Ever since its creation by Freud, psychoanalysis has been subject to recurrent attacks on its validity. Nonetheless, by mid-century psychoanalysis became the dominant force in American psychiatry. Its clinical concepts of psychic determinism, dynamically unconscious mentation, mechanisms of defense, and epigenetic development were incorporated into what has become known as psychodynamic psychiatry and psychotherapy. Despite the proliferation of nonpsychoanalytically based therapeutic modalities and the rise of psychopharmacology (mistakenly believed by some to be antithetical, rather than complementary, to psychodynamic concepts), DSM-III Field Trials revealed that over 75 percent of participating psychiatrists considered themselves to be psychodynamically oriented.