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The Future of Psychoanalysis is misleadingly subtitled The Debate About the Training Analyst System. It is misleading because it under estimates the scope of this book. The debate about the role of the training analyst opens the door to a very wide-ranging discussion of the history and future of psychoanalytic organizations that draws on authors from around the world. While there is some repetition, it is actually very helpful to read about the same issues in psychoanalytic history from different cultural perspectives. Several questions that might be considered existential create an underlying tension. Everyone seems to agree that psychoanalysis as defined by mid twentieth century standards is in serious decline world-wide. There is concern that efforts to preserve a more conservative notion of psychoanalysis may actually prove fatal. Of course, this leads to the vexing question of what is psychoanalysis and how it is distinguished from psychotherapy. Is it a matter of frequency of sessions or something more qualitative? If the matter is qualitative, experience counts and a certain hierarchy is inevitable. Harold Blum agrees that the criticisms of the training analyst system are valid but argues no true alternative has been proposed. Robert Wallerstein observes that even removing reporting training analysts doesn't eliminate the tendency of small in groups of senior clinicians from exercising potentially constrictive organizational control.
Robert Pyles, in a refreshingly candid account entitled “Still Crazy After All These Years” describes how a new institute broke off from the original Boston Psychoanalytic with the hope, in at least some people's minds, for a freer atmosphere. Instead, to quote yet another popular song, the new boss looks the same as the old boss. Pyles quotes Mark Twain that the “primary difference between education and a massacre is that a massacre is more sudden” (p. 236).
The very success of psychoanalysis in American psychiatry was so dramatic