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When the survey [of national programs of psychoanalytic education] was launched, Franz Alexander remarked that ultimately everything discovered would be explained by differences in history.
Like all life courses, the life course of child psychoanalysis, child psychotherapy, and clinical services to children at the Chicago Institute for Psychoanalysis has been determined by both internal and external factors. From within, child analysis, originally a subspecialty of adult psychoanalysis proper, has struggled to establish its legitimacy as a form of real psychoanalysis with its own practice theory, a struggle further complicated by the competing influences of Melanie Klein and Anna Freud and by the question of lay analysis (because early practitioners of child analysis often were educators, nonmedical, and women). Over time, child analytic influences have been integrated into the body of psychoanalytic thought, particularly in conceptions of development, practice within the widened scope, and applications to the allied fields of child psychotherapy and education. Even so, the question of whether child analysis is an authentic form of psychoanalysis runs through its history.
In the external world, the preeminent place of psychoanalysis within psychiatry and American culture shifted dramatically so that, even as it is embedded in the popular imagination, psychoanalysis no longer dominates mental health theory and practice. This has meant fewer patients in analysis, fewer candidates in training, an array of alternative therapies, and increasingly uncertain economics of practice