2. The Confrontation from America and the “1938 Rule”

I have used the year 1910—for our purposes, marked in Europe by the publication of Freud's “‘Wild’ Psycho-analysis” and in America by the issuance of the Flexner report on the deplorable state of American medical education—to signal the origin of the differing organizational and educational paths taken in the historical development of psychoanalysis on the two sides of the Atlantic. The alarming issue emerging in psychoanalysis at the time was that of the growth of a wild, pseudoanalysis, so well described in Freud's paper. The European response to this pending crisis of credibility for the new profession was traced in the preceding chapter; the creation of the International Psychoanalytical Association in 1910 to promote commitment to shared standards of professional practice, the subsequent creation of the committee of the seven ring holders to authoritatively promulgate the proper confines of psychoanalytic doctrine, and then, most decisively, the organization of proper psychoanalytic institutes, the first established by Eitingon and his colleagues as early as 1920 in Berlin, with the delineation then of the requisite training standards. From the very beginning, these standards consisted of the still-extant tripartite structure of personal (training) analysis, an appropriate sequence of theoretical and clinical seminars on both the theory and technique of psychoanalysis, and the satisfactory conduct of supervised analyses with carefully selected cases.

The American response to the same problem was different. It was to restrict eligibility for psychoanalytic practice to those whose preliminary training in the healing arts met the standards promulgated nationwide in the wake of the Flexner report, namely, those individuals who had completed medical school and a psychiatric residency in the now upgraded American medical education system, and could thus be trusted to travel to Europe to learn psychoanalysis properly and to return to America to practice and to