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Ever since 1938 the American Psychoanalytic Association has had a special autonomous relationship within the IPA accorded to no other component organisation. This Regional Association status has had two main features: (1) total internal control over training standards and membership criteria, with no accountability to the IPA; and (2) an ‘exclusive franchise’, so that the IPA was barred from recognising any other component within the United States. This unique Regional Association status reflected the resolution at the time (1938) of the long-standing controversy between the IPA and the American over the issue of ‘lay analysis’, and remained unaltered for half a century until, with the resolution of the 31/2-year long law-suit against the American (and secondarily against the IPA) in 1988, the Regional Association agreement was modified (but not totally abrogated) by the American's giving up the ‘exclusive franchise’ aspect (thus permitting IPA recognition of psychoanalytic groups in the US organised outside the American), but still retaining its internal full control over training and membership. The meanings and consequences for psychoanalysis of this special status of the American are explored.