ABSTRACT
Two interlocking problems account for much of the erosion and demoralization we are experiencing in the profession of psychoanalytic psychotherapy. The first problem is the undermining of traditional professional relationships, as a result of profound social and economic forces affecting all of the professions. The second underlying problem has to do with the relationship between psychotherapy and health care in general. Professions as we know them have not always existed. The medieval world recognized three professions - law, medicine, and teaching - but the system of professions we know today was established during the latter half of the nineteenth century during the flowering of industrial capitalism. Psychotherapy has come under the jurisdiction of medicine. This was by no means inevitable. The market is too strongly entrenched as our dominant ideology. Competition will prevail, services will continue to be commodified, and costs will continue to be questioned and cut.
