The need for psychoanalysis is alive and well in community psychiatry

While the author recognizes the positive impact community psychiatry has had on postpsychotic patients by the uses of medical management and environmental manipulation, he demonstrates that there is a deficiency in the treatment of lower socioeconomic patients with neurotic illnesses. Specifically, neurotic patients tend to be given supportive therapy and psychopharmacotherapy when a form of psychoanalytic psychotherapy would be more appropriate. The author supports these contentions by presenting three cases which have a diagnosis of hysterical neurosis and which clearly demonstrate the economic, topographical, structural, dynamic, and genetic components of the psychoanalytic theory. Finally, as psychoanalytic psychotherapy is too time-consuming, the author suggests that Freud's early psychoanalytic technique of symptom removal by memory recovery be used when appropriate.