Abraham in 1920 posited that women, because of penis envy, actually wanted to be men, he went on to state that he believed that this desire to be men led to lesbianism, women with masculine ambition, and feminists. Horney, who was from all reports not a lesbian, and did not consider herself a feminist (but may have possessed what Abraham called masculine ambition), was offended. Horney, who had already witnessed decades of male sexism, was put off by this theory not because of feminism but because of its illogical nature. Horney was feminist in her beliefs, but too much of an individual to join any organized feminist movement for any period of time. One of Horney's responses to Karl Abraham's idea was, "that one half of the human race is discontented with the sex assigned to it. . .is decidedly unsatisfying, not only to feminine narcissism but to biological science."

Perhaps because of her own childhood experiences, Horney was fascinated by how men view women and the reasons for their perceptions. What she concluded seems based, as is typical of Horney, in her own experience. Her feminist theories seem to have developed during her childbearing years, a time when she described being pregnant as, "It is just the expectation and joy in it that are now so indescribably beautiful. And the feeling of carrying in me a small, becoming human being invests one with higher dignity and importance that makes me very happy and proud." In her disagreements with Freud over penis envy, Horney came to believe that there was an even more common phenomenon—womb envy. Men unconsciously devalued women out of long-suppressed jealousy of the female reproduction capacity, the male lack of a uterus for childbearing and breasts for nurturing. She further noted that apparently womb envy was evidently more prominent a problem than penis envy, as men appear to have a far stronger urge to degrade women than women have to denigrate men.

Examples From infancy onward, Horney believed, men perceive their mothers as "nurturing, selfless, and self-sacrificing. . .the ideal embodiment of the woman who could fulfill all of his expectations and longings." This leads to envy of not being able to become this nurturing person themselves. As compensation for this, men have created a society where women are considered inferior to men, motherhood is cheapened, and male sexuality is over-esteemed.

A lecture given by Horney in 1930 in Dresden noted that the (then) male-dominated specialty of obstetrics was the theft of a power that women had traditionally held (as midwives)—the ability to facilitate childbirth. She saw it as an unconscious wish on the part of men to divest women of the capacity to be mothers.

In "The Dread of Women," one of her early papers written in 1920 rebutting Karl Abraham's statements regarding all females desiring to be males, Horney expressed the belief that male children had an innate dread of females, fearing that their reproductive organ was inadequate when compared with the reproductive organs of women. This dismissed Freud's supposition that men fear castration by women, replacing it with what Horney saw as the real fear: humiliation and devaluation of the boy's masculine self-image.

The symbolic manifestation of this fear, Horney states, is expressed in dreams of "a motorcar is rushing along and suddenly falls into a pit and is dashed to pieces," or "a boat is sailing in a narrow channel and is suddenly sucked into a whirlpool." In Horney's experience, dread of being rejected or humiliated was a component of analysis with every male patient, no matter what his mental status was or the structure of his neurosis.

In place of Freud's Oedipus complex, wherein sons identified with fathers in wanting sexual relationship with mothers and daughters equally desired their fathers, Horney believed that female babies from birth identify with their mothers. The reason for Oedipal feelings in girls is not based upon desire to have sex with their fathers, but rather in their perception that this is what their mothers do. In Freud's patriarchal theoretical realm, this was not possible. Horney was joined in her promotion of mothers and mothering as essential in the development of the psyche by Melanie Klein, a contemporary female psychoanalyst. (Klein was also the person who analyzed Horney's children.)

Horney often superimposed the tremendous power of mothering over the fear of the father that Freud posited so much. This feminine power could be used in varying ways, some leading to neurosis: the demanding mother who requires total devotion, constant attention, and sacrifices from her children simply "because she is the mother and she has borne them in pain," "making her offspring feel guilty if they do not constantly meet her needs" is one example.

The obvious irony in this discussion of Horney's early years in the psychoanalytic field is that Horney did not see herself as a feminist. For her, the issues expressed were simply matters of attitudinal and intellectual difference that she perceived as creating psychiatric difficulties. She found it entirely possible that little girls wished for penises like their little brothers, but felt that it was irrelevant to the larger discussion. What women really wanted, Horney believed, was not penises, but rather the opportunity to develop their own unlimited potential in a fair and unbiased society. Initially she focused strongly on a feminine persona, motherhood, and young girls' identification with their mothers. But as time went on, she developed equal difficulty with the concept of a feminine mystique. Though convinced that there were male and female personality traits, she believed that male-dominated society had so obscured and modified whatever personality qualities were distinctly feminine that it was no longer possible to determine what these traits are. Therefore Horney came to favor gender neutrality. In a 1935 lecture in Paris, France entitled "Women's Fear of Action," she summed it up in this way:

We should stop bothering about what is feminine. Standards of masculinity and femininity are artificial standards.... Differences between the two sexes certainly exist, but we shall never be able to discover what they are until we have first developed our potentialities as human beings. Paradoxical as it may sound, we shall find out about these differences only if we forget about them.

Perhaps the greatest reason Horney did not consider herself a feminist springs forth, as so many other things in her theories, from her own life experience. From her teens on, as her ex-therapist Karl Abraham had noted, Horney seems to have wandered from one heterosexual relationship to another. Her one marriage to Oskar Horney could not be termed a success, and in the long run, neither were most of her affairs. Her essay, "The Overvaluation of Love," published in 1934, looks at this behavior as one of her neurotic symptoms. It is actually the case studies of seven women possessing a compulsive need for having a man in their lives yet never being able to form a fulfilling and loving relationship. It is widely believed that one of these case studies is indeed a self-description by Horney. Her examination of these self-described neurotic needs is an early span in the bridge between her feminist years and those in which she more closely looked at society's role in creating neurosis.

One classic example of how valid feminine personality traits can be altered by a male-dominated society's expectations that Horney cites is the Victorian woman. Because it was expected of her by the society she lived in, women of Victorian times were so delicate that they frequently fainted, and could do very little. There is no scientific reason why these women would faint or be so weak and unable to do any sort of physical work. Therefore, the only possible explanation for their delicacy and weakness is the programming of the society in which they lived.

Horney also speaks of a woman clearly "more gifted than her husband," and of this woman's total inability to do anything for herself. This problem can be overlooked, Horney states, in a society where females are expected to be passive and not be achievers. This would then, in such a society, be considered "a normal feminine attitude."

Main points Horney's feminist theories as opposed to classic Freudian thought of her time:

• More focus on the pride and fulfillment of being a mother and mothering, rather than wishing to be male and have a penis as Freudians believed.
• Replacement of Freud's castration theory with the belief that the fear in young boys is of male inadequacy and the loss of self esteem.
• Society's perception of women: Horney's belief was that feminine psychological traits were impossible to determine because the male-dominated society she lived in had so completely obscured them. Freud's view was that women were both definable and treatable as a group because of these personality traits. Horney believed that it was preferable to look at the person's experience with and interaction with his or her environment rather than at sexuality.
• Freud's Oedipus and penis envy theories: Horney's basic tenet is that women do not experience penis envy as much as they experience the desire for equal status living in a just and fair society instead of a patriarchal one.
• However she also felt that if indeed penis envy did exist, it was equally possible for men to experience womb envy. She reasoned that womb envy was the precursor, in male-dominated societies, of men trying to subjugate women.

Horney's middle-decade theories: "Basic anxiety" and neurosis

No doubt because of her own life experience, Horney put great emphasis on childhood hostility developed toward rejecting parents. Because this hostility could not be safely expressed for fear of parental retaliation or abandonment, the child learns to avoid any kind of friction with the parent. This creates a psychic situation that makes it impossible for the child to stand up for his or her rights, and requires that he or she tolerate parental injustice. Desires and needs become submerged, and much of the child's energy is depleted in fighting these internal, dangerous impulses. The final result of this struggle is the crippling of personality development leading to neurosis or other psychopathological conditions. For Horney, the object of psychoanalysis was to assist her patients in being able to give up their defenses. These defenses, she believed, barred them from their real selves—from being aware of the things they innately loved, hated, feared, or wanted. This notion of self-realization would become one of the tenets of humanistic psychology. Her early espousal of, and emphasis on, self-realization as mental health makes her one of this movement's founders.

Examples Horney uses one of her patients as an example of this submersion of needs and desires. The patient's initial anxiety occurred when she wanted something for herself simply because she wanted it—not because it was necessary to her health or education. She felt rage, but suppressed it when people did not do what she wanted them to, or when she wasn't first in competitions. The unexpressed rage resulted for her in a feeling of exhaustion.

Horney cites her own lack of involvement in politics as an example of this. She states that because she was not expected to have her own opinions as a child, she did not grow up considering what opinion she should have. This is actually rather remarkable, considering that her life encompassed World War I, the Weimar Republic, and the rise of Nazism.

Basic anxiety

As noted previously, Horney came to perceive neurosis as one major type of maladaptive personality development, not nearly as abnormal as psychiatric thinkers prior to her had believed. Like Freud, she was convinced that it developed out of childhood experience. Surprisingly, she did not believe that parental abuse or neglect necessarily caused children to grow into neurotics. However she was convinced that what she termed "the basic evil," the lack of warmth or caring, the indifference of parents, did create neurotic personalities. Most significant about her observations is that she viewed this totally from the viewpoint of the patient. The parent may not have even actually been cold and uncaring, but if the child perceives the parent in this way, it becomes a reality for that child. Even those considered good parents may show a preference for one sibling over another; humiliate, shame, or unjustly blame a child; or alternate between being loving and rejecting behaviors. These parental actions, so tellingly similar to those of Horney's childhood, became for her the great underpinning of all neurotic psychic activity.

Generally children are thought of as defenseless and submissive, but Horney describes the earliest and primary response to parental indifference as "basic hostility," feelings of rage and aggression. If the child experiences victory from this reaction, belligerent behavior may become the method of choice for coping with life situations. But Horney notes that aggression is not the usual reaction that sustains the neurotic person through life. Instead "basic hostility" is typically followed by "basic anxiety," the fear of being helpless and abandoned as punishment for having had these angry feelings. In order to survive, the "basic hostility" felt must then be concealed, and every effort made to convince the indifferent parents that the child is worthy of their love. This is, according to Horney, the progression for the majority of these children. Despite their rage, if they experience success through making themselves pleasing and lovable, then this will be the façade they will present to the world throughout their lives. However, Horney also describes a third group. These children simply withdraw and make every attempt to make themselves self-sufficient in the belief that if no one can get close to them, no one can hurt them.

Horney said that children can only express this anger in dreams or fantasy. These include fears of being attacked and torn apart by wild animals, or ghosts or burglars chasing them. As long as this basic anger against indifferent or shaming parents is held in check, Horney states, the neurosis is held in check. When the angry child grows up and an event the person's life brings up the issues of love and rejection, the person may exhibit neurotic behaviors.

Example In analyzing the reasons for what she perceived to be Adolph Hitler's sado-masochistic perversions and nightmares, Horney posits that his mother was too afraid of her cruel and domineering husband to protect her son (Adolph) from him, and too obsessed with deifying his older, dead siblings to really love him for himself.

Horney spoke of a patient who told her that he disliked his mother intensely yet was able to live in the same house with her. They came to "a fine understanding" between them, but there were times when he suddenly and inexplicably broke out into an unprovoked rage.

Neurosis

As stated, the basis for all of Horney's theories was her personal experience. She considered herself neurotic, and all of her work relates to the treatment of neurosis. She also considered herself and the neurotic patients she saw to be victims. The psychic pain she had experienced from her earliest years convinced her that the events of her childhood had colored all of the rest of her life. In this belief—the notion that neurosis has its basis in childhood experiences—she and Freud concurred completely. Over the years though, Horney began to believe that these childhood experiences, while truly the basis of the neurosis, needed to put into their proper perspective. Dealing with the patient's current array of coping devices and inner conflicts became more important for Horney, because these could be treated. The ability to exchange ineffective defense mechanisms for those behaviors that led to self-realization became the emphasis of Horney's psychoanalytic practice.

Example Horney's path to self-realization required a patient to focus on the present. It would be impossible to change or repair the original causes of the neurosis as the person is no longer the same as they were when the basic hostility and basic anxiety first emerged. She used the example of the man who considered himself to be very gifted at times, and then considered himself stupid. He showed virtually no emotion most of the time, but was at times given to becoming very upset and angry. Horney chose to ignore interpreting the similarity between his interaction with Horney, as his analyst, and with his mother. She focused instead on getting him to see the connection between his attempts at being rational and unemotional and his fear of being disliked and humiliated.

Differences with Freud about neurosis After the divergence regarding feminine psychology, probably the next basic difference Horney encountered between her beliefs and Freudian thought regarded the definition of neurosis. Freud viewed neurotic behavior as biological, driven by instincts, the inevitable consequence of the clash between a necessary and orderly society and an equally necessary but disorderly id. Horney's early observations, though, convinced her that neurosis was far more common than previously thought. In fact, it was a method people use to cope with problems and feel like they have control over their lives. Of the two ideas, hers was clearly the more optimistic perception. Freud further had viewed the behaviors he studied as being universal, common to all humans, while Horney was convinced that cultural factors contributed heavily to the neurotic adaptation to life. She also believed that neurosis could not even be diagnosed without a careful examination of the society from which the person originated. Probably most important of all, Freud's vision of humans increasingly was one of pessimism. He thought the human race was condemned to repeat a pattern of destruction and suffering. Horney saw it differently. In Our Inner Conflicts, she said in this affirmation of hope: "Man can change, and go on changing, as long as he lives."

Horney's unsuccessful attempts at psychoanalysis as a young adult with both Freudian analyst Karl Abraham and Hans Sachs led her to try self-analysis. This was a concept few if any of her colleagues viewed as viable or useful. For Horney self-analysis proved to have value, but only because she had a remarkable and unusual gift: an ability to dispassionately pursue her own truth without rationalization or excuse. The knowledge she gleaned from that self-analysis became the information she imparted to mental health professionals through her books and to her patients in therapy. She addressed only neurosis, but many mental health professionals believe that her theory of neurosis is the best in existence. Horney defines neurosis as "psychic disturbance brought by fears and defenses against these fears, and by attempts to find compromise solutions for conflicting tendencies." Put more simply, neurosis is an attempt by the person to make life bearable.

Horney's approach to psychoanalysis was also different from Freud's. Freud saw analysts leading their patients through a complex maze of transference (falling in love with the analyst), repression, and denial. She saw the role of the therapist as a much more a humanistic one, helping the person to change the perceptions of him or herself and life—"striving toward a clearer and deeper experiencing" of the direction of life. Mental health, Horney felt, involved having an accurate understanding of who you are—self-realization. When that understanding is present, it is quite possible for a person to reach a mentally healthy potential. In Self-Analysis, Horney describes psychoanalysis as helping people toward their best possible further development. Freud's insistence of universal transference, too, seemed invalid in Horney's view—the patient in analysis "is not prompted by love for the analyst," she argues in Self-Analysis. She speculated instead that what Freud considered transference may actually be more related to the person's fear of others and the inadequate methods neurotics use in their attempt to cope with life.

Examples In psychotherapy, Horney from her earliest days was perceived by her patients and her students as an Earth mother. She describes one of her patients that clearly was extremely dependent on Horney and constantly craved her affection. When the patient was offered an extra therapy session because she was upset, the patient began to feel humiliated. This was because the offer made her perceive her own greed for both the therapist's time and for Horney's unconditional love.

Main points

• Neurosis, according to Horney, is an attempt to make life bearable.
• It includes the use of an array of defenses that a person develops against what Horney terms "basic anxiety."
• The initial reaction to parental indifference is anger. Ordinarily this anger creates fear ("basic anxiety") in the child over the possibility that he or she will be abandoned or punished because of having these angry feelings.
• These defense mechanisms are ultimately self-defeating and conflicted, and must be recognized by the person and then changed.
• It is necessary to move beyond this realization of the childhood "basic anxiety" to focus on the self-defeating coping devices currently in use. Only in recognizing and changing these methods of coping can the person reach self-realization.

Horney's later years: Self-realization, neurotic needs, and coping mechanisms

Like Carl Jung, Horney preferred the term "self" to the Freudian term ego. Horney's self is not a fixed entity. She believed that it was composed of both hereditary factors, including temperament, predisposition, talents, and abilities; and environmental factors such as the family of origin and area of residence. In a further expansion of discoveries of the 1930s, Horney began to see that in mentally healthy people, self-realization is necessary to allow people to see who they are and what they are capable of. This realization of self is what endows them with the ability to be spontaneous, enjoy life, and reach life goals. Neurotics, created by the "greatest evil," parental indifference, lack the capacity to view themselves in this way. Instead, the neurotic self is divided into two parts: the despised self and the ideal self. The neurotic person is in perpetual conflict, wavering each day between the despised and the ideal. Horney calls this conflict "the tyranny of the shoulds." The person finds the despised self to be unbearable; but equally, the ideal part is impossible to attain.

Horney's ten neurotic needs

In Horney's practice, she began to see patterns of needs in the neurotic patients she treated. She noted in The Neurotic Personality of Our Time in 1942 that neurotics utilize extreme and unrealistic measures to meet these needs, and will not even be aware that they are doing it.

She categorized these need patterns as the following:

• The need for acceptance and affection: All human beings need acceptance and affection, but in people with healthier selves, the need is balanced by an understanding of what is possible and what is not. This need in neurotics can be manifested by an obsessive need to please others and be liked by them, or an unreasonable belief that others will meet every need. As these techniques are unrealistic and doomed to failure, anxiety is constantly generated when this need, as perceived by the neurotic, is not met.
• The need for love: Obviously all people want and need to be loved, but again, the neurotic's perception of what this means is unrealistic. Loved ones are expected to completely take over the neurotic's life, and solve all difficulties and conflicts for them.
• The need to simplify what is seen as the complexity of life: This is clearly a need that is tempting to all people at times, but again the neurotic takes this need to a problematic level. He or she may desire a very small number of material possessions, or wish to have no laws or schedule to follow. The neurotic seeks to be able to virtually become invisible when stress-increasing confrontation occurs. This invisibility is aimed at making them safer and decreasing their stress.
• The need for having power: We all desire to be empowered, but the neurotic feels a desperate need to control and have power over others.
• The need to manipulate others: Generated in a basic belief that others are simply there to be used, the neurotic, who perceives him- or herself as having been manipulated and used, tries to carry out a preemptory attack against others. The primary rationale for this behavior is to avoid looking stupid or being used by others.
• The need for social recognition: Again, it is the outer limit of a desire that is considered normal, our innate need for prestige and recognition. The neurotic takes this to another level with overwhelming fear of not looking good, being popular, or considered "in the loop." No matter how difficult it may be, the neurotic tries to be sociable.
• The need for the admiring recognition of others: Among the greatest fears of the neurotic is that the people they interact with every day will see them as being less than important, or as worthless or irrelevant.
• The need for achievement: Clearly setting goals and reaching them are important facets of all people. But the neurotic becomes obsessed with succeeding at meeting goals and being the best in whatever they attempt to do. Failure to achieve their unachievable goals results in more mental pain and/or the devaluation of whatever it is that they try to do.
• The need for independence: Autonomy is important to all people, but the neurotic takes this to the extreme. The illusion of self-sufficiency becomes more important than seeking help when it is needed. At some level neurotics truly believe that they can handle the situation by themselves, but there is also the self-centered portion of their psyche that does not want another person to help them and be recognized for an achievement. This would take away from the individual attention they feel should belong only to them.
• The need for perfection: Neurotics have an innately immature view of the world in which they live. There should be happy endings for everything, and the neurotic should be in control of all situations at all times. There is a terror of being flawed, of others seeing the mistakes the neurotic makes.

Horney's coping strategies

In the course of Horney's experience in analysis with her patients, she began to see that these neurotic needs correlated with the psychic personality development she had observed and documented earlier. She called meshing of these neurotic personality types, and the needs addressed by each behavior, "coping strategies." Her coping strategies are broken down into three types: compliance, aggression, and withdrawal.

Compliance According to Horney, compliance, or the "basic anxiety" that overcomes "basic hostility" has its origin in fears of abandonment or punishment. This abandonment or punishment would be in retaliation for the feelings of rage experienced by the child in the early years of life. It is found, she believes, in neurotic needs number one, two, and three. If in fact "basic hostility" must be hidden and the victim of parental indifference must become more loveable in order to survive, then clearly the need for acceptance and affection, even to the point of people pleasing, becomes critical. So, too, is the need for all-encompassing love. Number three—the need for simplification, the rejection of schedules and laws—initially seems the antithesis of compliance. But when this is viewed as part of the need to avoid confrontation by becoming unnoticeable, it becomes more clear. That avoidance of confrontation is yet another means of not allowing the "basic hostility" to be witnessed by others, resulting in rejection and the desertion of loved ones. Horney sometimes referred to this strategy as the "moving toward" or the "self-effacing solution."

Aggression Aggression, also called the "moving against" or the "expansive solution," is the second coping strategy and deals with neurotic needs four through eight. The requirements of having complete power over others; the ability to exploit others; and to have total (unrealistic) social recognition, admiration, and fame are obvious. The need to be fiercely competitive and always to be number one in accomplishments is equally self-evident and easily seen as aggressive behavior in this light.

Withdrawal What Horney calls withdrawal is represented, she states, by neurotic needs three, nine, and ten: To be self-sufficient and perfect clearly correlate with a retreat from being a member of the human race. The totally independent person requires no one else, never needs to ask for help from anyone, and is completely unfettered from any type of committed relationship. The perfect person, it is immediately evident, is also divorced from the rest of the human race as none of the rest of those on Earth are perfect. Interestingly, Horney added number three neurotic need because of her belief that the total independence and perfection were not possible in the neurotic's view unless limitations were put on the dimensions and complexity of life. Withdrawal is also referred to in Horney's writings as the "moving away," or "resigning solution."

In Horney's lexicon, the defensive strategies people use for dealing with the outside world are termed interpersonal strategies, while those used for dealing with the inner selves are called Horney intrapsychic processes.

Example In Our Inner Conflicts, Horney paraphrases Franz Wittels' description of the neurotic's pursuit of love: "Love becomes a phantom that is chased to the exclusion of everything else." This need for love, she asserts, is the only way that the neurotic needs to be liked and to dominate someone else can both be simultaneously fulfilled. Horney often discussed this neurotic pursuit of love in thinly disguised references to herself and a lifetime of affairs.

Main points Self-realization is the goal of psychotherapy and the benchmark of mental health. It can be defined as the restoration of the person to their "center of gravity," making it possible for them to spontaneously achieve their goals. Without gaining self-realization, people cannot attain either spontaneous enjoyment of life or accomplish their dreams and goals. The self is fluid and ever changing; it is composed of all of our genetic features—temperament, predisposition, talents, and abilities—as well as the environment in which we live. The neurotic person lacks the innate capacity to recognize self accurately, instead dividing self into "the despised self" and the ideal self.

Horney recognizes three basic coping strategies linked to the ten neurotic needs in the following ways:

• Compliance is the first of these strategies. It is related to neurotic needs for (1) acceptance and affection, (2) all-encompassing love, and (3) avoiding confrontation and having no rules or regulations.
• Aggression is the next coping strategy and is associated with the needs to (4) have control over others, (5) manipulate others, (6) to be recognized socially, (7) have others admire them, and to (8) obsessively achieve.
• Withdrawal is the last of these. It is demonstrated in the needs for (3) avoiding confrontation and having no rules or regulations, (9) having complete independence including never asking for help, and (10) the need for perfection.

HISTORICAL CONTEXT

It is important to note that psychoanalysis was not a creation of Sigmund Freud. Islamic (Sufi) literature frequently discusses psychological insight and what we would consider psychotherapy. Afghanistan's Jalaludal Rumi and El Ghazali from Persia are two of the known psychotherapists of ancient times. Writings from over three millennia ago mention "healing through words" used in both Ancient Egypt and Greece. But if the era often referred to in the Western World as The Golden Age of Psychotherapy was birthed by Freud, Adler, Jung, Horney, and the other luminaries of psychoanalysis from the late nineteenth and early twentieth centuries, then it follows that a disgraced charlatan was the midwife. Franz Anton Mesmer graduated from the University of Vienna, then one of the foremost schools in Europe, in 1766. In 1773, one of his patients, a Miss Oesterlin came to him complaining of a multiplicity of somatic ailments. Mesmer's doctoral dissertation had been on the influence of the planets on human illness. He quickly began to explore the possibility that the woman's recurring symptoms were based on tidal variations related to such cosmic phenomena. He concocted a tonic containing iron that he had her drink. He attached magnets to her body, and remarkably, her symptoms improved. With repeated treatment, her symptoms totally disappeared. Such a remarkable cure quickly made Franz Anton Mesmer among the most famed men in Vienna medical circles.

BIOGRAPHY:

Women of Freudian psychology

"If it had been a son I should have sent you the news by telegram, but as it is a little girl. . .you get the news later."

Sigmund Freud's words, written to his friend Wilhelm Fleiss (also his cocaine-supplier) in 1895 upon the birth of his daughter Anna show the bias encountered by early female psychologists. From birth, Anna had a poor relationship with her mother and siblings, describing herself as "not part of them," but not her famous father. Early in life, Anna became her father's favored child and showed herself to be brilliant. She was self-taught for the most part as she hated school, but availed herself of the many members of the intelligentsia that frequented the Freud household. (In her teens she spoke five languages.) At 14, she wrote to her father: "I have read some of your books, but you should not be horrified by that, for I am already grown up and so it is no surprise that I am interested." Her father's possessiveness and her total loyalty to him kept her tied to him, and she never strayed very far from his rigid beliefs. Anna taught in England, wrote several books, and together with Melanie Klein, she co-founded the discipline of child psychology and became one of its foremost thinkers. The Freuds escaped Vienna in 1938 just as the Nazis were coming to power in Austria. They settled in London, England, where her famous father died the next year, but Anna continued an illustrious career. (Among her many claims to fame are the fact that she was famed American movie-actress Marilyn Monroe's analyst.) Anna Freud died in 1982 at the age of 87.

Born in 1882, Melanie (Reizes) Klein apparently always resented her domineering mother. Melanie's Jewish, middle-class parents strongly encouraged education and enrolled her in a gymnasium in preparation for university. But family financial reverses made higher education for Melanie an impossibility. Like Horney, she married, had three children, and suffered from depression. Her husband Arthur's career as an industrial chemist brought them to Budapest, where she was analyzed by Sandor Ferenczi. Psychotherapy for children was then unknown, and Ferenczi encouraged her to learn by analyzing her own children. A pioneer of child psychotherapy, she developed the play technique and what is known as object relations theory—the belief that the mother-infant relationship is the hub of personality development. She moved to Berlin and then to London in 1927 after her marriage failed and her second analyst Karl Abraham (Karen Horney's old nemesis) died. Despite her work, Klein's relationship with her own children was poor. Her son Hans apparently committed suicide while mountain climbing, and her therapist daughter remained her implacable enemy. Klein died of cancer in London at the age of 78.

In some ways, Helene (Rosenbach) Deutsch's life paralleled Horney's. Born in Galacia, a Polish-speaking Austro-Hungarian province, her childhood was conflicted. Unlike Horney, it was Deutsch's mother that considered her "poison" because she was female. She would win the battle for her liberal attorney father's affection because of her rejection of her mother's bourgeois values and her own social activism. (Deutsch was an early feminist and protestor for social reform. Her protests even included the Vietnam War.) Following an affair with a married man and an abortion while at medical school, she met and married fellow-physician Felix Deutsch in 1912. Freud's Interpretation of Dreams made her a disciple, and she eventually worked in Freud's clinic. She unwaveringly supported her mentor (though she sometimes felt Freud focused on fathers too much to the exclusion of mothers) and reported at one point feeling that she was in love with Freud. She and her husband came to the United States in 1935. They lived in Cambridge, Massachusetts, and Deutsch practiced psychiatry at Massachusetts General and wrote extensively. She died in 1982 at the age of 91.

But Mesmer's early and dramatic success was speedily followed by marked skepticism among his scientific colleagues. Under a shroud of suspicion, he left Vienna for Paris. In Paris, once again Mesmer enjoyed early triumphs and a bustling practice. In large treatment sessions, he used lighting and music with his magnetic therapies. Eventually, he came under scrutiny for his failed cures, and an investigation came to the conclusion that there simply was no scientific evidence supporting Mesmer's ideas. Disgraced, Mesmer left Paris and returned to his birthplace in Germany. He died there in obscurity in 1815.

However, those in the scientific community began to question what had actually happened to produce successful outcomes in some of Mesmer's patients. After a prolonged study of the subject, an English physician named James Braid concluded that mesmerists induced "a peculiar condition of the nervous system, induced by fixed and abstracted attention. . .not through the mediation of any special agency passing through the body." Due to Mesmer's sullied reputation, Braid called the subject of his research "hypnotism." This is the treatment tool that was being used by Joseph Breuer in Vienna when Sigmund Freud began to work with him in 1893.

When Horney grew up, Germany was a place noted for fine education and intellectual pursuit. Art, philosophy, and medicine all flourished there. Yet when she graduated from medical school, married, and had her children, Horney did not have the right to vote. Women's suffrage came to Germany and Austria in 1918, only two years before the beginning of her feminist disputes with the Freudians. At that, both Germany and Austria were still ahead of the United States, where a woman's right to vote was not granted nation-wide until two years later, in 1920.

The start of Horney's career and her child-rearing years were contemporary with World War I, an era when the dreadfulness of modern warfare first saturated Western humankind's consciousness. It was the first time that cavalry units, little changed from the days of Napoleon, went into battle against tanks, airplanes, and machine guns. It was the first widespread use of chemical warfare. These horrors would add a new term to our vocabulary: "shell-shock." Shell-shock and the breakdown of Victorian society as the barbarism of World War I continued would prove good for business in the realm of mental health treatment. Certainly, witnessing the return of World War I soldiers with obvious emotional difficulties helped to assure that the theories of Freud, Horney, and others would not be discounted.

The other tragedy of the second decade of the twentieth century was less influenced by the actions of humans. The influenza pandemic of 1918 was mind-boggling in its severity and its ability to travel worldwide. It has been estimated that more people died of what came to be known as "the Spanish flu" than had died in the Black Death bubonic plague epidemic of 1347 to 1351. Admittedly spread to some degree by the movement of troops and refugees during World War I, this influenza pandemic moved rapidly across Europe, the United States, and eventually even to Asia, Africa, Brazil, and the South Pacific. No accurate figures exist for the death toll worldwide, but a paper entitled "The Influenza Pandemic of 1918" by Molly Billings of Stanford University estimates that the figure is between 20 and 40 million people. The uncertainty generated by the war and influenza added greatly to the stress and need for mental health treatment in both Europe and the United States.

The 1920s, a time of financial collapse and political chaos in post-war Germany, became the building block for the beginnings of the National Socialist Party (Nazis) under Adolph Hitler. It was a time of absurd inflation (it took over four billion German Marks to equal one American dollar) and abject poverty for many Germans. Gangs of armed Nazis and Communists fought each other openly in the streets. Though Horney does not appear to have ever been terribly involved in politics, she does seem to have early realized that the total annihilation of creativity and individuality was fast approaching in Germany as the Nazis gained members, support, and power. It apparently was a large factor in her reason for leaving for the United States just prior to Hitler's takeover in 1933. Since her daughter Brigitte, a movie actress, remained in Germany and another daughter Renate returned there to live prior to World War II, Horney had more than one occasion to visit Nazi Germany. As noted, she made these visits without problem and even lectured there. She never made her feelings public as her adopted country, the United States, and her childhood home, Germany, fought to the death. She did mention that the war created stress for women and mothers.

CRITICAL RESPONSE

Feminist theory arguments

From Horney's earliest (feminist) arguments against Freudian thought and through the development of her own theories, she was embroiled in controversy. In many ways, this controversy was a product of Horney's interpersonal style. She took on, at one time or another throughout her career, nearly every other luminary of psychotherapy that shared her time in history. Obviously the disagreements she became involved in with Freud and his disciple Karl Abraham from 1920 on were the first shots fired in what would come to be for Horney a long, long war. In 1926, she was asked to write an essay as part of a book honoring Sigmund Freud on his 70th birthday. Horney started with a brief complimentary recognition of his penis envy theory, but quickly went on the attack. She quoted Simmel's observation that men manage, in a male-dominated society, to invalidly fashion their subjective experience into what they term objective truth. It is said that Freud once characterized her as "malicious-mean."

Her lectures and papers expressing disbelief in Freud's Oedipus complex premise prompted Abraham to note her personal penchant for becoming involved with what he termed "forceful men," men similar to her own father. Karl Abraham's 1920 lecture at The Hague seems aimed at discrediting Horney. He cited his female patients' transference, making him a father figure, as evidence that women really wished to be men. He specifically mentioned a Horney theme—that this desire is based on being denigrated by a male-dominated society. But Abraham adamantly insisted that this female desire to be a man is not based upon any social factor, but rather on the little girl's lack of, and desire to have a penis. He went on to add, based upon his recent analysis of his own daughter, that female children believe, "I had a penis once, as boys have. But it was taken from me." He described women as carrying an unconscious sense that they had been wounded in their genital area (where the penis had once been), and that this sense of injury was re-stimulated by the onset of menses, sexual intercourse, and childbirth.

Karl Abraham took penis envy even further to insist that young daughters initially expect or hope that their father, who is responsible for providing for their wants and needs, will restore their penises to them. When they are disappointed in this wish, they then, as a second choice, hope to be given a baby. This patriarchal assertion clearly is in conflict with Horney's early conviction that feminine identity is innate in female children and derived from their identification with their mothers. In what almost appears a personal attack on Horney recounted by Janet Sayers in Mothers of Psychoanalysis, Abraham went on to state that this early sense of being wounded and deprived of their penis creates what Abraham perceived as "women's sense of vengeance against men." This, he states, accounts for two alternative behaviors in women: being frigid or (as was the case for Horney) a "defensive belittling of men by taking a succession of lovers."

In The Neurotic Personality of Our Time, Horney again disputed Freud's paper on "Some Psychological Consequences of the Anatomical Distinction Between the Sexes." This time she used quotations from Ruth Benedict's Patterns of Culture as an argument, thereby stressing another of her basic differences with the Freudians, her belief that the culture a person lives in plays a huge role in determining neurosis. Horney states: "In making statements like these (regarding penis envy), Freud is yielding to the temptation of his time: to make generalizations about human nature for the whole of mankind, though his generalization grows from the observation of only one culture zone." She goes on to question if Freud's hypothesis remains true in other societies where men are customarily more jealous than women, or cultures where there is no observable jealousy at all.

Is not the tremendous strength in men of the impulse to creative work in every field precisely due to their feeling of playing a relatively small part in the creation of living beings, which constantly impels them to an overcompensation in achievement?

Horney's belief that men tried to overcompensate (because of their inability to experience motherhood) caused both arguments from some male psychologists and affirmation from some female ones. Freud, too, felt compelled to argue against Horney's stance on maternal identification. In 1925 he once more insisted that female heterosexuality is not the result of early association with the mother, as Horney contended. He argued that if this were the case, as he felt could not be assumed, then it was necessary to explain how the young girl makes the transition from this affinity with the mother to a heterosexual wish for sexual intercourse (in Freud's belief, a desire for intercourse with the father). Freud referred to the work of Helene Deutsch, a contemporary of both Horney and Freud, who completely supported Freudian theory. Invited as a speaker to the International Congress of Mental Hygiene in Washington in 1930, newspapers described Deutsch as "a lady-in-waiting at the Freudian court," and "the master's foremost feminine disciple." Deutsch then became the target of Horney's assaults. Deutsch had stated that childbirth concerned both loss of the phallus and orgasm, claims that Horney, based upon her own child-bearing experience, quickly ridiculed as "patently absurd."

It seems that Melanie Klein must have been in agreement with Horney in some area, since Horney trusted her enough to send her three daughters for analysis with Klein when they were still very young. That point of agreement may have been Klein's development of play therapy for children, in which games are analyzed in much the same way dreams are probed in Freudian (adult) psychoanalysis. Klein's psychoanalytic theory modified one area that had been in dispute between Freud and Horney: she believed that sexual envy occurred in both sexes. However, there is determinism in Klein's work that seems at odds with Horney's optimistic belief that people can modify defense mechanisms and change. For Klein, one of the earliest and most basic of desires in infants is to experience the pleasure derived from the "good breast." Frustration of these pleasurable experiences, especially in the first year of life, created a schizoid, paranoid personality manifested by isolationism and suspiciousness. She believed in the presence of a primitive superego in infants, and posited that if the frustration was too severe, it would lead to depression later in life. Klein's death instinct theory was similar to beliefs held by Freud in his later years after experiencing the world wars and the rise of Nazism.

It was the death instinct theory that finally put Horney on the attack against Klein. Klein believed this death instinct to be the cause of childhood fantasies about harming their mothers. Horney countered that in her experience, these fantasies were not instinctual but rather the result of children being humiliated, abused, or rejected.

Neurosis arguments

Horney wrote extensively, disputing Freud's assumption that the Oedipus complex is a purely biological phenomenon. In her 1937 book The Neurotic Personality of Our Time, she cites several other analysts and writers of her time—Bronislaw Malinowski, Felix Boehm, Erich Fromm, and Wilhelm Reich—as asserting that this force is culturally driven, not biological. She went on to note that in her experience she knew of no case where "it was not neurotic parents who by terror and tenderness forced the child into these passionate attachments, with all the implications of possessiveness and jealousy described by Freud."

Franz Alexander, Horney's former student from the Berlin Psychoanalytic Institute and responsible for bringing her to the United States, came to believe in what he termed "corrective emotional experience," psychoanalytic therapy in which the patient gets the opportunity to alter the effects of past traumatic events from their early years. He believed that with a compassionate and affirmative therapist, these patients can change the way these childhood psychic injuries affect them and that they can grow from these experiences. In one way, Alexander's theory is contrary to the conclusions that Horney had reached. She had come to believe that the issues of early childhood were significant only as reference points. The neurotic coping mechanisms in use in the present time were what needed to be looked at. However, she and Alexander shared an optimism common among the humanist psychoanalysts—that people are capable of change.

By 1935, about the same time that she was elected a member of the New York Psychoanalytic Society, Horney began propounding an expansion of earlier (feminist) theories that she had espoused. She argued that the cause of neurosis was not the result of the conflict between masculinity and femininity; nor was it related to an Oedipus complex or conflict around perceived castration. Neurosis, she argued, was the direct effect of another conflict—between character trends that are sadistic and masochistic. These character trends, Horney believed, were the result of resentment and the desire for love generated in infancy by cold, unloving mothers. This belief would ultimately cost Horney her teaching position at the New York Institute.

She also differed from Alfred Adler's belief that an "inferiority complex" is the basis for neurosis. Neurotic strivings toward power, prestige, and possessing things, for both Adler and Horney, can be manifestations of neurosis. Adler's view was that efforts to gain power, prestige, and possession of things are a normal component of human nature, and that the more intense, out-of-balance forms of these seen in neurotics were a product of either an inferiority complex or physical handicap. Horney's perception was markedly more complex. For her, the goal of power is a bulwark against helplessness. It expresses itself in overbearing, bossy behavior. The aim of obtaining prestige is to prevent humiliation, and is manifested by a tendency to shame others. The importance of possessing things is to be protected against destitution. In neurotics, its manifestation is a penchant for depriving others of these things.

Despite these differences, Horney's three coping mechanisms seem related to Adler's three personality types. Horney's second mechanism, aggression, is quite similar to Adler's first type: the "ruling type," a person noteworthy for being aggressive and requiring domination over others. (In Adler's description, bullies and sadists are good examples.) Horney's first mechanism, compliance, seems like the very methods used by Adler's "leaning type." He describes them as sensitive and dependent on other people to aid them in surviving life problems. When overwhelmed, they develop classic neurotic symptoms quite similar to those described by Horney. The third coping mechanism in Horney's scheme is withdrawal, which certainly appears to coincide with Adler's third personality type, the "avoiding type," who only make it through life by avoiding life. They manifest this avoidance by shunning other people. Adler sees them as fragile. If pressed too hard, he believed, avoiding-type people would become psychotic, making the final withdrawal into their own inner world. Adler actually has a fourth personality type, the "socially useful type." "Socially useful" people appear to be Horney's individual who has reached self-realization.

Ultimately, it seems clear that Horney indeed was the victim of criticism and even ostracizing by other members of the psychoanalytic community for her disagreements with Freud and classic Freudian tenets. Her colleagues at the Berlin Institute in the 1920s surely made her a pariah because of her feminist and self-help beliefs, as well as her arguments against Freud's Oedipus complex and penis envy theories. When her book Self-Analysis was published in 1942, it was largely ignored or considered "simple-minded cultural determinism" by many of her peers, according to Janet Sayers in Mothers of Analysis. Horney's status downgrade at the New York Institute two decades later seems equally related to her failure to follow orthodox Freudian thought. However, she is hardly the only one to have disagreed with Freud.

There is much evidence to suggest that many of Horney's difficulties with others in her field were more related to her personal communication style than her professional beliefs. In fact, Horney's communication style seems as conflicted as any of the neurotic people she treated or wrote about. There are volumes of evidence to suggest that Horney, as a teacher, had students who literally lined up to take her courses. Described as "no beauty," and the flow of her lectures "interrupted by endless smoking," she was yet described by one of her students as "a little coy. . .a little of the actress in her. And everybody was just hanging on what she had to say." After her demotion at the New York Institute and her creation of the American Psychoanalytic Institute, well-known peers, including Harry Stack Sullivan, Clara Thompson, and Erich Fromm, flocked to join her newly formed organization. Within a year, however, they had left to form their own institute. If Erich Fromm could be taken out of the equation because of his personal relationship with Horney, there is still the question of why Sullivan and Thompson left. The most commonly given answer to this question is that Horney, for all the punishment inflicted on her for not following Freud's dogma, would not allow others to stray from her own tenets.

Horney's self-help stance

Probably no one will ever know if two transplanted Vermont Yankees that first met in Akron, Ohio, in April of 1935, had read the works of Horney. But Bill Wilson and Dr. Bob Smith, the co-founders of Alcoholics Anonymous, surely came to concur with Horney's ideas of self-help. Neither Wilson nor Smith were strangers to psychoanalytic theory. One of the earliest members of the Oxford Group, a spiritual assemblage that was the predecessor of Alcoholics Anonymous, had been in therapy with Carl Jung. When Wilson joined the Oxford Group, Smith shared his insights. In fact, Wilson and Jung continued a dialogue via letters over a period of many years. More interesting, perhaps, is the group that developed as an off-shoot of Alcoholics Anonymous—Al-Anon. It was begun by the loved ones of early members of AA who often accompanied their alcoholic family members or friends to meetings. As they talked over cups of coffee and snacks, they discovered that quite often they had a great deal in common. Al-Anon faces Alcoholism, a sharing of members' experience, strength, and hope first published in 1965, discusses many of the subjects Horney dealt with in her therapy sessions—anxiety, frustration, low self-esteem, and dependence on others for happiness.

THEORIES IN ACTION

Horney's greatest contribution to psychoanalytic thought clearly was her inability to accept the theories of her contemporaries as unquestionable. That ability to doubt was born in listening to her dogmatic, Bible-throwing father preach his "truth." Once Freud's work had gained acceptance in Europe during Horney's time, it became the ultimate reality. It did not become reality for Horney and a few other free-thinkers, however. Like Jung and Adler, Horney for the most part was able to dispassionately consider what parts of Freud's theories had validity and what parts did not. This led to the germination of a rich variety of psychoanalytic schools of thought. (There are an estimated 400 of them today.) Varied psychoanalytic thought ultimately makes it possible for patients to choose from abundant resources to find what will be helpful to them. Without Horney's (and others') voices, the Western world would have been condemned to only Freudian treatment with its (at least perceived) denigration of women and hopeless outlook. When Horney published The Neurotic Personality of Our Time in 1937, for the first time the mental health community and laypeople were offered a glimpse of therapy that was neither cold and distant nor allknowing, as Freudian analysis tended to be. It was instead motherly, warm, and supportive. It would lead into treatment modes totally divorced from Freud's. The Neurotic Personality of Our Time would prove so immensely popular that it would be reprinted 12 more times.

Horney's earliest work was related to the feminist movement, and it certainly has influenced women's rights worldwide since. She was hardly the mother of feminism, however. Many other more deserving candidates for that position exist in the annals of history. Horney and Erich Fromm, though, certainly do deserve the credit for founding the "culturist school" of psychotherapy. Their shared notion, that the outer world in which people exist is at least as important as their inner world, would greatly influence social scientists and even social programs in every Western nation. As noted in the statistics below, under Research, it appears that the Culturist School of Psychoanalysis—the insistence upon seeing poverty, domestic abuse, and other social evils as relating to mental illness—has become even more significant. Its beginnings are very much a part of both Horney's and Fromm's work, which has grown and remains viable.

Horney's impact on the world in the years since her death and the legacy she left behind can be measured by the organizations and treatment centers that still further the work Horney began, now more than 50 years after her death. Three years after her death, the Karen Horney Institute came into being. This New York-based foundation runs the Karen Horney Clinic, self-described as a nonprofit center serving a diverse socioeconomic group and providing affordable mental health treatment on a sliding scale payment basis.

In looking at Horney's life, it seems appropriate that among the services offered are:

• programs for people in the arts
• adult treatment programs
• child and adolescent programs
• foster care program
• therapeutic nursery
• victim treatment center
• treatment center for incest and abuse
• eating disorders treatment
• HIV and AIDS clinical services

The American Institute for Psychoanalysis begun by Horney in 1941 is yet another part of the Karen Horney Institute, along with the Association for the Advancement of Psychoanalysis. Both of these associations work closely with the clinic, providing training opportunities for advanced mental health professionals and an internship in social work.

The prevalence of mental health practitioners of the humanistic school of psychoanalysis today is further evidence of the validity of Horney's beliefs. As noted by Elizabeth Capelle in The Readers Companion to American History, "Horney was a thinker of undeniable originality, and many of the issues she raised can now be seen to be crucial to the psychoanalytic enterprise. Her questions, if not in every case her answers, have been vindicated."

CHRONOLOGY

1885: Horney is born outside Hamburg, Germany.

1904: After a tumultuous marriage, her parents divorce.

1909: Marries Oskar Horney.

1911: First child, daughter Brigitte, is born.

1927: After an increasingly unhappy marriage, Horney leaves her husband, taking her three daughters.

1932: Moves to United States with her youngest daughter, Renate.

1933: Begins psychiatric practice in United States.

1934: Takes teaching position at Washington-Baltimore Society for Psychoanalysis.

1936: Publishes Feminine Psychology.

1942: Publishes Self-Analysis.

1952: Dies of stomach cancer at age 67.

Research

Psychoanalysis is far too nebulous an undertaking to be quantified into a numerical breakdown of cures from one form of therapy or another. There is even some question as to whether psychoanalysis—the talking therapy—is an art, rather than a science. This further muddies the waters of the efficacy of treatments. Patrick Kavanaugh of the Academy for the Study of the Psychoanalytic Arts has described mental health treatment in this era of the brain and of managed care as "conceptual understandings of human behavior based upon a biologized-medicalized-chemicalized-pathologized reductive metaphysical position." Put simply, nearly all psychoanalytic and biological theories propounded over the decades of the twentieth century have had some validity and have been effective in helping some people. As noted by Mark Tyrell in Uncommon Knowledge, Ltd.,

So, what works in psychotherapy? What research tells us is effective is brief (that is to say time-limited and not endless) therapy which includes behavioral, cognitive, and hypnotic therapy and, if necessary, interpersonal (communication) training and practical support and help. Seeing someone as part of a wider system such as their family, community, and work environment is also essential to truly help them.

However, there is an area of statistical research that supports one of Horney's most basic premises: that society is a primary factor of much of our mental ills. The most recent (worldwide) statistics released by the World Health Organization (WHO), Mental Health and Substance Dependence Division, look at mental illness in a way that Horney, Erich Fromm, and other culturist psychoanalysts would favor. These figures are unequivocal in their support of the premise that social factors influence mental health.

BIOGRAPHY:

Mary Whiton Calkins

In 1863, when Mary Whiton Calkins was born, the United States was a broken and bloody place, in the full throes of a terrible and fratricidal Civil War. Born in Hartford, Connecticut but living a good part of her life in Buffalo, New York, Calkins came from a family that could best be described as eccentric. Her Welsh father and American (Puritan) mother spoke German, and were opposed to the American education system, believing their five children could be better educated by having them board with German and French families. Both parents actively encouraged all of their children to receive good educations. If there were any neurosis-producing issues in Mary Whiton Calkins' childhood, she kept them to herself. She began studies at Smith College in 1882, entering as a sophomore. The illness and subsequent death of her younger sister caused her to leave school for a while, but she returned and graduated in 1885.

The family traveled to Europe the next year and it is believed that Mary furthered her studies at the University of Leipzig. She had planned to tutor upon her return from Europe, but was soon invited to fill a vacancy at Wellesley College in the Greek department. When Wellesley expanded their philosophy department to include the newly added field of psychology the next year, Calkins was invited to take the position of professor of psychology, providing she studied psychology for a year. In 1890, Harvard, Yale, and even Clark University were not enthusiastic about a female student in their psychology programs. Calkins took courses at the Harvard Annex (not officially part of Harvard), but was soon encouraged to press for attending the university by Josiah Royce, her professor, who quickly had perceived her great promise. With petitions from Royce and her father, Mary was allowed to attend classes, but still not as a regular student. She went on to work in the psychology lab at Clark University and began teaching at Wellesley in 1891. She continued to attempt to complete graduate studies at Harvard, but was again refused. She finally was given an informal examination at Harvard, which she passed, but was still not given a degree.

In 1905 she became the first woman president of the American Psychological Association, and in 1918, the first woman president of the American Philosophical Association. She taught at Wellesley until 1927, when she retired. She was a prolific writer, advocating self-based psychology. She created a method of improving memory called "The Right Associates Method," and wrote extensively on a variety of subjects, including dream research, memorization, animal consciousness, and many others. She was the author of one of the earliest textbooks used in teaching psychology, Introduction to Psychology. She never married, and died in 1930 of cancer.

These figures, as reported by Dr. Benedetto Sarancenoe, Director of WHO, Mental Health and Substance Dependence, in September of 2003 show that:

• 450 million people on this planet suffer from mental health problems.
• At minimum one member of each four families worldwide has a mental disorder.
• Though no sector of any society is free of mental illness, the possibility of having a mental illness looms larger among children and adolescents living in poverty, the unemployed, poorly educated people, refugees, minority populations, abused women, other victims of violence, and neglected elderly persons.
• Though most mental illnesses are not fatal, they do account for 31% of all disability, worldwide.
• It is estimated that depression is emerging as among the most common mental health problems in the world, and by the year 2020, will be the second most common cause of disability.

Case studies

The classic case study in any discussion of Horney is the story of "Clare." It is believed to be autobiographical, or at least a melding of her life and some of her patients, as it clearly traces a woman's life that is markedly similar to the life of Horney. Clare is the second and unwanted daughter of parents involved in an unhappy marriage. The parents wanted no more children after their first child, a son. The father is a physician who is seldom home, and the mother is rather pompous and insists upon absolute loyalty and veneration from her children. Clare initially tries to win the love of the father, but soon discovers that her father is not interested in her or her brother. He is far too obsessed by his beautiful and clever wife to even notice the children. However his wife totally detests him and makes no secret of wishing him dead. Clare soon begins to see her mother as the much more powerful of the two parents, and allies herself with her mother.

This alliance with her mother does not give Clare the love she so desperately wants, but it does make her "the wonderful daughter of a wonderful mother." Totally divorced from her own feelings, Clare relies on her mother and others for her self-esteem, depending upon their admiration of qualities in herself that she actually detests. This early pattern of behavior leads to denial or lack of awareness of her own wishes, excessive need for and dependence on other people, and fierce competitiveness arising from the need to be better than others in order to replenish her self-esteem. Horney states that analysis for someone like Clare involves uncovering the reasons for these behavior patterns, how they manifest themselves in her life, and what effects they cause in her life.

Clare has, while in her 20s, separated from her husband. In self-analysis, Clare discovers why she felt unable to ask her estranged lover to return. It has to do with an unconscious fear from childhood of asking her mother for anything. The source of the fear was the possibility that her mother would reject her. Clare obsessively sought out men she could idealize—that would protect her and care for her. When these men didn't meet her obsessive needs, she hid her resentful feelings behind being a martyr and desperately sought attention and solace. Horney's belief was that human beings had an innate ability to overcome denial—the resistance to knowing themselves. Only when individuals were too much divorced from their "real selves" would they be unable to successfully enter into self-analysis. For Horney, Clare was a suitable candidate for self-analysis because she is not yet too alienated from her real self.

Horney also describes a patient referred to only as "a French girl" that she treated while in Germany in the 1920s. This girl was one of the several Horney saw during this time whose parents had believed her to be "feeble-minded" (cognitively impaired, what we commonly call mental retardation). No further description of the parents is ever given. After seeing the girl for several weeks, Horney began to question whether this patient was not, indeed, cognitively limited. Though the girl understood German perfectly, according to Horney, she seemed to understand nothing that was said to her, even when Horney used simpler language. In the process of their sessions, however, the French girl did begin to speak of dreams she was having that had to do with Horney's office. The girl was dreaming that the office was a jail or that it was the office of a physician who had examined her physically, something she hated.

These dreams, Horney states, were indicative of the girl's fear of being found out. Horney obtained further evidence that she was far from "feebleminded" when the young woman spoke of an incident during which she was legally required to present her passport, but forgot to do so. She laughed as she explained how she had finally gone to the appropriate official with her passport, but had feigned not being able to speak German in hopes that this would keep her from getting in trouble. As she described the incident, the girl realized that this behavior was identical to how she had been dealing with Horney. This insight helped her to realize that this behavior was a pattern in her life: in order to avoid punishment or accusation. she pretended to be stupid and not able to understand. Horney states, "From this time on she proved to be a very intelligent girl."

BIBLIOGRAPHY

Sources

Billings, Molly. The Influenza Pandemic of 1918. 1997. http://www.stanford.edu/group/virus/uda.

Boeree, C. George. Personality Theories/Erich Fromm. 2000. http://www.ship.edu/~cgboeree/fromm.html.

Capelle, Elizabeth, Eric Foner, and John Garraty. The Reader's Companion to American History. Houghton Mifflin Co., 1991.

Coleman, James. Abnormal Psychology and Modern Life. Chicago: Scott, Foresman and Co., 1956.

4000 Years of Women in Science. Mary Whiton Calkins. 1999. http://www.astr.ua.edu.

Hoffman, Dassie. 2000. Sandor Ferenczi and the Humanistic Psychologists.http://www.sonoma.edu/psychology.

Horney, Karen, M.D. The Neurotic Personality of Our Time. New York: W. W. Norton and Co. Inc., 1937.

Horney, Karen, M.D. New Ways in Psychoanalysis. New York: W. W. Norton and Co. Inc., 1939.

Horney, Karen, M.D. Our Inner Conflicts. New York: W. W. Norton and Co. Inc., 1945.

Inter-parliamentary Union, England. "Women's Suffrage." Serendipity.http://www.ipu.org.

Kaplan, Harold I., M.D., and Benjamin J. Sadock, M.D. Synopsis of Psychiatry, Behavioral Sciences, and Clinical Psychiatry. Baltimore: William and Wilkins, 1991.

Marcus, Paul, and Alan Rosenberg. Psychoanalytic Versions of the Human Condition: Philosophies of Life and Their Impact on Practice. New York University Press, 1998.

"Press Release." World Health Report, 2001, Mental Health: New Understanding, New Horizons. 2001. http://www.who.int/whr.

"Trance and Trauma: Functional Nervous Disorders and the Subconscious Mind." Serendipity.http://www.serendip.brynmawr.edu.

Sayers, Janet. Mothers of Psychoanalysis. New York: W. W. Norton and Co. Inc., 1991.

Tyrrel, Mark, and Roger Elliot. The Mad, Mad World of Psychotherapy. Uncommon Knowledge, Ltd., 2003.

Further readings

Paris, Bernard. Karen Horney: A Psychoanalyst's Search for Self-Understanding. New Haven, Ct: Yale University Press, 1994.

Rubins, Jack L. Karen Horney: Gentle Rebel of Psychoanalysis. New York: Dial Press, 1978.

Quinn, S. A Mind of her Own: The Life of Karen Horney. New York: Summit Books, 1987.