Freud Made It Sacred. We’re Making It Shared.
by Dr. Allan Steingart
The Usual Suspects—and One More
It’s not fashionable to blame Freud these days, unless we’re talking about his fixation on sex, his untestable theories, or the way he made therapy feel like an endless, inaccessible, members-only ritual. But I’d add something else to the list: the deep-rooted resistance to collaborative mental health care.
To His Credit: Freud Opened a Door
To be fair, Freud also pulled psychotherapy out of the hands of medical exclusivity (although in Canada, only medical doctors are reimbursed for psychotherapy by our fee-for-service government insurance). He argued that psychological healing wasn’t just about biology or disease; it was about meaning, memory, conflict, and language. In doing so, he created space for a new kind of clinician and a new kind of treatment. That legacy deserves credit.
The Culture He Created: Exclusive, Not Inclusive
Freud didn’t just invent a theory and method of treatment. He established a professional culture marked by an emphasis on privacy and the quasi-religious belief that only those initiated into the analytic mysteries could truly “know” the patient. The therapeutic dyad became sacred. Two people in a room; everything else was noisy and contaminating.
When Collaboration Felt Like Contamination
This model had consequences. It didn’t just discourage collaboration; it made it feel like a violation. Bringing in another clinician was seen not as adding value, but as betraying the analytic container. Psychiatrists were divided into communities of pill pushers vs. psychotherapy providers. Family doctors were nuisances. And if the patient had their own ideas, that was often interpreted in terms of resistance.
The Legacy Lives On—And We Still Feel It
That legacy lingers. We see it every time a certified Psychotherapy Matters Virtual Collaboration (PMVC) therapist hesitates to invite a psychiatrist into the room. Every time a clinician fears that collaboration will compromise their independence. Every time “case formulation” is hoarded like a private artifact rather than routinely co-constructed and shared.
A Different Model: Together in the Same Room
Psychotherapy Matters wasn’t designed to criticize Freud (or any model of psychotherapy) unfairly, but it is quietly undoing one of his legacies. We’ve put the psychiatrist and the therapist together, with the patient, on the same video call, in the same space, sharing the same goal. No silos. No gatekeeping. Just people trying to help someone gain insight and feel better.
Not Loud, But Still Revolutionary.
That might not be radical. But in a system still haunted by the ghosts of Vienna, it feels quietly revolutionary.
To learn more about becoming a member of PMVC, go HERE.