Sigmund Freud’s America

Philip Alcabes

Sigmund Freud’s America

 Freudian thought has been embraced, actuated, and exemplified in contemporary America. This essay explicates four features of the trans-Atlantic instantiation of Freudian thought: (1) Freud’s discovery of the unconscious mind laid the foundation for a central tenet of Western modernity: we cannot know our deepest motives. (2) Freud’s recognition of repression as the unique aspect of the individual mind made possible the modern notion of individual identity whose basis is narrative. (3) Freud’s recognition of the impossibility of full knowledge of the mind set the stage for the tenet of uncertainty. (4) Freud’s discovery that consciousness is based not in rational thought about reality but in a turbulent effort to control the unconscious offered a way to re-animate a world emptied of magic. The essay concludes with a critical summary of the process by which Freudian thought came to be pervasive in social-scientific viewpoints on American culture.


A Paradox

MITTELEUROPA was the home of Sigmund Freud, geographically and temperamentally. Born Sigismund Schlomo Freud to a Moravian wool dealer and his wife in 1856, he was raised in Vienna, his mother’s hometown, from the age of four. There, in the imperial capital, he went to school, gymnasium, and university. There, he changed his first name to Sigmund. In his early twenties, he carried out scientific research in Trieste, the Empire’s port on the Adriatic. He did spend the winter of 1885-1886 with Charcot at the Salpêtrière in Paris, but he then lived in Vienna for the next half-century, until he was in his eighties.

Freud evinced the European veneration of Greek, Roman, and Egyptian civilizations that Winckelmann had exemplified and extolled, even becoming a collector of antiquities once he had the wherewithal to do so.1 The philosophy of Brentano and the poetry of Schiller charmed him, and he worshipped the thinking of Feuerbach.2 Freud’s own work, at least in his later period when he had turned to social theory, continues the line of European rationalism that sought to uncover the “secret anthropology” behind theology.3 But even in his early, psychoanalytic work, he aimed to disperse the clouds of myth—to apply reason to reveal (in Hegel’s words) that “the life of the ever-present Spirit is a circle [Kreislauf] of progressive embodiments.”4 Throughout his life, he was wedded to the Vienna that had been the capital of Central Europe, both devoted to the city’s Enlightenment openness and contemptuous of its latent anti-Semitism, so much so that it was only in June 1938, after the Anschluss and five years after the National Socialists had burned his books in Berlin, that he finally left the city that had nurtured him.

And yet, it is in Americanism—the culture of late twentieth and early twenty-first century US society—that the impact of Freud’s mitteleuropäisch thought is most fully and consequentially revealed. Here, I will focus on four phenomena that show how Freudian thought has been embraced and actuated in contemporary America:

  • Freud’s discovery of the unconscious mind laid the foundation for a central tenet of Western modernity: we cannot know our deepest motives.
  • Freud’s recognition of repression as the unique aspect of the individual mind made possible the modern notion of individual identity whose basis is narrative. Stories give us selfhood.
  • Freud’s recognition of the impossibility of full knowledge of the mind set the stage for a second tenet of modern thought: uncertainty.
  • Freud’s discovery that consciousness—the self—is based not in rational thought about reality but in a turbulent effort to control the unconscious offered a way to re-animate a world emptied of magic, opening the door to consciousness-expanding movements but also to the denial of reality.


Americanness isn’t easy to define. I will have to generalize, but also avoid conflating differences between Europe and the US with aspirational truisms (when the Frenchman Michel-Guillaume-Jean de Crèvecoeur wrote of America in 1782, he reported a classless society, “the most perfect society now existing in the world,” where “man is free as he ought to be”5—notwithstanding the presence of slavery, indentured servitude, and want). I advise the reader to be wary.

Asked to specify hallmarks of Americanness, some might name a reliance on the quick fix; a faith (even if unaccompanied by evidence) that markets will be fair; an informality of language; a gravitation to inventive hucksters; a sense that cultural performance should  carry political freight; or a preoccupation with image. Then again, it would be easy to find Americans who exhibit none of these traits, and to find “Americanness” of this sort in other places, particularly among the well-to-do. In a way, the difficulty of defining Americanness is its definition and takes us right back to Freud: the true mind is unknowable. Unable to discover who we “really” are through tradition (about which many Americans are skeptical) or family (about which many Americans are ambivalent), we assert identity to be the crux of selfhood.

But what is this “identity”? With psychoanalysis, Freud gave the Western world a curiously comforting axiom: our selves begin with our stories. Our truest motives are unknown to us; we only know what the conscious mind claims. This remains the central tenet of modern thought. Consciousness, Freud tells us in The Ego and the Id, is only the “surface of the mental apparatus” [emphasis in original].6

In the case studies, beginning with Studies on Hysteria (cowritten with Breuer),7 Freud sets forth how the ego brings reality to bear, reining in the passions of the subterranean Id. Psychoanalysis unmasks the Id. By thus making some of the unconscious available to the conscious mind, analysis elucidates the mechanisms by which the unruly Id causes suffering. The paralysis of “Anna O.” can be traced to her fraught—but repressed—memories of her father’s decline and death. Later, the “Wolf Man”8 suffers from depression and constipation because his conscious mind represses the terror and disgust he felt when he witnessed, as a child, his father making love to his mother from behind. And so forth. The case studies are meant to show the craft of psychoanalysis—but they also demonstrate the foundations of the Freudian mind: most of anyone’s mind is beneath the surface, unreachable; and what can be reached, perhaps with the aid of the psychoanalyst, consists in stories.

Stories as Self

The paradigm of the psyche in Freud’s early work—the conscious/unconscious model, the concept of repression, the animation of interpersonal erotic feelings toward the listener/analyst (i.e., transference), the indeterminacy of motivation that repression ensures—emerges from the premise that narrative is the essential basis of selfhood. We construct the stories we need, the ones that let us make sense of our ordinary unhappiness.9 All human beings, Freud writes in the fifth of the 1909 lectures on psychoanalysis at Clark University in the US, “entertain a life of fantasy in which we like to make up for the insufficiencies of reality by the production of wish fulfillments.”10 It’s not only the neurotic who has stories to tell.

A story allows for a sense of self-importance. “Everybody needs his memories,” the (Canadian-born) American novelist Saul Bellow writes. “They keep the wolf of insignificance from the door.”11 To be more magnanimous than Bellow: stories express our moral selves, our values and desires, and how we distinguish ourselves as agents in the world from ourselves as objects acted upon by a disinterested universe. But, in fact, no individual matters to the universe. This truth is essential to the grand narratives of historical development promulgated by Darwin, Hegel, and Marx. All these great modern dramas of culture hinge on the individual’s insignificance. Yet they are never the full truth—because the individual matters to him- or herself. It is for this reason that “every individual is virtually an enemy of culture,” as Freud writes later, in his social-philosopher role.12 The individual is at the same time both subject and author of his or her own world. This aspect of the contemporary Western mythos is, arguably, essential to Americanness.

In Freud’s late work, a trenchant commentary emerges on the possibility of any truth outside of narrative. Truth is illusory not only because we don’t know how to discover our “true” self but because we are unavoidably invested in not knowing it. True and full knowledge of the self would confer real freedom—but the process of discovery would incite an intolerable degree of pain that would inevitably turn us away from the process itself. This is repression, about which more soon.

Stories are what sets us apart from the beasts. For Freud in his later writing, this had become essential. “We will never master nature,” he writes in Civilization and Its Discontents.13 It is human beings’ unique ambiguity that differentiates us from plants and nonhuman animals. We are organisms that are part of nature but, at the same time, separate from nature. Alone among organisms, we are compelled to accumulate pertinent knowledge and think rationally in ways that will alleviate suffering—distress that arises, inevitably, from our limitations in the face of nature’s power. Our relation to our civilization is existentially ambivalent.

Uncertainty: Is the Self Central?

Freud takes pains to sound unimpeachably authoritative. But while his self-assurance resonates throughout his work, early and late alike, he eventually signals that even he is not to be believed fully. At the beginning of Civilization and Its Discontents, he takes up the “oceanic feeling” (the term comes from a play by his friend Romain Rolland, Liluli) of oneness with the whole world, a feeling that, as Rolland asserts, is experienced by millions of people. Freud claims this is only an “intellectual perception” because he himself has never experienced it. This denial of the feeling of oneness is, to me, the most revealing aspect of the book. Through it, Freud tells us that he, too, is subject to repression: even he can’t know himself in full. But by revealing his own tendency toward repressing a desire to explore the dissolution of his ego’s limits, isn’t Freud pointing to an uncertainty about whether the self is central at all?

That true motivation is inscrutable is a kind of unshakeable truth, even in contemporary brain science. Neuroscientists who seek to explain the mind purely on the basis of neural functioning in the brain still resort to the concept of the unconscious14 as a metaphor for what our mind does but isn’t aware of.15 The ancients held truth only to be knowable through mysterious means of accessand then only as glimpses of the work of ineffable forces: demons and gods, spirits, charms, spells. Today’s neurobiologists hold that truth is only knowable by access to the yet-undeciphered language of neural networks, and only through contemporary magic such as positron emission tomography. In between was Freud, the modern, arguing that motivation isn’t really knowable no matter what. The best we can do is guess at it. Uncertainty is an accompaniment of all observation.

And this uncertainty—the possibility that what is being perceived is not real but surreal—is a spur to an aspect of modern life that is characteristically American: the institutionalization of the irrational. I refer not to the discovery of pathways to expanded consciousness, an ancient and universal pursuit—peyote ceremonies, séances, the life of the anchorite, Burning Man, and so forth, nor even the ur-American version, adherents of the Pentecostal Church speaking in tongues. Instead, I mean virtual reality, One America News Network, the cult of climate-change denial, the poor embracing right-wing rhetoric about the dangers of government aid to the poor. These aren’t just moments of ritual escape from the fixed reality of the everyday; they are shared agreements that it is impossible to know how to distinguish what is real from what isn’t.

Rationalist though he is, Freud rejects the idea of the universally valid: the Divine. That might seem ill-suited to the US, where ninety percent say they believe in some kind of “higher power.”16 But Freud’s repudiation of belief in God is complemented by his insistent ambivalence about the centrality of the individual. On the one side, humans are driven primarily and incessantly by the desire to satisfy our erotic drives and by a death wish17 that is irremediably self-directed. On the other, we are “not even the master in [our] own house.”18 The melding of noisy egotism with humility about the universe is, one could say, an echt-American trait.

Yerushalmi illustrates the dialectic of self-importance and self-abnegation in narrative by retelling an old joke. Here, it’s set in the apartment of an upper-middle-class, vocally liberal, and militantly atheist Jewish couple on Manhattan’s Upper West Side.

Wanting a superior education for their son, the couple enroll the boy at Trinity School [which is] now secular, open to all. One day, after about a month, the boy comes and says, casually, “By the way, Dad, do you know what Trinity means? It means the Father, the Son, and the Holy Ghost.”

Whereupon, barely controlling himself, the father seizes the boy by the shoulders and declares, “Danny, I’m going to tell you something now and I want you never to forget it. There is only one God—and we do not believe in Him!19

Nature and Human Motives

“Countries have attained a high level of civilization,” Freud writes, “if we find that in them everything which can assist in the exploitation of the earth by man and in his protection against the forces of nature […] is attended to and effectively carried out.”20 Civilization consists in organizing human society to resist that of which we are inextricably part: nature. On this score, Freud applauds medicine, hygiene, agriculture, and some other applications of technology as ingredients of the civilizing process. Setting aside for a moment the seeming obsolescence of this view (more on this later), what is important for us here is his celebration of philosophy, the development of ethical ideals, and the regulation of social relations. Important because, in those three areas, stories are intrinsic.

By the time he writes Civilization and Its Discontents, Freud has moved on from his early, psychoanalytic stance on stories. In his sixties now, he views the two sides of the human mind, one animal and the other oriented against nature, as fundamentally irreconcilable. It is only through humans’ capacity for “civilization,” i.e., social organization, that we can set ourselves apart from the beasts.21 To strive to overcome nature—that sounds like an outdated prescription, even an immoral one, in our era of deep awareness about the spoliation of nature by human technologies. Nonetheless, the prescription retains its urgency. Indeed, isn’t the irrepressible drive to overcome nature exactly why the fact of climate change is so troubling—and, for many Americans, so hard to accept? It isn’t just the wildfires and the floods in themselves—it’s the suspicion that these phenomena are meant to tell us something deep: that we have swung too far to the against-nature side of the human mind. In fact, since nature has no will to tell us anything at all, they signal nothing about our deepest being as humans. And yet, we are free to interpret climate change as evidence of human error, and this is only possible because we are possessed of the Freudian ambivalence: we know we are of nature but also obligated to shape it.

Magic and Dreams

Psychoanalysis was supposed to be a supremely rational approach to the ungraspable, unobservable mind. It comes as no surprise, then, that Freud, the Rationalist, would contribute to the instrumental thinking that was coming to dominate Western culture: if this, then that. Paradoxically, though, the repression that makes the unconscious unknowable also makes the mind a magical land. In his constant assertion of the rationality of psychoanalysis, Freud spared himself having to acknowledge the magical domain he had revealed. 

Oedipal longing, so central to Freud’s explanation of human suffering in both his early and later work, is essentially a magical drama of the past.22 In a culture so resolutely devoted to the instrumental rationality of getting, accumulating, spending, and accumulating more, what else could the unconscious child-parent erotic drama be, if not magic? The link between the superficiality of the dominant worldview and the magical nature of the dream is inescapable: Benjamin notes that with capitalism came “a new dream-filled sleep,” and with it “a reactivation of mythic forces.”23 For psychoanalysis, though, the form that consciousness takes is never dependent on any clear sleeping/waking dichotomy of the sort Benjamin implies—not for the individual nor for the collective.24 Freud’s magical drama thus allows us to rethink Max Weber’s claim of Entzauberung. Magic has not vanished: human consciousness remains mythically linked to destiny. The mythic link might not be obvious in the sort of cause-and-effect thinking that governs day-to-day affairs, but it reappears in dreams, the “royal road to the unconscious” as Freud calls them.25

Which brings me to the American Dream. Much is written and argued about the empty promise of the American Dream. It is ever more evident that not everyone has the chance to re-invent themselves and that economic success isn’t simply there for anyone’s taking; opportunity isn’t equally open to all. But the American Dream isn’t a reactivation of mythic forces, as in Benjamin’s view: it’s just an advertisement. Self-invention is a sucker’s trap. Horkheimer and Adorno claim it’s a ruse perpetuated by the “culture industry,” one that is “aiming to subordinat[e] all branches of intellectual production equally to the single purpose of imposing on the senses of human beings […] the imprint of the work routine”26—so much so that an individual amounts “only to those qualities by which he or she can replace everyone else: all are fungible, mere specimens.”27 But these are critiques of European modernity; they don’t quite work for America today. In America, there is no history to be found in culture. American fascism exists—and it’s increasingly clear that fascism is popular in the US—but is differs importantly from the sort espoused by Mussolini or the Nazis. Not only is American fascism not state-centered, but it doesn’t dismiss modern incarnations of historic culture. Because in America there is no historic culture.

Let me be clear: I do not claim that there is no American culture or history. Plenty of Americans see history as relevant and significant for life in the present. Similarly, not everyone seeks to self-invent the self. Indeed, the limitations on imagination are a major concern for political philosophers and cultural critics who look at the hegemony of standardized cultural “realities” created, for instance, by corporate news media or the political communications industry around Washington, D.C. Still, even such critiques draw on a sensibility about the possibility of self-invention.

A rabbi asks his congregants to imagine that they can hear what people say about them after they are pronounced dead. In the front row, the wealthy businessman says he hopes he would hear, “he was a great family man, and a pillar of the community.” Next to him, the teacher says he hopes he would hear, “what a learned man and fine teacher, he helped so many.” A poor man who sits in the back of the synagogue raises his hand. “Rabbi,” he says, “I would hope to hear someone say, ‘wait, I think he’s still breathing.’”


Does America manifest Freud’s views more so than his native Europe? I can’t say. But America certainly has a rich tradition of seeing the human being as ambiguously positioned in history. This might be because history, to the extent that it is acknowledged at all in America, is supposed to be entirely manifest in nature. One reason for the prominence of the environmental movement in the US is that Americans had already come to see the devastation of the landscape and the pollution of the waters as an insult to history. That was well before the human consequences of climate change—the floods, heat waves, and wildfires—had become evident. Similarly, there is little tradition in America of crediting either “civilization” or a Hegelian “state” with carrying forward an imagined moral legacy of which each generation is supposed to be the inheritor. Because we are in nature, Americans are (in the American view) born moral. Freud’s view that “the normal man is not only far more immoral than he believes but also far more moral than he knows” resonates.28

Marilynne Robinson, our great explorer of the moral drama of modern life, points out that Freud held fiercely to the fundamental motive force of the Oedipal attachment because his main aim (consciously or not) was to shape “a model of human nature that enters history already moral and religious […] and already guilty and self-alienated.”29

Thus, in America, not only does social organization stand between the human organism and its destruction by nature, but the individual stands alone and unformed by historical forces. Each of us must create him- or herself. Granted, the man-alone-in-nature motif is both ancient and perpetual (Christ in the wilderness, Mohammed in the cave at Jabal al-Nour, Dr. Frankenstein in pursuit of his monster, Caspar David Friedrich’s Wanderer Above the Sea of Fog, Conrad’s Lord Jim, et cetera); even its purely American manifestations long predate Freud (Melville’s Captain Ahab, Thoreau at Walden Pond, Hiawatha, Cooper’s Natty Bumppo, Joseph Smith finding the Urim and Thummim). But Freud’s insistence that the human being is both alone and sui generis; is a product not of culture but of an (apparently) irresistible erotic attachment to a parent; and is both at the mercy of nature, to which he or she belongs, and continually threatened by nature—these assertions confirm a suspicion that resonates in America. The individual is a character to be written in a play about him- or herself, on a stage whose function is not to continue the past but to make it new. Freud’s work laid the foundation for a distinctly American cultural innovation: the self-authored self.

The Self-Authored Self

The modern conception of the individual self is that of a character in a play yet to be written. The American view goes further: All humans should be the authors of our own lives. You hear this in the admonitions to “take responsibility,” in the workplace training offered by corporations’ “Human Resources” offices, as an incentive to buy a handgun to protect your home. The self, in this framing, does not emerge from any cultural certainty or mores. And that, as we will see, makes the polarization about the nature of race at once customary and untenable.

The conceptualization of the self as self-made explains why today’s efflorescence of self-help strategies seems strikingly American. The diet plans, yoga classes, YouTube videos on character building, guides to success in business, and so on are seemingly everywhere now, not just in America. Further, embracing a “you can be what you want to be” ethos makes room in the culture for new organizational structures that come to seem normative: the financial advising business, the life coach, the personal shopper, et cetera. In these, guidance about effectuating one’s own happiness is exchanged for money. Typically, these structures are viewed by leftists as extravagances—emblems of the phantasmagoria of capitalism. There is some truth to that. But the critique from material dialectics alone overlooks an important point: these sorts of structures can only come to be normative because there is an underlying belief. That belief is that the self is (a) unknowable to us but interpretable by others; (b) unprecedented, affected by history yet not subservient to it; and (c) subject to revision. That the revision of the self into a more congenial form is supposed to bring “happiness”—a concept that Freud famously eschewed—shouldn’t stand in the way of seeing the connection to the Freudian model of the psyche.

The new cultural organizations for “actualizing” the self spill over into other, more traditional forms of social organization. The medical-and-public-health industry—I will use the shorthand “medical establishment”—makes considerable use of what Freud construes as the repetition compulsion:30 the tendency not only to seek pleasure and avoid pain, but to repeat certain actions although they make life harder. The repetition arises from our incapacity to know our instincts and the instincts’ persistence in trying to be noticed by the ego. If only we could know our (hidden) drives, we could do something with them; we can’t, so we repeat even that behavior that we wish to cease, as well as all sorts of actions that offend others.

In America, the medical establishment offers redress. No longer limited to providing diagnoses and treatments, it now offers enhancement to the quality of life. This enhancement requires allegiance to the establishment, which we are enjoined to demonstrate through frequent visits to a professional, now known tellingly not as a doctor but as a “provider.” Providers provide ego-organization, however much they must claim (and probably do believe) that what they are doing is treating illness.

Take, for instance, cancer screening. Now, this serves a purpose: evidence indicates that screening for breast31 or colon cancer32 reduces the chances of dying with one of these conditions. But screening requires repetition: if you are without cancer now, you might still show signs of it two years from now, or five, or ten. Significantly, if the screening test is positive now, a full diagnostic workup might demonstrate that cancer itself is present, allow for prompt treatment, and thereby increase your chances of survival. It might. For instance, under the currently recommended screening policy (using mammography) for women over the age of fifty in the US, for every 100,000 women who undergo screening, between 45 and 125 deaths are avoided over time.33 But the probability of detecting a cancer at any single screening is infinitesimal. Only about 50 cancers are detected per 100,000 American women screened by mammogram.34 In other words, nearly every woman who undergoes a mammogram (i.e., 99,950 out of 100,000) does it for no reason.

For no reason? Of course, not for no reason. To a woman whose undiagnosed breast cancer was detected through this process, the reason is starkly black-and-white: without screening, she might have died. Screening seems reasonable because for some, like our hypothetical woman with undiagnosed cancer, it is a matter of managing a real problem. This appeal makes it acceptable. It allows everyone to ignore the fact that, in almost all cases, the screening manages not cancer (which is almost never there in the first place) but fear of it. In other words, the provision of screening and the requirement to return for additional screening if—or, indeed, because—the first screening test is negative, as were the second, the third, and so forth, depend on repetition compulsion. The inchoate fear of dying prompts repetitive action. It might even be called obsessive-compulsive behavior, except that the centrality of the medical establishment as our collective superego drives us to view compliance with screening recommendations not as craven but as positive, “life-affirming,” a sign of “self-esteem” and “self-care.” The same goes for diet recommendations, exercise recommendations, and so forth. The recommendations, like divine prescriptions, generate their own force. We keep going back for more admonition to keep going back.

More revealing: moral problems turn into diseases. For instance, although the psychiatric profession already included both alcoholism and drug addiction in its initial Diagnostic and Statistical Manual (DSM) in 1952,35 in most cases, the profession understood these to be signals of some underlying primary pathology.36 But as the World Health Organization had labeled alcoholism a disease in 195137 and the American Medical Association had done the same in 1956,38 the American Psychiatric Association was moved to add alcoholism and substance abuse as primary diseases—i.e., not signs of deeper malaise but illnesses in their own right—in the third edition of the DSM in 1980.39

A common take on this shift is offered by sociologists who see the “medicalization” of erstwhile social problems (alcoholism being a leading example) as a feature of social control in modern Western society.40 The medicalization critique, building on both Foucauldian principles and a conceptualization of scientific knowledge as socially constructed,41 has aimed especially at understanding deviance as a social role. In this view, the medical establishment assists in redefining deviance as illness, and then, through regulation and treatment, in quelling the threat that deviance poses to the maintenance of power.

There is much to be said for the medicalization argument, regarding not only the transformation of alcoholism and addiction into medical entities but also a host of other social conditions that became illnesses later, such as attention-deficit/hyperactivity disorder, post-traumatic stress disorder, depression, borderline personality disorder, learning disabilities, and more. An accompanying anthropological perspective associates this shift with changes in the cultural performances of risk.42 What links these perspectives is their debt to a Freudian anthropology.

In our world, the human being is understood as constantly battling to protect the self from influences in the social and physical environments—to shield the self from baneful modernity. Unable to be fully aware of the self, each of us must nonetheless carry out a lonely struggle for wish fulfillment (Freud’s term) to self-create the self. Freud’s model thus describes the modern condition: the individual is the main actor, the culture is unavoidable but dangerous, the challenge is to create—“actualize”—the self. Medicalizing alcoholism, addiction, or the inability to sit still is more than just a way for the powerful shapers of history to corral deviance and take control: it is a sign that we have resigned ourselves to the Freudian view. We are alone, our psychic struggles, evident in symptoms (Freud’s term, again) such as drinking too much, are signs of failure in the self-actualization project. A chronic relapsing illness, heroin addiction, “sex addiction,” post-traumatic stress disorder, or any another condition is a sign of what Freud saw as the return of the repressed instinct. To answer the return of the repressed urge, we must return to the controller. We crave the discipline of the moralizing superego. Again, we keep going back for more treatment.

Clearly, the provision of medical treatment (or financial advising, or “life coaching”) is not merely evidence that clever entrepreneurs take advantage of market-based economic systems for the purpose of making money. Nor is it just a sign that some people are confused about real needs. The buy-in to the Freudian self is general, to the point that the priesthood that once offered healing has been transformed into an expert caste (physicians: “providers”) who bestow moral direction and assist all of us with our inevitable struggle to repress unwanted energies.

It is commonplace in today’s circles of psychology to assert that Freud’s psychoanalytic model of the mind was wrong; my aim here is not to enter into debate about the correctness or falsity of Freud’s views. My point is that his model of the mind, and his later consideration of the struggles that individuals go through in culture, was a prescient description of what is viewed as an Americanized society today.

Identity and “Identity”

Given the appeal of the Freudian self, how paradoxical it is that culture increasingly requires us to define ourselves based entirely on an externality: “social identity.” America seems to have taken a lead in this endeavor. You are who you are because you exemplify a group—a race, most prominently, but alternatively an ethnicity, a nationality, a sexual or “gender” orientation, a disability. Not only that—your group affiliation emerges not from family or erotic bonds, ones that develop through ego struggles; its existence has been postulated by steering forces.

Some might see this as evidence of the Lacanian claim that the self is an object. Indeed, the forces operating on the self are irresistible. Sometimes, because it assuages the inchoate anxiety of being, it’s even comforting to surrender to them. Others might see it as evidence of an existential lonesomeness, an allegation often put forth by those who are troubled by the declining appeal of traditional religions (for the first time ever, fewer than half of Americans belong to a church;43 a recent Pew survey in western Europe found that in most countries, less than one-third of the population says they attend church regularly, and in no country does more than 40 percent or the population attend regularly44) and by the Marxian critique of capitalism. But while there is plenty of evidence for an increase in what sociologists call “social isolation,” the evidence for lonesomeness is hard to interpret.

I argue that what we are seeing with the new “identity” emphasis is something unusual: an inversion of the self. It’s an acquiescence with the external forces (call them what you will: “the culture industry,” the capital-accumulating private sector, or the constant state of emergency) because they seem to correspond to an inner life. Myths need not emerge solely from dreams or folk tales. Our myths, for instance the constant threats of home invasion and airplane hijacking, are produced by the companies that manufacture security systems. They are disseminated by advertising, by social media, and by the continued encounter with these systems so that the need for the security being proffered becomes implicit. The sense of threat becomes indistinguishable from the genuine wishes/fears of the unconsciousbecause, as Freud points out in his social-philosopher role in Beyond the Pleasure Principle,45 what we truly experience must indeed be defended against. It cannot be allowed to be fully known in the conscious mind. Thus, we assimilate the (alleged) experiences of others as if they were real.

In this way, when we follow the directions of the myth-making corporate forces, we believe that these are our own, private myths. And perhaps that’s inevitable in an era in which all private struggles are understood to be available for observation and discussion by a disinterested circle of “friends” and “followers,” “fans” and “stans.” I suspect that the paradox of group identity entails not a revision of the Freudian self, as Lacan intended, but a full rewiring. What is outward is made to seem inward.

For instance, your erotic instincts are unquestionably an aspect of the deepest reaches of the psyche. When they draw you to others of the same sex, you are, nowadays, “LGBTQ+.” So you are labeled LGBTQ+ if you are erotically drawn to people of both sexes; or if you are male and your erotic preference is for females but you perform publicly as a woman; or if your public performance is indefinite as either male or female; or if you are unsure. In America, if your parents or grandparents came from western hemisphere countries south of the US (but not Spain itself) and spoke Spanish (but not Portuguese), you are “Hispanic” or “Latino” (or “Latinx”) and are deemed to have characteristics in common with Black Americans—up to a point, since distinctions of darkness continue to matter, as witness the turmoil over the casting of mostly light-complected Hispanic actors in the 2021 film version of In the Heights.46

The imposed identity doesn’t obliterate inner struggle. But it is supposed to help. In community with others of your tribe—Black, LGBTQ+, immigrant, Muslim, sex-abuse survivor, et cetera—you are supposed to realize a shared heritage. Heritage usually signals historical underpinning, and in this case the heritage is a linguistic one, an abstracting of language (or, pace Kristeva, of the semiotic) so that the urgency of identity has been removed and symbolized in the culture. Identity has turned into mere difference (of skin color, of “culture,” of desire, of geographic origin), and is now being returned as if it were both profound and private.

The social value of externally crafted identity mustn’t be underestimated. Consider the shame that was borne, alone, by women who had been raped or by men who desired other men when those subjects could not be voiced—a shame that must still be carried in many places. The migration of deafness from pathology to symbol to recognized Deaf culture—with a language and sensibilities that make it distinct while allowing it to interact with non-Deaf cultures—shows how bracingly humane the process can be.

Group “identities” are important politically, too. Nowadays, they seem necessary for collective action. Power is now structured in a way that the old affiliations of political party, class solidarity, or religious preference are no longer sufficient bases for the demand for rights—a fact that is itself worthy of study. The point here is that today the political is personal. The subject does not only view the object, but is formed from it.

Only when the self was reconceived as a unique entity, capable of identity formation and subject to unfathomable forces—Freud’s reform—did it become possible for the American “self-actualized” person to emerge. Earlier, when the individual was understood to be both defined and constrained by heritage, the behaviors thought to be derived from tribe or race could be “corrected” (Cuddihy, writing about Freud’s contribution to revising the central European mythos, called this the “ordeal of civility”47). The self could not defend its integrity against the alienation of labor, the mass production of consciousness through religion, or the Darwinian struggle to perpetuate the genes. Nonetheless, the self was fixed. But now, the self-actualizable individual can really be the object, qua subject, of the identity claims put forth by the political demands for solidarity based on “race,” “gender identity,” “immigration status,” “ethnicity,” and so forth.

That this kind of Americanization—i.e., the penetration of culture by a constant awareness of socially based “identity”—depends on the Freudian anthropology is a grand paradox. Not only because Freud himself was possessed of an apparently constitutional anti-Americanism,48 but because his project was ever devoted to establishing a model of the mind that was universally shared. Freud even went so far as to point out the “psychological poverty [psychologisches Elend]” of group identity and warn of its consequences: “where the bonds of a society are chiefly constituted by the identification of its members with one another […] individuals of the leader type do not acquire the importance that should fall to them in the formation of a group.”49

The Freudian psyche defies the premise of the European civilization in which he was raised and for which he wrote. Freud’s view of the mind isn’t susceptible to differentiation by the epiphenomena of race, religion, or “type.” That the Americanization of the self today returns to a presupposition that the categories matter more than the internal struggle testifies to just how penetratingly submersive and subversive the currents of influence—advertising, film, social media, and so on—are. Freud, I think, would have hated to see the modern self, powerfully developed around the agency of the individual in his or her own internal struggles, seduced into seeing itself as externally determined. 

A secret agent is instructed to make contact with a deep-cover operative living under the cover name “Goldstein” in an apartment building in a distant city. The agent is to identify himself with the phrase “the oranges are ripe in Seville.” The agent takes a flight, lands in the city, makes his way to the apartment building, sees “Goldstein” on the panel by the door, presses the buzzer. A tiny elderly man wearing pleated slacks and an undershirt and carrying a violin comes to the door. The agent says, “the oranges are ripe in Seville.” No response, just a quizzical look. He tries again, and still the man with the violin says nothing. After a few seconds, a light seems to go on in the small man’s eyes. “Ah,” he says, “you’ve made a mistake. I’m Goldstein the violinist. You’re looking for Goldstein the secret operative. Upstairs, rear apartment.”

“All the fun of a secret is in keeping it,” the novelist Philip Roth said. “Why blab?”50 But blab we do. Because, after all, we must discover ourselves, or at least have other people think they are discovering us.

Is culturally dictated identity a grand paradox or no paradox at all? Yes, the contemporary return to a tribal consciousness does seem to reverse the Freudian direction. But remember: we are our stories. We may tell ourselves that our “identity” comes through solidarity with a social status, a perceived sexual orientation, a religion, and so on. And that becomes our story; that becomes who we are. It does not obliterate the internal struggle, the centrality of the erotic drama, the motive force of fear, or our irreparable inability to know our selves. Indeed, because we can’t know ourselves, we have no choice but to be the story we tell. 

In this sense, if America is Freudian, it isn’t in the empty self-actualization advertised by TV talk shows or exemplified in TikTok videos, but in a more thoroughgoing embrace of the sheer impossibility of being anyone other than the unknowable self. It is a great luxury not to feel obligated to uphold ancestral traditions, as American “freedom” implies, but it means that the moral struggles—the trauma of interacting with other unknowable selves in a society—must be shouldered by each individual. We may choose to take up a tradition—Blackness, Jewishness, Gayness, or what have you—but our struggles with the drives and the constraints, Id and superego, remain our own.


Does Sigmund Freud’s work seem to be manifested in contemporary America, as I argued above, because his predictions about human nature happened to be borne out? Was he merely a good describer of fin-de-siècle bourgeois culture, but unable to foresee that that culture would become normative? Was he too narrowly a product of his own culture to be able to conceive of forces more capable of shaping human behavior than Id-ego-superego struggles, to imagine that those would come to encourage bourgeoisification, to recognize that middle-class mores for the many would disguise the consolidating of power by the few? Did he just happen to seem prophetic because the bourgeois came to look like the everyday?

I must answer yes, at least in part. For instance, the claim that psychic distress isn’t primarily an effect of heredity, as the neurologist Richard von Krafft-Ebing had argued in his influential Nervousness and Neurasthenic States,51 but of the impact of society on the individual, was a minority viewpoint that Freud adopted. But the people whose minds Freud explored in his psychoanalytic practice occupied economically comfortable places in the cultural matrix. When he referred to the pathology evident in “everyday life” (Alltagsleben), as the title of his 1901 monograph asserts, everyday meant the customary, socially acceptable forms and functions of bourgeois Vienna in the late nineteenth century. The dreams he recounts in The Interpretation of Dreams are his own, or those of “an intelligent jurist of my acquaintance,” a “young married woman” who (he infers) is fearful of pregnancy, an “intelligent and cultivated young woman,” the polar explorer Fridtjof Nansen, and so forth. And their dream images involve funerals, shops, flowers, travel, and other objects or activities that are infused with meaning by the prevailing culture. Indeed, it is Freud’s self-professed skill to be able to identify hidden, personal meanings underneath the socially imparted ones, as motive forces in the dream.

And Freud’s refusal to leave Vienna even as the Nazis took and consolidated power is perhaps evidence of an incapacity on his part to compass the full capacities of power. He becomes aware, but late. To the original (1930) closing of Civilization and Its Discontents,52

Men have gained control over the forces of nature to such an extent that with their help they would have no difficulty in exterminating one another to the last man. They know this, and hence comes a large part of their current unrest, their unhappiness and their mood of anxiety. And now it is to be expected that the other of the two “Heavenly Powers,” eternal Eros, will make an effort to assert itself in the struggle with its equally immortal adversary[,]

Freud adds a final sentence in 1931: “But who can foresee with what success and with what result?” He declares himself, in this last chapter, to be sure he is not a prophet. Yet he clearly continues to believe, even as Stalin consolidates power in Moscow and the National Socialists win eighteen percent of the seats in the Reichstag, that the pleasure principle might just win out. Perhaps he suspected that his analysis was too narrow. Perhaps, as Yerushalmi suggests, it was his awareness of the possibility that his own people were about to be extinguished that led him to ask, as he does in a letter to the writer Arnold Zweig, how it is that “the Jews have come to be what they are and why they have attracted this undying hatred,”53 and to write the book that became his final essay, Moses and Monotheism

Still, I propose that Freud’s success as a forecaster was more than accidental. To recognize how Freudian thought became a paradigm for American society, we must think in two different registers. One is the search for meaning, or at least sense, in American culture, which I attempted in Part 1. The other is the explicit migration of Freud’s writings into American social science. 

Freud’s early work accentuated the divide between psychiatrists and neurologists in America. Some biologically oriented neurologists, frustrated by the limited capacity of neurology based on then-available knowledge and techniques,54 saw psychoanalysis as a potentially useful new pathway. Notable among them were powerful voices like William Alanson White, superintendent of St. Elizabeth’s Hospital in Washington, DC, and James Jackson Putnam, who became the first president of the new American Psychoanalytic Association. Psychoanalysis became increasingly acceptable to American practitioners in the years after Freud’s 1909 lectures at Clark University in Massachusetts—but still remained a minority taste. On the other side, psychiatrists who were affiliated with asylum-based “treatment” were resistant to psychoanalysis—particularly to the claim of the centrality of sexual impulses.55 The influential psychologist Edward Bradford Titchener of Cornell University criticized Freud’s approach: always devoted to harnessing psychology to observable behavior, Titchener called Freud’s concept of the unconscious “both foreign to the spirit and inadequate to the status of experimental psychology.”56

At the same time, social reformers gravitated toward Freud’s ideas—a significant route to attracting the attention of Americans. The Austrian Jewish feminist Grete Meisel-Hess made use of Freud’s claims to argue that sexual repression was an essential aspect of patriarchy and to call for women to be emancipated from financial dependence on their fathers and husbands.57 In the US, the anarchist Emma Goldman, who attended the Clark Lectures, argued for full sexual emancipation of young women as an aspect of revolution—dismissing the mere economic emancipation that progressives like Meisel-Hess demanded as a recipe for converting the modern woman into an “automaton.”58

The professionalization of medicine in the US offered psychoanalysis a special boost. Looking at asylum keepers as “amateurs,” physicians were able to embrace the modern psychoanalytic approach as a form of expertise,59 part of the general development of their profession into an expert guild with an increasing monopoly on curative schemes and an expanding sector of lucrative, privately run, physician-controlled hospitals.60 Advocating licensure as a condition of practice, the medical profession was able to consolidate its power as an independent authority on health (licensing was ostensibly a function of the government of each US state, but in practice was left up to local medical associations61). Beginning in 1910, the physicians’ main guild, the American Medical Association, promulgated strict standards for medical education and limitations on the number of medical graduates each year. This allowed physicians to control the market in medical services—establishing physician care as both the authoritative form of healing and a consistently remunerative one, and relegating competing healers (chiropodists, midwives, etc.) to a small corner of the healing market.62

Psychoanalysis benefited from this establishment of physician care as a cornerstone of the marketing of health—and, by extension, the peddling of the increasingly popular middle-class style of “healthy” life in America. The prominent popularizer of psychoanalysis in the US, A.A. Brill, a Jewish immigrant from Austro-Hungarian Galicia, began in 1908 to contend that psychoanalysts should be physicians (as he was).63 Although Brill’s New York Psychoanalytic Society did not formally exclude those non-physician analysts who had been trained in Europe, by the 1930s Brill came to see medical licensure as a way of increasing legitimacy in American culture, especially given the success of physicians’ entrepreneurship. The American Psychoanalytic Association resolved in 1925 that all psychoanalysts should be physicians—despite Freud’s protests.64

If the aim was to solidify the cultural position of Freudian thought, Brill was surely correct. Although prominent non-physicians, including Karen Horney and Erich Fromm, were well-known among American psychoanalysts, and Freud strongly voiced his concern that demanding a medical degree would open the door for “psychoanalysis to be swallowed up by medicine,”65 medicine was exactly the imprimatur that Freud’s concept needed in the US. It allowed psychoanalysis to position itself as a therapy. While much has been written about dissent from the Freudian orthodoxy within the field of psychoanalysis, and much debate has been devoted to other modes of psychotherapy as alternatives to psychoanalysis, the transformation of psychoanalysis from a bourgeois (and largely Jewish) affectation into a medical treatment situated concepts such as the ego, repression, and the urges of the unconscious in the mainstream and the instrumental rationality of American culture.

Another avenue for Freudian thought in America was a new hygiene craze. When Freud came to the US in 1909, both the US and Europe were in the midst of a fascination with germs—but the American version took the form of a preoccupation with personal hygiene, a preoccupation so close to a religious doctrine that historian Nancy Tomes calls it the “gospel” of germs.66 Roughly between 1890 and 1920, this creed gave birth to the American emphasis on self-monitoring and the control of “unhealthy” impulses for the sake of public health. The trend is evident from the early-twentieth-century laws banning spitting on the streets as an anti-tubercular measure through the 1980s’ “Just Say No” campaign against illegal drug use, the condom crusades responding to HIV/AIDS, and the “social distancing” and mask-wearing requirements of the Covid Era. The new discourse about the individual’s personal responsibility for public health, particularly its emphasis on the taming of sexual urges, made the unconscious available for inspection even by those whose interests were far from either psychology or the alleviation of mental suffering.

Thus it is no surprise to encounter mental hygiene as the name of a new approach pioneered by Swiss-American neurologist Adolf Meyer with the wealthy former asylum patient Clifford Beers. The two founded the National Committee on Mental Hygiene in 1909, launching a new movement opposed to the warehousing of people with psychic troubles in asylums. In keeping with Progressivism’s personal hygiene approach to social reform and public health, the focus of “mental hygiene” would be on individual failures—in this case, the failure to adjust to the demands of the outside world.67 Meyer developed the idea of (and coined the term for) the maladjusted individual—who was not mentally ill but was at risk of falling ill.68 For all that Meyer promoted a different view of pathology than Freud, he was a prominent teacher of US psychiatrists (he directed the psychiatric clinic at Johns Hopkins University) and was, at least initially, a proponent of Freud’s views. He undoubtedly contributed to the influence of the Freudian model among American professionals.

Psychoanalysis also arrived at a moment when other professions, especially psychology, anthropology, and philosophy (William James and Franz Boas both attended the Clark Lectures69), were turning to the task of explaining human social behavior. James had published Pragmatism: A New Name for Some Old Ways of Thinking in 1907, connecting truth to psychology by defining the former in terms of belief. Boas, who spoke at the Clark conference, noted that anthropology is concerned with “the biological and mental manifestations of human life as they appear in different races and in different societies” [emphasis added].70

Finally, the arrival of psychoanalysis in America coincided with a dramatic shift in popular culture: the movement of millions of Black Americans from the largely rural South to industrial cities in the North, known as the Great Migration. In 1910, almost ninety percent of Black Americans still lived in the South,71 but beginning in about 1915, the Black populations of northern cities began to increase dramatically. In Chicago, for instance, the Black population roughly doubled between 1915 and 1919, and continued rising thereafter.72 In just the one year between September 1922 and September 1923, the US Department of Labor reported half a million Black Americans leaving the South for California or the North.73 Besides the improvement in economic conditions for many Blacks, a fortunate outcome for American culture was the flowering of arts in New York known as the Harlem Renaissance. But the unfortunate outcomes were legion, taking the form of institutionalized anti-Black policies—a nationwide moral panic, most evident in so-called restrictive covenants that banned the sale of homes to Blacks and in police brutality. Less obvious, but also linked, was Prohibition, i.e., the nationwide ban on the production, importation, or sale of alcoholic beverages beginning in 1920, and prohibitionist anti-drug laws directed at users of heroin and cocaine.

Prohibition and the drug war were, in part, the culmination of a long-standing temperance movement, powerfully abetted by nativism. But the sudden presence of Black Americans in large cities was a reminder, for whites, of the fragility of the social compact that had kept Blacks out of sight and essentially indentured to the white Southern landowners even after they were no longer enslaved. Was the price of industrialization to be the weakening of the white race and its hold on power? So the nativist thinking went.

Two orientations dominated the American cultural scene. One was based on a long-standing belief in race, aided by a post-Darwinian revision claiming race to be an aspect of evolution.74 The races are inherently and inescapably different, this school of thought holds, either because they evolved from separate progenitors (the theory of polygenism) or because they represent differentiated stages of human evolution. Stereotypical depictions of Black Americans as uncouth, ineducable, sexually voracious, or incapable of sustaining family allegiance all came to depend on the notion that such traits are evolutionarily ordained. This belief was backed by “scientific” findings on skull size or facial features that imputed biological determination to racial differences, thereby validating the racialist claims. Black Americans are, in this view, less advanced and less capable of advancement.

The contrary orientation was fortified by the Freudian anthropology: there is no inheritance of character from ancestry; it comes solely from the innate struggles of the individual to form a self that is distinct from the (Oedipally freighted) parents—a self that is capable of love and equipped to make a life in the face of indomitable nature. Freud wasn’t the only contributor: Christian theology was at work, as was the American creed that all men are created equal. But many Christians had made their peace with slavery, and history had shown the equality-of-all-men standard to be more honored in the breach than the observance. So the Freudian view that each individual faces their own moral struggle was instrumental.

The Freudian view lent the unconscious to the anti-racialist school of thought. Black Americans are not biologically different from whites; any apparent differences arise from unknowable differences in unconscious responses to the social environment. Differences between Black and white Americans could be understood as matters of differential intersubjectivity, linguistically mediated—matters, ultimately, of “culture.” Adding the unconscious to the Christian credo allowed Americans to reject the biological-deterministic definition of race and substitute a view in which race was a distinction without a difference.

The struggle about “race” continues. It is about power and received identity, identity of the external sort as examined above. And therefore, it is also about the primacy of the Freudian unconscious. Are we essentially free of our supposed roots, subject to the same interior struggles with unruly impulses and internal parents, and therefore bound to strain against the bonds of our culture—with its identities, its false promises of fulfillment, its fetishization of the flesh and “color”—and to adore them at the same time?  Or are we stuck with “history,” and therefore with submission to the power structures that write it? Are we unhappy but free, or unfree and still unhappy?

Whatever race is, and whatever Americanness is, they are—empirically—inseparable. The Freudian model enables a bifurcation, one that is evidently essential to all American narratives. We embody our history (although we don’t have one); we are self-made (although we are products of circumstance). Pundits today relish speaking about “polarization”—red states vs. blue states, public-health supporters vs. anti-vaxxers, Black Lives Matter vs. All Lives Matter; pro- vs. anti-abortion forces—as if this were new. But is this really anything more than the anxious ambivalence of the ordinary mind? The distance between the wish and the fear is no distance at all.

There’s a story about a Jew who is marooned on an uninhabited island and survives there for many years. Finally, one day, a ship spots him and pulls up to the shore to rescue him. The crew wades onto the island and sees that the man has built two structures out of leaves and branches, each bearing a Star of David. “I built these synagogues,” the man tells the captain.

“Understood,” the captain says. “But why two?”

“This one,” the man says, “is where I pray every day. And that one,” pointing to the other, “is the synagogue I would not set foot in if my life depended on it.”

And this is what it is to be human, no? Wish fulfillment and fear avoidance. We are castaways in the discontented civilization.

PHILIP ALCABES is Professor of Public Health at Hunter College of the City University of New York and a member of the faculties of Public Policy and Human Rights there. His essays on mind and health have appeared in publications such as The American Scholar, Los Angeles Review of Books, and The Chronicle of Higher Education Review. He contributed to dePICTions volume 1 (2021), Pandemic Times, with the article, “Coronavirus, Epidemiology, and the Myth of the Primacy of Will over Matter.”

dePICTions volume 2 (2022): U.S. vs. … (Un-)American Crossings and Appropriations

1. Peter Gay, Freud: A Life for Our Time, New York: Norton, 1988, 170-171.
2. Letter from Freud to Eduard Silberstein, 1875, cited by Gay, Freud: A Life, 28-29.
3. Ludwig Feuerbach, The Essence of Christianity (Das Wesen des Christentums) (1841; English 1854), translated by George Eliot, New York: Harper & Row, 1957, 207.
4. Georg Wilhelm Friedrich Hegel, Lectures on the Philosophy of History (1837; English 2007), Lecture III, translated by J. Sibree, New York: Cosimo, 2007, 79.
5. J. Hector St. John de Crevecoeur, Letters from an American Farmer, London: Davies, 1782 [3 February 2022].
6. Sigmund Freud, “The Ego and the Id” (1923), in The Standard Edition of the Complete Psychological Works of Sigmund Freud, volume XIX, translated by James Strachey, London: The Hogarth Press, 1961, 1-66, here 19.
7. Josef Breuer and Sigmund Freud, Studies on Hysteria (1895), translated by James Strachey, London: The Hogarth Press, 1955.
8. Sigmund Freud, “From the History of an Infantile Neurosis” (1918), reprinted in Peter Gay, The Freud Reader, London: Vintage, 1995, 400-428.
9. Sigmund Freud, “The Psychotherapy of Hysteria,” in Josef Breuer and Sigmund Freud, Studies on Hysteria (1895), translated by James Strachey, London: The Hogarth Press, 1955, 253-306.
10. Citation pending.
11. Saul Bellow, Mr. Sammler’s Planet, New York: Viking, 1970, 202.
12. Sigmund Freud, The Future of an Illusion (1927), translated by W.D. Robson-Scott, Garden City: Doubleday, 1957, 4.
13. Sigmund Freud, Civilization and Its Discontents (1930), translated by James Strachey, New York: Norton, 1961, reissued 1989, 37.
14. See Bernard J. Baars and Stan Franklin, “An architectural model of conscious and unconscious brain functions: Global Workspace Theory and IDA,” Neural Networks 20.9 (2007), 955-961.
15. See Benjamin Kissin, Conscious and Unconscious Programs in the Brain, volume 1, New York: Springer, 2012, chapter 1. Also Natalie M. Trumpp, Felix Traub, and Markus Kiefer, “Masked priming of conceptual features reveals differential brain activation during unconscious access to conceptual action and sound information,” PloS One 8.5 (2013), e65910.
16. Pew Research Center, “When Americans Say They Believe in God, What Do They Mean?” 25 April 2018 [13 August 2021].
17. Freud, Civilization and Its Discontents, chapter 5.
18. Sigmund Freud, “Fixation to Traumas—The Unconscious,” in The Standard Edition, volume XVI, translated by James Strachey, London: The Hogarth Press, 1963, 273-285, here 285.
19. Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable, New Haven: Yale, 1991, 55.
20. Freud, Civilization and Its Discontents, 45.
21. Nicholas Ray, “Interrogating the human/animal relation in Freud’s Civilization and its Discontents,” Humanimalia 6.1 (Fall 2014), 10-40 [7 June 2021].
22. Julian Barnes says something similar in his novel The Only Story (London: Jonathan Cape, 2018). I expand his viewpoint here.
23. Walter Benjamin, “Convolute K, Dream City and Dream House, Dreams of the Future, Anthropological Nihilism, Jung,” in The Arcades Project, translated by Howard Eiland and Kevin McLaughlin, Cambridge: Belknap, 1999, 388-404, here 391.
24. Benjamin, “Convolute K,” 389.
25. Sigmund Freud, The Interpretation of Dreams (1900), translated by James Strachey, New York: Basic Books, 2010, 604.
26. Max Horkheimer and Theodor W. Adorno, Dialectic of Enlightenment, translated by Edmund Jephcott, Stanford: Stanford University Press, 1987, 104.
27. Horkheimer and Adorno, Dialectic of Enlightenment, 116-117.
28. Freud, “The Ego and the Id,” 52.
29. Marilynne Robinson, “The Freudian Self,” in Absence of Mind, New Haven: Yale University Press, 2010, 77-108, here 89. The Nietzsche assertion is from Genealogy of Morals, First Essay, sections 8 and 9.
30. Freud explains the repetition compulsion in Beyond the Pleasure Principle (1920), translated by James Strachey, New York: Norton, 1990, xxxiii-xxxiv.
31. R. Edward Hendrick, Jay A. Baker, and Mark A. Helvie, “Breast cancer deaths averted over 3 decades,” Cancer 125.9 (2019), 1482-1488; Nadine Zielonke, Andrea Gini, Erik E.L. Jansen, Ahti Anttila, Nereo Segnan, Antonio Ponti, … & Eveline A. M. Heijsdijk, “Evidence for reducing cancer-specific mortality due to screening for breast cancer in Europe: A systematic review,” European Journal of Cancer 127 (2020), 191-206; Stephen W. Duffy, Daniel Vulkan, Howard Cuckle, Dharmishta Parmar, Shama Sheikh, Robert A. Smith, … & Sue M. Moss, “Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial,” The Lancet Oncology 21.9 (2020), 1165-1172.
32. Chyke A. Doubeni, Douglas A. Corley, Virginia P. Quinn, Christopher D. Jensen, Ann G. Zauber, Michael Goodman, … & Robert H. Fletcher, “Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study,” Gut 67 (2018), 291-298; Theodore R. Levin, Douglas A. Corley, Christopher D. Jensen, Joanne E. Schottinger, Virginia P, Quinn, Ann G. Zauber, … & Chyke A. Doubeni, “Effects of organized colorectal cancer screening on cancer incidence and mortality in a large, community-based population,” Gastroenterology 155.5 (2018), 1383-1391; Andrea Gini, Erik E.L. Jansen, Nadine Zielonke, Reinier G.S. Meester, Carlo Senore, Ahti Anttila, … & Iris Lansdorp-Vogelaar, “Impact of colorectal cancer screening on cancer-specific mortality in Europe: A systematic review,” European Journal of Cancer 127 (2020), 224-235.
33. US Preventive Services Task Force, “Evidence Summary: Screening for Breast Cancer,” 11 January 2016 [4 September 2021].
34. University of Rochester Medical Center, “Mammograms: Facts on ‘false positives’,” 14 December 2015 [26 August 2021].
35. American Psychiatric Association, Diagnostic and Statistical Manual: Mental Disorders, 1st edition, Washington, DC: American Psychiatric Association, 1952.
36. Sean M. Robinson and Bryon Adinoff, “The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations,” Behavioral Sciences 6.3 (2016), 18 [13 May 2022].
37. Expert Committee on Mental Health, Report on the First Session of the Alcoholism Subcommittee, World Health Organization Technical Report Series 42, Geneva: World Health Organization, 1951.
38. Reports of Officers, Journal of the American Medical Association 162.8 (1956), 748-819 [4 September 2021].
39. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, Washington, DC: American Psychiatric Association, 1980.
40. Peter Conrad, “Medicalization and Social Control,” Annual Review of Sociology 18 (1992), 209-232; Deborah Lupton, “The Social Construction of Medicine and the Body,” in Gary L. Albrecht, Ray Fitzpatrick, and Susan C. Scrimshaw (eds.), The Handbook of Social Studies in Health and Medicine, London: Sage, 2000, 50-63; Adele E. Clarke, Janet K. Shim, Laura Mamo, Jennifer Ruth Fosket, and Jennifer R. Fishman, “Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine,” American Sociological Review 68.2 (2003), 161-194 [13 May 2020].
41. David Bloor, Knowledge and Social Imagery, London: Routledge & Kegan Paul, 1976.
42. Mary Douglas, Purity and Danger: An Analysis of Concepts of Pollution and Taboo, London: Routledge & Kegan Paul, 1966; Mary Douglas, Risk Acceptability According to the Social Sciences, New York: Russel Sage Foundation, 1985.
43. Jeffrey M. Jones, “US Church Membership Falls Below Majority for First Time,” Gallup, 29 March 2021 [26 August 2021].
44. Pew Research Center, “Being Christian in Western Europe,” 29 May 2018 [26 August 2021].
45. Sigmund Freud, Beyond the Pleasure Principle, translated by Ernest Jones, London: International Psycho-Analytical Press, 1922, 7, 9, 14, 15.
46. See, for instance, Astrid Galvan, “Controversy Over ‘In the Heights’ Raises Awareness of Colorism and Racial Identity,” PBS NewsHour, 18 June 2021 [27 August 2021].
47. John Murray Cuddihy, The Ordeal of Civility: Freud, Marx, Levi-Strauss, and the Jewish Struggle with Modernity, Boston: Beacon Press, 1987.
48. Gay, Freud: A Life, 562-564.
49. Freud, Civilization and Its Discontents, 74.
50. Benjamin Taylor, Here We Are: My Friendship with Philip Roth, New York: Penguin, 2020, 21.
51. See Gay, Freud: A Life, 119-123 for discussion and citations.
52. Freud, Civilization and Its Discontents, 112 (translation slightly modified).
53. Letter of 30 September 1934, cited in Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable, New Haven: Yale, 1991, 16.
54. Anne Harrington, Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness, New York: Norton, 2019, 37-38.
55. Charles Burr, “A Criticism of Psychoanalysis,” in Proceedings of the American Medico-Psychological Association, Baltimore: Lord Baltimore Press, 1914, cited in Harrington, Mind Fixers, 37.
56. Edward B. Titchener, “The Past Decade in Experimental Psychology,” The American Journal of Psychology 21.3 (1910), 404-421.
57. Grete Meisel-Hess, Die sexuelle Krise. Eine sozialpsychologische Untersuchung, Jena: E. Diederichs, 1909. (The Sexual Crisis: A Critique of Our Sex Life, translated by Eden and Cedar Paul, New York: Critic and Guide, 1917.)
58. Eli Zaretsky, Secrets of the Soul: A Social and Cultural History of Psychoanalysis, New York: Vintage, 2004, 55.
59. Zaretsky, Secrets of the Soul, 67.
60. Paul Starr, The Social Transformation of American Medicine, New York: Basic Books, 1982, especially 169-170.
61. Starr, The Social Transformation, 102-109.
62. Starr, The Social Transformation, 119-127.
63. Paul W. Moser and Arnold Richards, “The History of Membership and Certification
in the APsaA: Old Demons, New Debates,” Psychoanalytic Review 92 (2005), 865-894.

64. Zaretsky, Secrets of the Soul, 186, citing Ernest Jones, The Life and Work of Sigmund Freud, volume 3, New York: Basic Books, 1961, 297-298.
65. Sigmund Freud, “The Question of Lay Analysis: Conversations with an Impartial Person,” in The Standard Edition, volume XX, translated by James Strachey, London: The Hogarth Press, 1959, 183-250, here 246.
66. Nancy Tomes, The Gospel of Germs: Men, Women, and the Microbe in American Life, Cambridge: Harvard University Press, 1998.
67. Harrington, Mind Fixers, 42.
68. Harrington, Mind Fixers, 74 onwards.
69. Zaretsky, Secrets of the Soul, 81.
70. R Kenny, “Freud, Jung and Boas: The psychoanalytic engagement with anthropology revisited,” Notes and Records of the Royal Society of London 69.2 (2015), 173-190 [13 May 2022].
71. Marcus Jones, Black Migration in the United States with Special Emphasis on Selected Central Cities, Saratoga: Century Twenty One, 1980, 137; Reynolds Farley, “The Urbanization of Negroes in the United States,” Journal of Social History 1.3 (Spring 1968), 241-258, here 250.
72. Hana Layson and Kenneth Warren, “Chicago and the Great Migration, 1915-1950,” Digital Collections for the Classroom, 14 March 2013 [26 August 2021].
73. Louise Venable Kennedy, The Negro Peasant Turns Cityward, New York: Columbia University, 1930, 35.
74. Nell Irvin Painter, The History of White People, New York: Norton, 2010.