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The history of nonmedical professionals in psychoanalysis is long, complex, and fascinating. It extends from Otto Rank's admission into Freud's inner circle in 1907 to the birth of the “waiver” policy after years of laborious deliberation within the American Psychoanalytic Association (“the American”) in 1957, from the 1926 lawsuit by a disgruntled analysand against Theodore Reik to the 1985 antitrust litigation against the American, from Freud's (1926) impassioned defense of “lay analysis” to the recent Gaskill Committee report, and from the 1946 bylaw of the American requiring all new members to be physicians to its proposed 1990 bylaw relaxing the policies for nonmedical training. This bittersweet history includes many instances of misunderstanding and clarifications, rivalries and collegiality, and confrontation and cooperation between medical and nonmedical psychoanalysts.
While a comprehensive and balanced account of this history remains to be written, one thing is obvious. Nonmedical professionals, mostly psychologists, have made profound contributions to psychoanalysis from its earliest days. Besides Anna Freud, Otto Rank, and Hans Sachs, a number of “pioneers” of our discipline were nonphysicians. Some names that readily come to mind are August Aichorn, Ronald Fairbairn, Lou Andreas-Salome, Melanie Klein, Theodore Reik, Ella Freeman Sharpe, and James Strachey. Psychoanalysis in Europe never became strongly identified with academic medicine. Consequently, nonphysicians have continued to form a sizable group among analysts practicing there. Even within the mainstream American psychoanalysis with its strong medical identity, psychologists have played a prominent role in all three “generations” of psychoanalysts. An admittedly incomplete list of these distinguished individuals includes among the “immigrants,” Erik Erikson, Ernst Kris, David Rappaport, and Robert Waelder;