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Bychowski, G. (1970). Psychoanalytic Reflections on the Psychiatry of the Poor. Int. J. Psycho-Anal., 51:503-509.

(1970). International Journal of Psycho-Analysis, 51:503-509

Psychoanalytic Reflections on the Psychiatry of the Poor

Gustav Bychowski

The origins of psychoanalysis were responsible for its initial neglect of socio-economic conditions as an important factor in both the development and stunting of personality. With their interest geared to the discovery of the repressed instinctual impulses, Freud and his first followers could not focus their attention on the impact of factors characteristic merely of certain groups of population. This disregard of socio-economic factors coincided with the growing importance of the classic psychoanalytic situation and its emphasis on and the exploration of the dual relationship ideally divorced from external factors.

To be sure, Freud was always interested in the deeper exploration of the social structure and, more specifically, of the social bonds. However, his clinical remarks related to this subject were sparse.

One outstanding comment should be mentioned: its character of quaint obsolescence is a striking example of the rapid change in our mores and even in the principles of behaviour.

In the 22nd introductory lecture Freud compares the psychosexual development of two little girls, playmates in their early childhood: the one a daugher of the landlord (first floor), the other of the caretaker (in the basement). The latter will experience little external interference with her sexual impulses, which she will satisfy in keeping with her advancing age: accordingly, she will not suffer from conflicts which might lead to a neurosis. On the other hand, the daughter of the landlord will be subjected to restrictions characteristic of her environment and, consequently, 'during the years in which she should exercise a feminine attraction upon some man, a neurosis breaks out in her which cheats her of marriage and her hopes in life' (1917p.

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