Because the treatment of inpatients necessitates a great variety of interventions and because hospital patients suffer from structural personality defects with much evidence of conflict, the primary psychoanalytic treatment approach of a hospital may be overridden by nontreatment pressures, such as accreditation standards or hospital organization. The pseudopsychoanalytic hospital is the result of a paucity of attempts to clarify the content and direction of the analytic treatment program. Undesirable clinical complications set in when the emphasis is not on the individual patient's need, when a clearly conceptualized treatment philosophy is not agreed upon. Impediments to this approach include economic considerations, the staff's own psychological needs, and the concerns of the institution for education, research, and public relations. Arbitrariness in setting individualized treatment standards permits the acting out of unconscious fantasies of omnipotence,