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Listed under the heading. "Special Article," this paper is indeed special; it deserves study by every psychoanalyst and psychiatrist. Wallerstein's penetrating
analysis of the problems within and between psychoanalysis and academic psychiatry is clearly related to the problems confronting the nonacademic practitioner as well. He presents a lucid history of the subject, highlighting the differences between developments in Europe and the United States. Wallerstein describes the tremendous post-World War II growth of psychoanalytic influence and prestige in medical school teaching and training of psychiatrists. This reached its peak in the mid-1950's. He then traces the gradual decline of psychoanalytic influence as it had to make room for the burgeoning fields of psychopharmacology, learning theory, behavior modification, the humanistic psychotherapy based on European existentialist phenomenological philosophy, the community mental health center movement, social systems theory, etc. Among other topics, Wallerstein instructively discusses the state of psychoanalytically oriented psychotherapy vis-à-vis the increasingly popular short-term substitutes, the declining number of medical students specializing in psychiatry, and the declining number of psychiatrists in training who are seeking psychoanalytic training. Obviously, there are no easy solutions to these complex problems. Wallerstein presents a number of options and suggestions of others as well as his own. These constitute an operational agenda for further exploration and discussion.