8. Psychoanalytic Thinking and the Relief of the Poor

8 Psychoanalytic Thinking and the Relief of the Poor ALAN KEITH-LuCAS The test of a free society, writes Delafield Smith, lies not in "the independence and unplanned, unregimented freedom of its rich and powerful members," but in "the scope and privilege reserved to, and· possessed by, its weakest elements, those who are under the greatest pressure to surrender their independence." 1 There are certainly other tests of a. free society and maybe other criteria by which a society should be judged. But the way in which a society treats its unproductive sector is to some extent a test of its dedication to certain ideals. The very existence of a segment of society that is socially, economically, and politically powerless is in fact an invitation to the exercise of personal (that is, politically unsanctioned) power without fear of reprisal, and the need of this group to obtain relief may well tempt them to surrender their independence in order to eat or to be clothed.

Here too may become explicit pretensions, only implicit else where, to control the behavior of others in the name of morality, science, or culture, or disclaimers of any such pretensions. Not so much what society is, or is even likely to become, but what its leaders would like it to be, may be foreshadowed in the relation ship between those who ask and those who give. Psychoanalytic thinking has had an important part to play in 157 158 Psychiatry and Responsibility the development of this relationship as it exists in America today .. The social work profession, which, in general, administers and determines the type of hUlnan relationships in this country's system of public and private relief, was one of the earliest and the most enthusiastic groups to welcome the new knowledge. Since 1928, at least, all social workers have thought more or less in psychiatric terms. The way in which this profession has made use of these concepts, therefore, would seem to have some signifi cance for society as a ·whole. It provides us at least with a chance to see where we may, in fact, all be going.

At the time that psychoanalytic concepts began to spread out into America in the 1920's, the basic assumptions about the nature and purpose of man and his relationship to society, which as always underlie and are tested by a society's treatment of its poor, had already begun to shift from the base on which they had been built for more than two hundred years. In the place of a theo centric vie"v of man, which had, in fact, long ceased to justify this description, so closely had it identified the Will of God with the cultural aims of man, there had developed or was developing a type of thought that, for lack of a better term, I shall call humanist-positivist-utopian, or HPU for short. The basic tenets of this view may be summarized as follows: (1) The primary purpose of society is to fulfill man's needs, both material and emotional. (2) If man's needs were fulfilled, then he would attain a state that is variously described, according to the vocabulary used, as that of goodness, maturity, adjustment, or produc tivity, in which most of his and society's problems would be resolved.

(3) What hampers him from attaining this state is external circumstance, not in general under his individual control. This, in various HPU systems, has been ascribed to lack of education, economic circumstance, his childhood rela tionships, and his social environment. (4) These circumstances are subject to manipulation by those Psychoanalytic Thinking and the Relief of the Poor 159 possessed of sufficient technical and. scientific knowledge, and, consequently, (5) man and society are perfectible. In this milieu psychoanalytic thinking found a ready acceptance. Its basic contribution was to be not so much in its content, in its discoveries, or even in its usefulness as a means of help (although it helped to explain much that had puzzled people until then), but in its compatibility with a view of man and society that was already on the way to being generally accepted. It came as an answer to questions that had already been asked, rather than as a revelation de novo. This can be sho\vn, for instance, by noting how American Freudianism has accepted some of Freud's (gen erally earlier) work and has rejected other parts of it. The Freud whom America adopted was the Freud who believed that repres sion caused anxiety and not the Freud who, recanting, recognized in man a primal anxiety, which, in turn, caused repression. It was the optimistic Freud of the oral-anal-genital progression and not the Freud of the death-wish. 2 Not only did the psychiatrists who went to Europe in the 1920's to study psychoanalysis have "a point of view which must have in many instances modified their approach to Freud's orientation," ~ but those in other professions at home who listened to them did so in terms of their HPU orientation and their need to find something other than the Puritan view of man.

The proces&' by which Calvin's wholly (and utterly Holy) transcendent God, before whom the best of men merited nothing, had become the ally of the successful and the guardian of society's values has been traced most adequately by Weber, Tawney, R. B. Perry, and others. Whether incertitudo salutis J the frontier, or bourgeois economy was the greatest factor in this transformation, the impact on those who had to turn to society for help was to become involved in a relationship in which they were held wholly responsible for their own inadequacy (and, often in directly and by a curious reversal of the relationship between merit and Grace, for their own misfortune as well); in which to 160 Psychiatry and Responsibility ask for help meant to surrender one's control over one's own affairs, one's freedom, one's civic rights 4 and sometimes even one's children;5 in which the" recognized relationship was that of one man judging another's deserts, needs, and potential, pre sumably by some set of commonly accepted standards ultimately derived from Scripture, but often in fact impulsively or from self-interest; and in which the fulfillment of man's legitimate needs or the correction of certain invidious inequalities was entirely subordinate to the principles of correction and deter rence. At its best, such a system was paternalistic-and in fact it became more so during the Nineteenth Century, in its somewhat disguised forms of Christian Socialism and Friendly Visiting. At its worst, it was little short of totalitarian-the "intolerable rule of the saints."

Yet this was not the whole story. The Puritan view of man, although it denied personality, in the sense that it cared little for the ideal of the fulfilled human being, remaining in this respect still theocentric or at least culture-centered, laid a great deal of stress on man's individuality, his difference from his fel lows. The American tradition here is quite different from the British and was so even before the advent of psychoanalytical thinking. Basically this was, at a venture, the difference between a Puritan and an Evangelical tradition. British reformers of the Poor Law, such as Beatrice and Sydney Webb, in denying man's total responsibility for his condition, shifted the blame of personal failure to society as a whole, and in particular to its economic organization, and sought to remedy matters by legislation. 6 American social reformers also shifted the blame onto the environ ment, but concentrated on the individual's condition, his re sources, and his immediate environment and sought to remedy these in each indi vid ual case. Social casework is an American invention. Mary Richmond's Social· Diagnosis) its source book or "Old Testament," published in 1917, called for a minute, indi vidual, scientific, and differential examination of each man's situa tion and prescribed remedies for it. Psychoanalysis, its "New Testament," crowned and fulfilled Miss Richmond's work. It offered a new and deeper method of diagnosis. It explained many Psychoanalytic Thinking and the Relief of the Poor 161 of the discrepancies that had become apparent between the environmental theory of man's growth and what had been ob served in practice. It was acceptably scientific and thereby pro fessional, and it provided a complete rejoinder to the debased Puritan view of man. It freed the poor from personal, impulsive, or moralistic judgments.

But it did more. In its concentration on the individual's inner rather than his outer needs, in its insistence on self-expression, in its permissive techniques, it made possible a change of viewpoint whereby social work and, to some extent, society itself (although the cultural lag was considerable) were able to look at a man's problem through his own eyes, to grant him for the moment at least the status of subject rather than object, to serve him rather than to control him for his own o'r for society's good. Philip Klein expresses this shift of focus and ascribes it to the newly "scientific" and indeed "analytical" character of social work. By virtue of its new scientific character the perspective of all social work shifted from an "external" view previously held by social re formers, theorists and philanthropists alike, in which the poor, the sick, the criminal or the neglected child appeared mainly in contrast to the normal and quantitatively solid mass of the population, to an analytic view as if from the angle of the client himself. The social worker in this new conception was no longer an agent serving the social mechanism so much as an instrument of adjustment manipulated in the interest of the client and upon the physical and social environ ment of the client. 7 This was a tremendous leap of the imagination. It was an act of empathy that put to shame the social. thinkers of the last half millenium. It gave to America's treatment of its poor and to its profession of social casework a quality not found anywhere else in the world. As a writer said as late as 1947: At its best, social casework can make the tenets of democratic living a deeply personal experience. Completely oriented to the individual and his very personal needs, it concentrates on him, trying to serve his purposes only, flexibly and in a nondirecting way.s 162 Psychiatry and Responsibility To psychoanalysis must go luuch of the credit. And yet it must be recognized that there were certain special conditions that enabled it to be used in this way.

The strongest factor in these conditions was the impact of the depression. Quite suddenly millions of people who could not conceivably be thought of as inferior, inadequate, sick, or sinful, carne to be in need. America turned, after a struggle with older concepts that broke down one after the other, first to a system of social insurance and thell, ostensibly as a stopgap, but actually as its main weapon, to a concept of a legally guaranteed right to assistance under prescribed circulnstances. Those who thought in psychoanalytic terms went along. and nurtured this concept. It was consistent with their orientation to man fulfilling his own needs. There are, in fact, three ways in which a man may be judged as entitled or not to relief: (1) in accordance with his deserts, or the judgment of the saint, (2) in accordance with the best interests of either society or hilTIself, or the judgment of the social scientist, and (3) in accordance with his recognized or established rights, or the judgment of the law.

The Puritan had made his decision principally around the first. Congress in 1935, able to identify itself with the needs of man faced ,vith a disaster disproportionate to his deserts, now turned to the third, and in the hands of such leaders as Altmeyer, De Schweinitz, Delafield Smith, and the Abbotts, the principles of the unconditioned money grant and of noninterference in the lives of those in need were given precise form. De Schweinitz speaks of this process as one of relying "first of all upon the identification and use of basic principles of the law," but arriving at a principle that is "consistent with prevalent political, eco nomic and social beliefs." 9 Any tendency that practitioners of the new psychoanalytical knowledge might have had to insist on the second criterion was held in check, both by the acceptability of this new concept of legal Tights and a sense of humility in the face of what this new knowledge was thought to portend.

Psychoanalytic Thinking and the Relief of the Poor 163 Another liberating factor was, curiously enough, the deter minism of the new psychiatry. Modern American psychoanalysis, or that part of it taken over by social work, lays great stress on the culture or environment as the shaper of man's unconscious being.I° But Freud himself laid considerable emphasis on bio logical man-on man that is predetermined, distinct, outside his culture, even opposed to iLLionel Trilling says: Now Freud maybe right or he may be wrong in the place he gives to biology in human fate, but I think we must stop to consider whether this emphasis on biology ... is not so far from being a reactionary idea that it is actually a liberating idea .... It suggests that there is a residue of human quality beyond the reach of cultural control, and that this residue of human quality, elemental as it may be, serves to bring culture itself under criticism and keeps it from being absolute. ll The first social workers to make use of the new psychiatry were closer to Freud than we are today. There was a determinism in their psychiatry which is missing today and which, perhaps, could not survive in the optimistic American culture any more than, as R. B. Perry points out, the concept of God's inscrutable decrees had been able to survive in the self-reliant world of the New England colonist. 12 A typical statement of the early days of psychoanalytically oriented casework is Bertha Reynolds' de duction from what she calls "the illumination which began to trickle into social case work through its contact with dynamic psychiatry." "The futility of coercion," she says, "becomes in creasinglyevident."

... it is no longer a question of whether it is wrong to try to make our fellow beings think and feel as we want them to. In the long run it is simply silly. The vital needs of their being will in the end deter mine what they shall feel and how they shall act. 13 Both politicallyand psychologically,therefore,and indeedboth ethically and pragmatically, protections were placed around the individual's right not to be interfered with without adequate sanc tion. Grace Marcus' well-known words express social work's ethic in this respect and at that time: 164 Psychiatry and Responsibility In administering assistance as a right, the agency is bound not to use the individual's economic helplessness for purposes that have not been generally declared or defined even though these purposes are presum ably inspired by interest in the individual's welfare or the welfare of his dependents. 14 This is what American social work leaders took from psychiatry at this time. It helped make possible by far the most humane and dignified system of relief that America has ever seen. At the same time, in other spheres, it proved its pragmatic worth---in the juvenile court, the family agency, the guidance clinic, the mental hospital, and helped to establish there too a feeling for the dignity of the personality. For a long time, and still in many aspects of social endeavor, those who thought psychoanalytically . were in the forefront of a struggle against what they conceived of as "prescientific" social theories and could profess to value the dignity of the individual to a greater extent than the culture as a whole. 15 They fought and still fight for more adequate relief and against such measures as the forcible sterilization of those with illegitimate children. They have been and still are leaders in the fight against segregation. In the days before World War II, when the rights of labor were a burning social question, they were not infrequently associated with the representatives of an other type of HPU thought-MarxIsm-as in the journal Social Work Today/6 now on the Attorney General's list, but still the source of the clearest statements ever written about the helping process.

A glance at the relief situation today, some twenty-five years later, would suggest at first sight that the battle for the emancipa tion of the relief client was being quietly lost; that older points of view were returning, perhaps in reaction against the tendency of some workers to equate lack of interference with a supposed duty to protect the unwise and unfortunate from the natural conseq uences of their acts. Certainly there has been a change in temper. The purpose of the public assistance titles of the Social Security Act has been restated; public assistance is no longer seen as "social security" guaranteeing to a man something on which to Psychoanalytic Thinking and the Relief of the Poor 165 depend in disaster, but as a means toward a culturally desirable good, the re-establishment of a recipient's ability to be self-sup porting. I7 "Suitable home" provisions in the Aid to Dependent Children category, which were progressively eliminated during the 1940's, have been re-enacted in many states. IS There is grow ing agitation for the appointment of guardians for incompetent families and for methods of controlling the individual's use of his relief. There has been increased pressure on mothers of dependent children to work in spite of the Social Security Act's originally announced intention to relieve them of what was con sidered an intolerable double burden. I9 The newest category of relief, Aid to the Permanently and Totally Disabled, has, despite its name, included as an eligibility requirement referral to Vocational Rehabilitation and has, in many states, replaced the meeting of more or less clear-cut eligibility requirements with evaluation by a medico-social team of experts.

Part of this change may be simple reaction. Part is undoubtedly due to a change in actual circumstance. Those who are in need in a period of economic boom are likely to be more dependent than those in need in a depression and thus offend more against the cultural norm. Part may be due to actual experience. There are undoubtedly those who appear, at least, to become dependent on relief or 'who have found somewhat unrealistic ways to make themselves eligible for relief although there is no clear evidence that the system of relief, and not other factors in the culture, has led to this dependency.2o But what is much more significant is the growing tendency, in the psychoanalytically oriented social work profession itself, to approve these changes in our relation ship to the poor. There has been a turning away from social work's single-minded effort to help people find their own solutions and a tendency to assume more 'and more willingly the functions of social control.

The beginnings of this change in social work temper can be traced to the middle 1940's, but until recently it has been im plicit rather than explicit. When, in 1953, I tried to show that I believed this was happening, I was accused, not without justice, of "misrepresenting the field" and quoting authors out of context. 21 166 Psychiatry and Responsibility At that time the indications were straws in the wind, more or less unconscious claims to control set within an ethic which said consciously quite the opposite. To some extent this is still true. There are many rationalizations, familiar to anyone who is aware, for instance, of the rationale for colonialism or for white supremacy, that conformity with the culture's values is what the client really wants; that responsible choice is possible only if man can be freed from disabling attitudes, or that influence and per suasion do not involve the imposition of standards in the same way as·do command and exhortation. But recently the trend has become too obvious to be denied. The ethic of the social worker's responsibility is replacing that of the client's rights to his own decisions. The caseworker's "authority" has become a common place. One well-known and respected practitioner has proposed a graded set of relationships between client and worker, some more authoritative and some less so, according to the client's believed capacity for self-direction. 22 In a single number of a widely accepted professional periodical there appear in three successive articles the statements that social workers may need to be authoritative (although not authoritarian),23 that they must act as the instruments of social control and social change,24 and that social work needs to reassert its earlier faith in the plasticity of man. 25 This again would not be significant if it were merely a read justment, a minor movement in response to a former unrealistic permissiveness. What makes it important, however, and pertinent to the discussions of this symposium, is the rationale of this move ment and its similarity with developments in other areas of HPU thought.

The rationale is one of knowledge. It is the equation: Knowl edge equals the right to contro1.26 And this knowledge is psychi atric and sociological-that is, a knowledge about people in their most intimate lives. The knowledge that the social worker of the 1930's took from Freud filled him with humility. He saw in it the likeness of man to man. He reached it with something of the Calvinist's awe in face of the "unchangeable decree" of pre destination. Although hoping to find in it a means of help, he was Psychoanalytic Thinking and the Relief of the Poor 167 impressed with the need not to impose values on a client, believ ing, indeed, that all sets of values were suspect in view of th,e unconscious bias of their possessors, including the social worker himself. To use a phrase from Norman Brown, "The doctrine of the universal neurosis of mankind is the psychological analogue of the theological doctrine of original sin." 27 But at th~ sam~ time the social worker's insistence that the psychiatric knowledge that he was using was "scientific" held within it the temptation to pride.

Three insights drawn from other fields may be of help here. One is Erich Voegelin's concept of what he calls "gnosticism" in the political sphere. A "gnostic," in Voegelin's difficult vocabulary, is one who. believes himself to have an exclusive revelation of truth and who attempts to create the Kingdom of God on earth in accordance with it. This occurs, Voegelin contends, through an immanentization of God-that is, the location of the ultimate power in society rather than outside it.28 In Voegelin's thinking, Freud, Calvin, and Marx were equally "gnostics." The likeness between the judgmentalism of the saint and that of the psychii trist then becomes apparent. But, it might be suggested, "gnosti cism" resides not so much in the system of thought itself as in the claims made for it. It is not psychoanalysis that is at fault, but those who claim for it an ultimate authority. "Gnosticism" begins where Calvinism stops, proclaiming the miracle of unmerited Grace and begins to claim in the name of this miracle that men should live by its deduced morality. It begins when Freud stops treating patients and makes patients of half the world. 29 "Gnosticism" arises, in fact, when a social science fails to recognize its ultimate dependence on a system of values wholly distinct from it and develops a Weltanschaung of which it is itself the base.30 This is why Voegelin's insight about transcendence and immanence is so valuable. Culturally oriented psychiatrists may and do argue that their researches have discovered inman dependency needs that justify a more authoritative approach. But all that this means is that if such needs are fulfilled, this will help man to achieve certain ends that, at the moment, our culture finds acceptable)H Psychiatry cannot say that these are good ends,· 168 Psychiatry and Responsibility although, in giving to them the authority of science, it can help to disguise their relative nature. What those who claim authority in the name of psychiatric knowledge are, in fact, doing is to admit that the tendency of our cultural relationships is to become more authoritative and, under the illusion that they are creating values, to surrender the power of this science to those who would wield authority for quite unscientific reasons.

The second insight is one about the fate of any system that starts by considering man as naturally good. "This buoyant atti tude," says one writer even before World War II, "which built its confidence on belief in Man, that he needed God no longer, has ended in such a disbelief in Man, such radical distrust in human nature, that the world is half-paralyzed by reason of it." 32 The process is well illustrated by the French and Russian revo lutions. Both started with the belief that man, freed froln his chains, would naturally act responsibly, would even, as Lenin held, not need a state to control him. Both, having created utopia, found man as irresponsible as before; each had to find some reason to explain this anomaly and found it in assuming subversion from foreign sources or incorrect ideology. Each re sulted in a system of rigorous control. The answer of the Freudian gnostic, faced with the same problem, is that man must be sicker than he thought. It is therefore not without significance to find, in the same number of the national social-work periodical referred to above, the follow ing statement: Sharper social study methods and increased psychiatric knowledge bring us daily more usable information about the uncontrolled im pulsivity, the impairment in capacity to form relationships, and the ego and superego defectiveness of those whose social and emotional dysfunctioning comes to our attention.~3 Science in the hands of its gnostic enthusiasts must inevitably find man progressively sicker, because it can regard him only as an object-and objectively man is entirely inadequate to the demands made on him both by society and by God. It is only Psychoanalytic Thinking and the Relief of the Poor 169 man as subject who can transcend these limitations. It looks, in fact, paradoxically, that a lively sense of man's limitations, in cluding those of the wielders of power, is necessary before one can recognize man's potential. In theological terms "original sin"

is a necessary prepostulate to Grace. And this prepostulate, para doxically, the Puritan did not have. He saw original sin in the poor, but Grace only in the relation to the saints. And this, again perhaps paradoxically, the "nonjudgmental" social worker of the 1930's had in abundance, not in a theological form, but ina sense of man's common irrationality. But a sense of man's limitations in itself is only half the answer. Without a sense of purpose, this knowledge leads only to despair. And it is this teleological or even eschatological sense that HPU thinking lacks. Our present psychiatry is no exception. Although it believes in man, it offers very little content that makes man or his life worthwhile. Its utopia is hardly worth the effort, consisting largely, in the popular mind at least, of a free dom from tension or struggle reminiscent of the most vapid of Nirvanas, without even the Puritan's joy in finding entirely un merited Grace. Kenneth Keniston has suggested that our present state of "alienation" or lack of purpose is due to the fact that we have repressed into our unconscious all our aspirations. 34 He notes the effort of a number of American psychoanalysts to develop positive terms, including Horney's "real self" and Fromm's "creative personality," but these offer very little beside a concept like that of Berdyaev's "personality," which transcends the limita tions of the natural and social world and gives to man absolute worth.

It may ,veIl be, indeed, that the problem of the 1960's may not be the tensions and anxieties to which we have become accustomed in the 1940's and 1950's. If this is so, psychoanalysis may have little to offer. There is beginning to accumulate evidence in social work, as in other fields, that in one sense man's ego has been working too well, although the phenomenon can also be described as an "ego deficiency." Man may have learned to insulate himself against anxiety, and the rnajor psychological problem of the future may well be the attitude of "what's the use?" The 1960's 170 Psychiatryand Responsibility may be the era of the alienated, the beatnik, the rebel without a cause. It has been recently suggested that, in fact, juvenile de linquency, as it is known in New York, for instance, is an attempt on the part of youngsters to find some code that offers content and 10yalty.35 This may help to explain, for instance, why a helping profes sion, bound by its nature to be pragmatic, is apparently turning again to the concept of the social worker as the "ego-ideal, the personification of the core-culture." ~6 For if the problem is lack of content, and there is no eschatological hope, there is little else to offer but what the worker is, had, and has. The fact that the social worker is himself a product of an increasingly con tentless culture only underlines the hopelessness of the situation.

This leads to the third insight, that of Berdyaev when he says: The error of humanism certainly did not lie in the fact that it laid too great an emphasis upon man ... but in the fact that it did not give sufficient emphasis to man, that it did not carry its affirmation of man through to the end, that it could not guarantee the independ~ ence of man from the world and included within itself a danger of enslaving man to society and nature. 37 It is this affirmation that psychoanalysis, as its concepts are popularly used, '''ould seem to lack, and that may have led, not only to its use as a measure of social control in the name of a not too admirable culture, but to certain attributes in that culture itself, such as its identification of all change, all struggle, with trauma and loss, not only for the sick but for the supposed well. Popularized psychoanalysis, like all forms of HPU thought, it might be suggested, constantly underrates man while pro fessing an unrealistic belief in his worth.

About the specific effects of this kind of hegemony of the social scientist and, even more, about the effects of its content on those on relief-whether, for instance, it has made them more or less self-reliant-a social ,,,orker is not equipped to write. He may believe, as I believe, that psychiatric concepts are more a symptom than a cause of a cultural change. But he is not an applied socioloPsychoanalytic Thinking and the Relief of the Poor 171 gist or any other kind of applied social scientist. The one thing he cannot afford to do is to regard people as objects or to forget that his competence, whatever knowledge he needs or may use, lies not in knowing about people, but in entering into a helping relationship with them. Indeed, the tendency of many modern social workers to behave like social scientists is a sign of the condition with which this paper deals. But about this relation ship a social worker is legitimately concerned and may properly express his concern for what it means for our society.

The present condition of this relationship and the part that psychoanalytic knowledge has played in it may be summarized thus. Psychoanalytic knowledge came to social work, and ulti mately thereby to our relationship with our least powerful and neediest people, as Berdyaev said of humanism as a whole, as "a dialectic movement in the revelation of human personality." 38 It was desperately needed. It made possible a leap of the imagina tion, an outpouring of love, that we cannot afford to neglect. But it was in itself insufficient. In the remarkably short time of twenty-five years 39 it has begun to be used as an instrument of social control. As yet the relationship so created is not as harmful as that which it superseded. It is in the hands of a profession with a great deal of good will but within the framework of which certain tendencies toward the devaluation of man are working, as sin or error always work within the framework of good rather than in opposition to it, so that the judgmentalism of the social scientist and the judgmentalism of the Puritan are seen to be far more alike than they are different. To devaluate a man because he is maladjusted is not essentially different from devaluating him as a sinner. 4o We are faced also by the fact that psychiatry has in many ways a power that religious moralism never had. In the end, religious moralism was bound by its own revelation and could discover, as it has in neo-orthodox thought, the vanity of its pretensions.

But science has no such checks. It may be indicative that extra polations, serious as Brave New World and 1984} or popular as the mass of science-fiction, consistently cast psychiatrist and psychologist in the role of powerful forces for conformity and 172 Psychiatry and Responsibility subservience. There are echoes of this in the popular fear of brain-washing and subliminal advertising. In the testing labora tory that the helping relationship offers there are more than suggestions that under pressure our society may be willing to yield personality to the ideals of adaptation and adjustment and, in doing so, make of psychiatry its tool. The task is not to deny psychoanalysis. A return to moral judgmentalism is unthinkable, even if it were possible to turn the clock back in this way. The task is rather to use psychoanalytic thought in a controlled way, to provide it with a framework and a missing dimension, to recognize its use as a tool and not as the creator of values. It is to find, or prepare the way for, the next step in the dialectic.

In what form this step can or will take place is a moot question. It does seem clear that what is needed is a renewed humility and a sense of awe. It must become clear, somehow, that even to claim the possibility of knowing enough about a man to justify one in assuming, on one's own initiative, power to control his life in its intimate dimensions is both ultra vires and a ridiculous pre tension. Men must, of course, sometimes assume certain powers over their fellows, as parents, warders, judges, or teachers, and it is desirable that these people have psychological knowledge ade quate to their tasks. But there is a great difference between exer cising necessary power to the best of one's always incomplete knowledge and ability, and claiming the right to control others by virtue of a belief that knowledge makes one competent to do so. Even if another's behavior seems· to us childish, a democracy can not afford to treat anyone of its adult citizens as a child until he has been legally-that is, by due process of proof-declared incompetent. Nor, incidentally, can it afford under any circum stances to declare a substantial proportion of its citizens to be incapable of directing themselves. 41 It may be clear that my own personally preferred solution of the problem of rediscovering humility is a theological one. This is not a matter of replacing psychology with theology. The former, particularly I would aver in its psychoanalytic form, offers too many useful insights and is, in any case, of a different order of Psychoanalytic Thinking and the Relief of the Poor 173 expertise. But I do see the need to undergird it with certain prop ositions about men's relationship to one another and to the universe that psychoanalytic thinking cannot in itself supply, and I do, myself, believe that theology offers the clearest exposi tion of what this relationship can be. I therefore welcome what seeIllS to Ille a valuable and iIllportant, although generally un recognized, growth of a social-work practice based on theological tenets but making use of psychoanalytic knowledge. Others who distrust theology or have unhelpful associations with its termi nology may arrive at the same conclusions in some other way.

What does seem to me indisputable is that some moral reorganiza tion, political, philosophical or procedural, is necessary if psycho analytic theory is to become again an ally rather than an enemy of our common desire to preserve human personality. NOTES 1. A. Delafield Smith, "Community Prerogative and the Legal Rights and Freedom of the Individual," Social Security Bulletin~ IX (August, 1946), 8. 2. This point is made very forcibly in regard to psychiatrists by Norman O. Brown, Life Against Death (New York, 1959), p. 112, and in D. W. Harding's review of Philip Rieff's "Freud: The Mind of a Moralist" in the Spectator~ February 12, 1960, p. 226, and in regard to social work by Gisela Konopka, Eduard C. Lindeman and Social Work Philosophy (Minneapolis, 1958), p. 185. The "recantation" can be found in New Introductory Lectures on Psychoanalysis (London, 1933), p. 159. 3. Clara Thompson, Psychoanalysis: Evolution and Development New York, 1957), p. 192.

4. As late as 1940 there were fourteen states that deprived persons re ceiving public aid of the right to vote. See Edith Abbott, Public Assistance: American Principles and Policies (Chicago, 1940), I, 127, 220-1. 5. The classic case in which a farmer receiving disaster relief after a drought lost title to his children on this ground alone is ]. H. E. Ackley vs. A. A. Tinker~ 26 Kan. 485 (1881). 6. See Beatrice Webb, My Apprenticeship (London, 1926), pp. 173-4. 7. Philip Klein, "Social Work," Encyclopediaof the Social Sciences, XIV, 168. 8. Hertha Kraus, "The Role of Social Casework in American Social Work," in Cora Kasius (ed.), Principles and Techniques in Social Casework, Selected Articles 1940-50 (New York, 1950), p. 139.

174 Psychiatry and Responsibility 9. Karl de Schweinitz, People and Process in Social Security (Washington, 1948), p. 25. 10. Particularly by Karen Horney, The Neurotic Personality of Our Time (New York, 1937). II. Lionel Trilling, Freud and the Crisis of Our Culture (Boston, 1935), p.48. 12. R. B. Perry, Puritanism and Democracy (New York, 1944), p. 95. 13. Bertha Reynolds, Re-Thinking Social Case Work (San Diego, 1938), p. 15. 14. Grace Marcus, The Nature of Service in Public Assistance Administra tion (Public Assistance Report No. 10 [Washington, 1947]), p. 29. 15. Herbert Bisno, The Philosophy of Social Work (Washington, 1953), p.5. 16. Published by the National Co-ordinating Committee of Social Service Employee Groups, 1934-42. 17. 1956 Amendments to the Act. The Act as it now stands is quite ambiguous. It retains many of its "rights" features and at the same time enunciates a purpose that seems to contradict its content.

18. "Suitable home" provisions require that a parent maintain a "suitable home" before assistance is given. They should be clearly distinguished from general measures to protect neglected children, since they permit, in many cases, assistance to be withdrawn without legal action to remove the child from the home or, alternatively, lead to the removal of children from conditions that would not have this result if the family had not asked for assistance. 19. See, for instance, Report to the President of the President's Committee on Economic Security (Washington, 1935), p. 36. There is, of course, some change here in cultural expectancy. 20. There does not seem to be any clear evidence that restrictive measures have in any way dealt with this problem. What reaction there has been is, on the whole, most unrealistic and has sought to control through relief what is in fact a symptom of a progressive lack of content in our society. Thus, for instance, the sudden rise in illegitimate births in the last few years is hardly attributable to relief policies that have been constant for the past twenty years, but is likely to be much more related to the absence of father persons in the early years of a war generation and to a progressive lack of meaning in a somewhat rudder less age.

21. Alan Keith-Lucas, "The Political Theory Implicit in Social Casework Practice," American Political Science Review, LXVII (December, 1953), 1079-91, and Notes and Comments by the editor, "Casework Labelled Undemocratic," Social Science Review) XXVIII (June, 1954), 205-6. 22. Elliott Studt, "Worker-Client Authority Relationships in Social Work," Social Work) Vol. IV, No.1 (January, 1959), p. 23. 23. Berta Fantl, "Integrating Psychological, Social, and Cultural Factors in Assertive Casework," Social Work) Vol. III, No. 4 (October, 1958), p. 32. 24. Kermit Wiltse, "The 'Hopeless' Family," ibid.} p. 19.