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  After a long battle for premises, the Ambulatorium was finally established in the ambulance entrance of the cardiology unit at the General Hospital on Pelikangasse – where, according to the historian Elizabeth Ann Danto, it resembled ‘a gatekeeper’s house on an opulent estate’. Each afternoon, the four ambulance garages were transformed into consulting rooms, a metal examination table serving as a couch, while the analyst sat on a wooden stool. Despite these unprepossessing surrounds, which illustrate just how highly psychoanalysis was regarded by the Viennese medical establishment at the time, vast numbers of patients streamed through the Ambulatorium’s doors. Reich, who had just completed two years’ postgraduate training in neuropsychiatry when the clinic opened, was appointed clinical assistant to the director, rising two years later to become deputy medical director.

  The patients he saw there were industrial labourers, farmers, housewives and the unemployed, and their stories exposed the tattered inadequacies of the psychoanalytic model. Their problems weren’t a result of Oedipal conflict or witnessing the primal scene. They were struggling with poverty, overcrowding, overwork, exhaustion, drunkenness, domestic violence, prostitution, incest, rape, teenage pregnancy, illegal abortions and venereal disease. In short, every individual he saw was being affected by social and economic forces that couldn’t possibly be addressed by psychoanalysis.

  What Reich longed to do was treat the cause. ‘From now onward, the great question was: Where does that misery come from? While Freud developed his death instinct theory which said “the misery comes from inside”, I went out, out where the people were.’ In 1927, he read Das Kapital with as much amazed recognition as he had once read Freud. He was gripped by Marx’s account of capitalism as a brutal system of exchange that converted people into commodities, objects of arbitrarily fluctuating value. The notion of alienated bodies, estranged from their own needs and desires, chimed with what he’d seen in his own patients, lying stiff and rigid on the couch. He already believed that marriage had deleterious effects on people’s sex lives (his own was firmly open), and he was excited to discover that Marx thought social change would require the abolition of the nuclear family. Within a year, he’d joined the Communist Party.

  Both psychoanalysis and communism were full of potential for understanding human unhappiness and expanding human freedom, Reich thought, but each had major blind spots. The problem with psychotherapy was that it insisted on treating the individual as if their pain occurred in a vacuum, unmediated by the society they inhabited or the politics that governed their lives. As for Marxism, it failed to recognise the importance of emotional experience, not least the trouble caused by shame and sexual repression, especially to women.

  Therapy was not enough. Politics was not enough. Only sex was a sufficiently powerful force to reshape society. Reich kicked off his quixotic campaign in 1928, trawling the suburbs of Vienna in a van he’d kitted out as a mobile ‘sex-economy clinic’, accompanied by a female doctor who fitted contraceptive devices and arranged illegal abortions for desperate women. He went from door to door dispensing condoms and communist pamphlets, like some lay preacher of the erotic. The following year, and with Freud’s uneasy blessing, he established six free clinics in the poorer areas of the city, offering psychotherapy for the working classes alongside free sex education, contraception and abortion advice. ‘What was new about our counselling centres’, he explained, ‘was that we integrated the problems of the neuroses, sexual disturbances and everyday conflicts. It was also new to attack the neuroses by prevention rather than treatment.’

  It hadn’t escaped Reich that Berlin was the hot zone of sexual liberation, and in 1930 he transferred operations across the German border, joining what he described in People in Trouble as ‘the great freedom movement’. He moved with Annie and their two daughters to an apartment on Schwäbische Strasse a year after Isherwood first drew back the curtain on the Cosy Corner and a few weeks after Hirschfeld left the city on an epic world tour. While Isherwood was giving English lessons and gallivanting with Otto, Reich was working at the Berlin Poliklinik, the first of the free clinics. He soon established a splinter group of radically-minded young analysts, who met at his apartment to discuss patient case histories, politics, the future. Fascism was on the rise. Surely psychoanalysis had to become politically engaged?

  From the moment he’d arrived in Berlin, Reich was aware of the presence of the Nazi Party. Day by day, as Germany tumbled deeper into financial crisis, the Sturmabteilung, SA, became more visible, marching through the streets in their polished knee boots and brown uniforms. Both Reich and Isherwood described seeing anti-Semitic graffiti and smashed windows in Jewish-owned department stores. In 1931, Reich’s communist group (which included the writer Arthur Koestler) heard the SA was planning an attack on a Red housing block on Wilmersdorferstrasse. They organised a defence, filling hundreds of glass bottles with water and lining them along the windows, ready to smash on the heads of the troops.

  On holiday in Rügen Island that summer, Isherwood observed families decorating their beach encampments with swastikas, a scene he inserted into Goodbye to Berlin. As he drifted down the sand, brooding over Otto, he saw that someone had spelled out HEIL HITLER! with fir-cones. At the Topography of Terror Museum in Berlin in 2017, I came across a photograph of a similar scene: an embracing couple in bathing suits, hers lavender, his black, their faces close together, their legs entangled. They were curled in the hollow of a dune, and to mark the boundaries of their hedonistic domain they’d planted a line of swastika bunting in the sand, along with three beach-sized swastika flags, snapping gaily.

  Even as he’d been preparing to attack and potentially kill a member of the SA, Reich still felt there was a human being inside the uniform. It was plain to him that the young people joining the SA were not that dissimilar to his comrades in the Communist Party. They were all ‘individuals living under the same working conditions, in the same material situation, and even sharing the same determination to “do away with the capitalist machine”.’ Why, then, were some people choosing fascism? Reich suspected the growing popularity of the Nazis was a consequence of the same sexual discontent he saw in his patients, and he was certain that fascism was the malign end product of sexual repression, which made people dangerously susceptible to the authoritarian experience of a dictatorship, from the seductive spitting figure of Hitler to the compensatory pleasure of marches, rallies and uniforms.

  Sex was key. Sex was the way to turn the tide, to reach the masses and liberate them from their rigid, infantile fixation with fascism. In the early 1930s, Reich coined the term the ‘Sexual Revolution’ to describe the universe of happiness and love that would arise once people had shaken off their shackles, divesting the world of its punitive, prurient attitudes. He was undoubtedly naive in this, as the French philosopher-historian Michel Foucault so scathingly observes in the first volume of The History of Sexuality, published in 1976. If the orgasm is so powerful, Foucault asks, why is it that the vastly expanded sexual liberties of the intervening years have failed to dissolve capitalism or topple the patriarchy, despite all Reich’s ardent predictions to the contrary?

  It’s an easy criticism to make, but it doesn’t mean Reich’s utopianism was completely without solid, practical foundations. If people had access to safe sex, and especially to contraception and safe, legal abortion, they were far less likely to produce unwanted children, or to find themselves shackled by poverty or unhappy marriages. As he pointed out in The Sexual Revolution, between 1920 and 1932, twenty thousand women a year died in Germany because of illegal abortions, while seventy-five thousand became ill with sepsis. You don’t need to believe in the magical power of the orgasm to see why a sexual revolution might be desirable, especially for women.

  With Hirschfeld away on his world tour, Reich began to channel the Berlin reform groups into his own explicitly communist organisation, the German Association for Proletarian Sexual Politics, shortened to the catchier Sex-Pol. Although t
he limits of his work are contested, he was a prominent, passionate figure in the city, lecturing crowds of thousands. Young people in particular came to him in droves, begging for help with the difficulty of reconciling their own desires with their anxiety and ignorance around pregnancy and disease.

  Reich liked to establish demands, and those of Sex-Pol echoed Hirschfeld’s World League for Sexual Reform. Even now they sound strikingly progressive: free divorce, birth control and sex education; the elimination of venereal disease; the abolition of punishment for sexual crimes in favour of treatment, combined with robust protection for children against paedophiles. In addition, they demanded free and legal abortion, something the more conservative groups in the World League had refused to countenance.

  But there were limits to Reich’s radicalism. What he didn’t want, and what Sex-Pol refused to address, was the abolition of the homophobic Paragraph 175, which criminalised sex between men. The World League had made a clear case for sexual diversity, demanding a rational attitude towards sexuality, ‘and especially towards homosexuals, both male and female’. Reich didn’t agree. Like Freud, he was depressingly proscriptive about sex, believing it had to be heterosexual, penetrative and orgasmic. His genital utopia, it turned out, required a passport and visa at the door.

  In People in Trouble, he writes contemptuously of how sexology in the period after the First World War was ‘shrouded in darkness’ because the ‘great names’, Hirschfeld and Ellis among them, ‘dealt with (and could only deal with) the biopathic sexuality of the time, that is to say, the perversions and pro-creation of the biologically degenerate human animal.’ Homosexuality he regarded as a product of sexual repression, a kind of warping. Years later, in New York, he refused to treat Allen Ginsberg because he was gay.

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  When Reich referred to ‘the biologically degenerate human animal’, he was drawing on a concept that has had malign consequences on bodily freedoms across the world. Degeneration is a pseudoscientific theory about bad and undesirable bodies that emerged in the nineteenth century, played a disturbing role in the sexual liberation movement, contributed to the rhetoric that underpinned the Holocaust, and which continues to drive prejudice, racism and even genocide in our own century. When Darwin’s On the Origin of Species was published in 1859, the limits of inheritance were poorly understood. Was evolution always progressive, or was there a counter-movement of stagnation, regression and relapse, passed on through the generations? Perhaps you could inherit insanity, weakness, laziness, even criminality. This latter belief was popularised by the Italian criminologist Cesare Lombroso, who argued in his influential 1876 work Criminal Man that the criminal was a throwback to a more primitive, atavistic being.

  Throughout the Victorian era, the category of degenerate people kept expanding. Paupers. Homosexuals. Prostitutes. Alcoholics. Vagrants. Beggars. The sick, the diseased, the disabled, the suicidal, the insane. The idea gathered immense racist force, justifying imperial violence as well as missionary zeal against so-called backward or primitive nations. Its frequent association with parasitism intensified a feeling that the bad, degenerate body should not be supported, perhaps not even tolerated at all.

  If degeneration was inborn, it meant the problems it was associated with weren’t caused by poverty or social regimes, but were the consequence of the body itself. This brutal worldview, still prevalent on the right today, regards the welfare state, charity and even vaccination as powerless and wasteful in the face of inherited weakness and incapacity. It’s visible, for example, in a controversial document written in 2013 by the-then senior advisor to the UK Education Secretary, Dominic Cummings, which questions the value of programmes like Sure Start, arguing that ‘most of those that now dominate discussions on issues such as social mobility entirely ignore genetics and therefore their arguments are at best misleading and often worthless’.

  By the end of the nineteenth century, the question had arisen as to whether the degenerate should be allowed to reproduce. Though it sounds like pure Third Reich rhetoric, the concept of eugenics was invented in 1883 by Darwin’s cousin Francis Galton. He thought that just like sheep and cows, humans could be improved by selective breeding. He proposed two pathways to what he regarded as a utopian future populated by ‘the best stock’: positive eugenics, which meant encouraging the reproductively desirable to breed, and negative eugenics, which meant preventing the so-called Unfit from reproducing.

  Although positive eugenics is regarded as less horrifying than negative eugenics in its effects, both models clearly depend on establishing a sliding scale of human value. It’s not enough to simply possess a body. It has to be the right kind. Eugenics always involves identifying which types of bodies are worth preserving and which should be discarded from the communal store of humanity. The question of which court or power would define the Unfit, what police would enforce it, and what punishment there would be for resistance and refusal would soon be amply addressed. But there was abundant evidence of the authoritarian potential of eugenics long before the rise of Hitler. The first sterilisation to eliminate ‘inferior’ offspring took place illegally in Germany in 1897. The procedure was rapidly popularized, particularly in the United States, where it was used to carry out an outspokenly racist agenda. Race hygiene, as eugenics was also called, wasn’t always literally an imperial programme designed to ensure the survival of a pseudo-scientific white or Aryan race, but it was a quest for homogeneity and purity.

  What seems truly astonishing now is that a great many people involved in the sexual liberation movement of the 1920s were in favour of some kind of eugenicist programme. In the period before the wars, and despite evidence that it was already being used non-consensually, so-called ‘welfare eugenics’ (as opposed to ‘racial eugenics’) was still considered a utopian tool, a rational way of engineering a world without sickness and inherited disease. Just as Fabians like H. G. Wells and Beatrice Webb joined the British Eugenics Society, so Marie Stopes, Margaret Sanger and Helene Stöcker all subscribed to eugenic theories of one kind or another.

  By providing a rationale for legalising birth control, eugenics seemed to offer a way of uncoupling sex from pregnancy, thereby allowing women to fully participate in sexual liberty. In Germany, as in many other countries, part of what drove prohibitions against abortion and contraception was a desire to increase population. Sexual hygiene arguments allowed the liberationists to argue for legalising contraception by reframing it as part of a patriotic campaign to increase the quality of the nation’s offspring, rather than polluting the communal gene pool. Even the seemingly innocent rebranding of contraception as ‘birth control’ and later ‘family planning’, terms now so ubiquitous as to be unquestioned, were actually a way of making non-reproductive sex – sex for sheer pleasure – acceptable by smuggling it beneath a conservative, eugenicist banner. Many sex liberationists used the spectre of degeneracy to bolster their arguments, writing in hostile language of the feckless, asocial poor and reproductively unfit, whose fecundity must be disciplined if not actively prevented.

  Reich was disturbed by all this. In People in Trouble he described how frustrating it was to hear eugenicist arguments trotted out by people who had evidently never spent time in a working-class clinic, seeing women who slaved at piecework, who were beaten by their husbands and who already had six children they couldn’t feed. ‘They demanded whether or not tuberculosis, mental retardation, or flat feet in a family constituted indications for abortion,’ he recorded wearily. ‘Only the extreme radicals advocated the woman’s “right to her own body”.’ His solution, as ever, was fusion, this time between Marx and Malthus: ‘social struggle to eliminate the misery of the masses and selective birth control.’

  One might have hoped that Hirschfeld too would have refrained from demonising the Unfit. He didn’t believe in the concept of racial purity, and regarded nations as communities of hybrids. In Racism, he wrote emphatically: ‘There is no difference between the races, only individuals. I can
appeal to an experience which must be almost, if not quite, unrivalled, so numerous are the men and women from every part of the world who have consulted me on sexual matters.’ As the world descended into war, he dreamt of a Menschenheitsstaat, a republic for all humanity. Forced to decide whether he was primarily a German or a Jew, he stated that he was a citizen of the world (when the British Prime Minister Theresa May told the 2016 Tory party conference, ‘If you believe you are a citizen of the world, you are a citizen of nowhere’, I thought of Hirschfeld).

  But in the interwar period, even Hirschfeld believed in welfare eugenics. In 1913 he was one of the founders of the Medical Society for Sexology and Eugenics. According to his biographer Ralf Dose, he represented the society at public hearings of the Imperial Council on Health, where he agreed with the compulsory sterilisation for paedophiles as well as people who were ‘mentally . . . stupid’; an extreme idea even at the time, and one that he was arguing passionately against by 1934, by which time its implications had become frighteningly clear. He also expressed doubts about whether transvestites should have children, fretting over the possibility of degenerate offspring, before adding uncertainly: ‘on the contrary, the children of the transvestites whom I saw gave me the impression of being good and healthy.’

  His first biographer, Charlotte Wolff, is somehow even more damning. Wolff was a German doctor, sexologist and lesbian who was herself active in Berlin’s sex-reform circles before the war. In a biography otherwise explicitly designed to restore the reputation of a forgotten hero, she describes herself shocked to discover that Hirschfeld maintained an ongoing and pseudo-scientific interest in the bodily markers of degeneracy. He kept a list of signs and symptoms, she said: anatomical evidence of unacceptability, betrayed by a helplessly exposing body. It was the opposite to his liberatory record of sex and gender difference. One argued for acceptance of diversity; the other for discrimination. Wolff records it with dismay, the minute, betraying stigmata of the Unfit: ‘asymmetry of face and head, small eyes, nystagmus, squinting, too big ears, stammer, multiple lipomas, tendency to varicose veins.’