<i>Background:</i> We aim to elicit how far the public has incorporated Freudian theory in its understanding of mental illness in different countries, focussing on the unconscious conflict as a possible cause of mental disorders. <i>Sampling and Methods:</i> We conducted representative population surveys with identical sampling procedures and face-to-face interviews in Germany (1990, n = 3,078; 2001, n = 5,025), Novosibirsk (Russia, 2002, n = 745), and Bratislava (Slovakia, 2003, n = 1,000) and a representative telephone survey in Germany in 2006. <i>Results:</i> Two thirds of respondents in Germany endorsed an unconscious conflict as a cause of mental disorder. Endorsement was stronger for depression than for schizophrenia, increased with duration of schooling, and was less prevalent in Bratislava and Novosibirsk and in East compared to West Germany. Endorsement in Germany increased between 1990 and 2001. However, only 5% of respondents could offer a definition of unconscious conflict that resembled Freud’s initial theory. <i>Discussion:</i> The observed West-East gradient is likely to mirror the past political undesirability of psychoanalysis in former communist countries. The popularity of psychoanalytical concepts seems to lag behind their actually declining influence within psychiatry in Germany. Public conception of unconscious conflict however hardly resembles Freud’s original ideas. <i>Conclusions:</i> Although psychoanalytical concepts warrant consideration when exploring patients’ causal beliefs about mental illness, psychiatrists should focus on the subjective meaning of seemingly psychoanalytic phrases.