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Strupp, H.H. (1982). Is the Medical Model Appropriate for Psychoanalysis?. J. Amer. Acad. Psychoanal., 10(1):123-128.

(1982). Journal of American Academy of Psychoanalysis, 10(1):123-128

Is the Medical Model Appropriate for Psychoanalysis?

Hans H. Strupp, Ph.D.

The subject of this symposium, almost a century after Freud's seminal discoveries, is truly amazing. Its apparent timeliness is on a par with a debate on whether there may be some merit in the theory that the earth is flat or whether we should return to the hypnotic techniques first practiced by Breuer and Freud. I doubt that this audience would have much interest in the issue were it not for third-party payments or the impending enactment of National Health Insurance. All of this proves no more than the well-known fact that science and politics make strange bedfellows and that a clash between the two, the world being what it is, usually results in a (temporary?) victory for economics and power. I also question whether I can summon any arguments that have not been heard many times before.

The movement toward the so-called remedicalization of psychotherapy in general and psychoanalysis in particular is a fact, and it is perfectly understandable that as practitioners we (and our clients) would like to be included under National Health Insurance. On the other hand, the Senate Finance Committee, which has begun to play a powerful role in shaping the future of psychotherapy in the United States, is particularly critical of long-term, intensive psychotherapy. If there is one psychosocial treatment modality they are most eager to exclude from reimbursement it is psychoanalysis. For this reason (as well as for others), psychoanalysis is in deep trouble.

As I read the current debate, the legislators employ a two-pronged attack.

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