How Many Psychoanalysts Were in North America Around 1930?

Andrew Scull says North America had probably 300 psychoanalysts around 1930. Classical psychoanalysis took five hours a week, so a workforce that size could treat only a few thousand patients while hundreds of thousands were in hospitals.

Asylum psychiatrists who dealt with psychotic patients wanted nothing to do with Freud or talk therapy, and Freud's ideas were not popular in mainstream clinical psychotherapy either. The partial exception was St. Elizabeth's, the only federal mental hospital, in Washington, D.C., where superintendent William Alanson White was somewhat sympathetic and tried a bit. Thousands of patients still put talk therapy out of reach, and the patients were much more severely disturbed.

Novelists, painters, artists, playwrights, and the audience for elite culture tended to embrace Freudian ideas. Freud lamented that his case histories read like short stories and that people thought they lacked the stamp of serious science, because psychoanalysis recovers memories and rebuilds stories of conflict and hidden motives. Surrealism drew heavily on the idea of extracting things from the subconscious. Sex sold in the theater and in movies, but the analyst workforce still could not reach the hospital population.