"The environment as a cause of disease in children": Josef Friedjung's transnational influence on modern child welfare theory.

Josef K. Friedjung's Advanced Pediatrics-A Companion to Traditional Textbooks (Erlebte Kinderheilkunde-eine Erganzung er gebrauchlichen Lehrbucher), published in 1919 in Vienna, has cast a long but nearly-vanished shadow over modern child welfare theory The originality of his focus on "the whole child" was in some ways a commentary on Sigmund Freud, but its overtly progressive political character gave Friedjung's argument visible applicability within the field of urban social welfare. As a pediatrician and an ardent cosmopolitan, Friedjung was willing to consider conflicting values between traditional family systems and the state. Had the Nazis not forced him into exile in Palestine, where he died in 1946, Friedjung's pioneering oeuvre would have joined our child welfare narrative long ago. Fortunately today archival evidence on which this study draws, fragmented as it is in both German and English, does confirm that the first and second generation psychoanalysts, Friedjung among them, built a mental health movement around a social justice core closely allied to the cultural context of central Europe from 1918 to 1933. In many ways, child welfare as we know it emerged as a practical implementation of that ideology.By January 1934, Josef Karl Friedjung, a Viennese psychoanalyst and City Council member, had been practicing pediatrics at Ebendorferstrase 6 since the turn of the 20th century. The office buzzer rings and Friedjung, a fairly short, slender man of sixty, answers it. He's wearing a light brown suit, a small handkerchief in the breast pocket, and a round-collared white shirt. He stays with his child patient and her mother for about 20 minutes, talking to both while examining the eight-year old. Friedjung speaks in a fatherly tone, yet clearly and with a depth of compassion that relaxes the mother enough so that she can catch the doctor's unusual question. "Is the child merely bad or is she ill?" (Friedjung, 1938).He took the question seriously, and in 1909 (see Nunberg & Federn, 1967) he had led his colleagues in Sigmund Freud's relatively new Psychoanalytical Society to accept that both parents and the schools must be engaged to prevent childhood neurosis from deteriorating into later adult psychopathology. The question at hand was: To what extent was the psychoanalytic method applicable to children? For the most part, Friedjung thought, simply informing parents and teachers about the psychological aspects of illness was sufficient. But where children's disorders were severe or long-standing-such as enuresis or chronic asthma-or their behaviors were compulsive, then "an analysis lege artis cannot be avoided" (Friedjung, 1938).He proposed that social fairness demanded extending psychoanalysis to gravely ill children since the treatment had already helped troubled adults recover from childhood trauma, regardless of social class (Hitschmann, 1932). Over the course of his forty year career, Friedjung analyzed children, applying the technique he learned from his colleague in Vienna, Hermine Hug-Hellmut. Indeed, even before the work of Melanie Klein and Anna Freud, Hug Hellmuth had developed child therapies based on games and drawings and, as such, is known as the first practitioner of child analysis. Her views found their way into education, parenting and child welfare facilities, and her practice of treating children in their own homes was picked up by Vienna's emerging social work profession. To this, Friedjung added elements from his three other fields-child sexuality, children's rights (in the political sense), and public health-to merge advocacy for children with psychoanalysis. Thus, his career as a political pediatrician-psychoanalyst grew in tandem with the increasingly powerful presence of the Social Democrats in Vienna.In May, 1919, in a landslide election that would be repeated in 1927, the Social Democratic Workers' Party (SDAP) triumphed over the conservative Christian Socials in Austria's first balloted election. …