WASHINGTON PSYCHOANALYTIC SOCIETY

The organizational history of psychoanalysis in the Washington D.C.-Baltimore metropolitan area is as convoluted and complex as the intellectual weave that created it. Psychoanalysis started early in Washington, embraced by key U.S. psychiatrists, and it mutated and expanded over the better part of a century. Currents of thought and practice, often in conflict, came to include ego psychology, Freudian revisionism, Sullivanian interpersonal theory, and the use of psychoanalytic theory to understand and treat psychoses. Among the important figures in its history must be counted psychiatric pioneers Adolf Meyer and William Alanson White, the maverick Harry Stack Sullivan and his colleagues Frieda Fromm-Reichmann and Clara Thompson, and the determined Viennese defender of orthodoxy, Jenny Waelder-Hall.

The precursor to the Washington Psychoanalytic Society was founded in 1914, with William Alanson White as its chair. Like several other psychiatrists fascinated by Freudian ideas, White was superintendent of the Government Hospital for the Insane, soon to be renamed St. Elizabeth's Hospital. White, who had been interested in Freud's teachings since about 1909, became the first American author of a book on psychoanalysis when his Mental Mechanisms was published in 1911. Other significant figures early on the Washington scene included Adolf Meyer, who was associated with Johns Hopkins University, Ives Hendrick of Sheppard and Enoch Pratt Hospital, and John MacCurdy, one of the founders of the American Psychoanalytic Association. Interest in treating the psychoses was common to all these figures, and the use of analytic ideas for therapeutic ends with severe psychopathology became an enduring feature of psychoanalysis in Washington-Baltimore.

Members of the Washington Society originally met regularly and discussed papers. A hiatus at the end of the First World War lasted for several years, and for a time the organization changed its name to the Washington Psychopathological Society to distinguish itself from a competing society. By the late 1920s, however, distinguished analysts were visiting Washington from abroad and the society had attracted significant local psychiatric talent. Ernest Hadley, one of the first to open a private psychoanalytic practice in Washington, became a major administrative figure in the American Psychoanalytic Association (APA) over the next two decades.

Efforts to create a more formal group culminated with the founding of the Washington-Baltimore Psychoanalytic Society in 1930. From the beginning the institute situated itself as a constituent of the APA, to which it became accredited in 1932; it also subsequently affiliated with the International Psychoanalytical Association. Members soon created a training program, formally established as the Washington-Baltimore Psychoanalytic Institute in 1940. Lewis Hill directed the institute until 1949; he was succeeded by Ernest Hadley for five years thereafter, until the latter's death in 1954.

Background and education of members of the Washington-Baltimore society in its early years distinguished them in the broader context of the evolution of psychoanalysis in the United States. "From the beginning," wrote Donald L. Burnham (1978) in an early historical evaluation, "diversity of membership and of approaches was a feature of the psychoanalytic groups which formed in this region." He added, "This may have been partly because of their 'home-grown' quality. There was less leadership and dominance from analysts who had come originally form Vienna or Berlin" (p. 89). Analysts in Washington included Midwesterners, Roman Catholics, and children of rural America.

Harry Stack Sullivan, a representative American who had grown up in upstate New York, strongly affected the whole trajectory of psychoanalysis in Washington-Baltimore; in retrospect, his influence was as pervasive and crucial as it was controversial and divisive Like Meyer and White, Sullivan came to psychoanalysis via the treatment of psychoses. Soon after establishing the Washington Psychoanalytic Institute, he went on, during the mid-1930s, to help found the William Alanson White Psychoanalytic (later changed to: Psychiatric) Foundation and Washington School of Psychiatry. Active and influential in psychoanalytic circles, Sullivan was also loudly not a conventional analyst and eventually he developed a systematic theory of development that emphasized the interpersonal determinants of psychological life and the cultural components of mental disorders.

Sullivan's predominance also expressed itself through the people he influenced in Washington and Baltimore, as well as those he antagonized. Clara Thompson was a friend, colleague, and ally who became a powerful figure in the Washington-Baltimore Psychoanalytic Society and helped establish and lead the William Alanson White Institute in New York, originally as a satellite of the Washington-Baltimore Institute. Frieda-Fromm Reichmann, who was also influenced by Sullivan, became prominent in treating severe mental illness with intensive psychotherapy, and was active in all the local organizations. On Sullivan's antagonistic side was Jenny Waelder-Hall, a Viennese-trained analyst who arrived in Washington in the mid-1940s. Considerable personal enmity grew up between her and Sullivan, said to be apparent from their first meeting. Donald Burnham (1978) suggested that "it is tempting to view Waelder-Hall and Sullivan not only as eloquent spokesmen but as literal personifications of Vienna orthodoxy and American eclecticism and of the difficulty, if not impossibility, of reconciling the two" (p. 102).

The permutations that occurred in Washington psychoanalysis soon after the end of World War II proceeded, in any event, along intellectual fault lines with the help of some personal and professional hostility. By 1946 the Washington-Baltimore Psychoanalytic Society split into two groups, although they would share a single training organizations until separate institutes were both officially approved in 1952 and fully accredited by the American Psychoanalytic Association three years later. The Baltimore Psychoanalytic Society represented a strong version of the European and Viennese current of orthodoxy led by Waelder-Hall; while the Washington Psychoanalytic Society, although it included orthodox analysts, also expressed Sullivan's influence, which was to outlast his premature death in 1949.

Using psychoanalysis to treat severe mental disorders followed a unique and separate but intertwined trajectory in Washington-Baltimore. Apart from the early work of Meyer and White, Sullivan, who declined to accept the therapeutic pessimism commonly seen in European psychiatry concerning psychosis, developed a treatment scheme for schizophrenia for which he claimed a high rate of success. By the late 1930s, Chestnut Lodge, a private sanatorium in Rockville, Maryland, became the site of efforts to treat patients with sever mental illness using psychodynamic principles. Invited by director Dexter Bullard, Frieda Fromm-Reichman became the first of a number of psychoanalysts to employ intensive, long-term therapy with schizophrenics at Chestnut Lodge

Although tensions between orthodox analysis and dissident currents persisted through he 1950s and 1960s in Washington-Baltimore, the period saw steady growth in psychoanalysis at a time when the profession found support at the National Institute of Mental Health and a host of local institutions, including Walter Reed Hospital and Georgetown University Medical School. In the institutional skein, many prominent analysts held multiple appointments. When Fromm-Reichman's celebrated Principles of Intensive Psychotherapy was published in 1950, for example, she not only was a leader at Chestnut Lodge but taught at the Washington School of Psychiatry and the Washington-Baltimore Psychoanalytic Institute, as well as the William Alanson Institute of Psychiatry in New York.

By the 1970s, the decline of psychoanalysis as a medical specialty led to modifications in many programs that encouraged postgraduates outside of medicine, and those in Washington and Baltimore were not exceptions. The Washington Psychoanalytic Institute expanded its theoretical base, and training has come to embrace a diversity of viewpoints in addition to a Freudian core, including object-relations theory, self psychology, intersubjectivist, and constructivist approaches. The Baltimore Psychoanalytic Institute, founded by Jenny Waelder-Hall on classical lines, was now the Baltimore-Washington Psychoanalytic Institute, and relocated to Laurel, Maryland. It modified its programs beginning in the 1960s, and now trains psychologists and social workers as well as psychiatrists.

Other institutes also opened in the Washington-Baltimore metropolitan area in the last two decades of the twentieth century. The International Institute of Object Relations therapy, founded by David E. Scharff and Jill Savage Scharff, is based in Chevy Chase, Maryland, although it has created training modules in nearly a dozen other cities. The Institute of Contemporary Psychotherapy and Psychoanalysis of Washington, founded by Joseph Lichtenberg and Rosemary Segalla, bases its training program on Heinz Kohut's self psychology.

John Galbraith Simmons

Bibliography

Burnham, Donald. (1978). Orthodoxy and eclecticism in American psychoanalysis: The Washington-Baltimore experience. In J. Quen and E. Carlson (Eds.), American psychoanalysis: origins and development (pp. 87-108). New York: Brunner Mazel.

Noble, Douglas, and Burnham, Donald. (1969). History of the Washington Psychoanalytic Society and the Washington Psychoanalytic Institute. Washington DC: Washington Psychoanalytic Society.