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This book's basic premise is that "political Freudians" were an essential ingredient in the creative development of psychoanalysis. According to Jacoby, the political Freudians were people who extended Freud's humanistic investigations by concentrating on his studies of human social interaction. Jacoby minimizes the fact that Freud began as a physical scientist working in a laboratory, and later was a physician treating patients.
Through scholarly research, Jacoby has uncovered the radical political orientation of many analysts whom he regards as second generation analysts (born between 1900 and 1910). He then develops the theme that suppression of those analysts' political freedom led to a smug, stultified psychoanalytic sterility. By innuendo, he suggests that a plot was directed against those "political" European analysts by American psychoanalysts who were afraid of competition for affluent patients. The evidence he offers is a quotation from a single psychoanalyst who reportedly said that he feared such competition. He also attributes suppression of the "political psychoanalysts" to forces within the American psychoanalytic movement that wished to align it with the medical discipline. He further indicts the American psychoanalytic movement as a repressive force that opposed the true "spirit" of psychoanalysis. It