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Ken Frank has passionately argued that in order to emerge from its current crisis of marginalization, psychoanalysis must be willing to engage ideas from other disciplines, including integration with other psychotherapies. The authors agree with Frank that psychoanalysis is at a crossroads, but argue that calling for psychotherapy integration is not sufficient. Rather, in order for psychoanalysis to thrive and not merely survive, it is essential to understand the historical, cultural, and economic factors that have led to its isolation from other psychotherapies. Specifically, the authors examine how psychoanalysis came to define itself so narrowly, and by opposing itself to psychotherapy. Second, they argue that psychoanalysis is at its best not when it is part of the mainstream, but when it is “optimally marginal.” They show that Freud and the early analysts were caught between two worlds, situated at the margins of their society, and that it was precisely this position that allowed them to develop a psychoanalytic sensibility. In offering this brief cultural history and deconstructing the psychoanalysis/psychotherapy binary, the authors hope to provide the background for envisioning a progressive psychoanalysis that moves beyond old polarities and adapts to our changed world, while remaining true to the revolutionary and humanistic spirit of Freud and his followers: a “psychotherapy for the people” (Aron & Starr, 2013; Freud, 1919, p. 168).