ABSTRACT
This chapter argues that the debates in the past have been contaminated by two covert, underlying issues. First, the debate about psychotherapy was muddied by the fact that, on an institutional level, psychoanalysis did become, as Freud feared, a mere handmaiden of psychiatry. The second underlying issue in the debate stems from the closed and hierarchical nature of psychoanalytic institutions. In America, psychiatry embraced psychoanalysis and psychoanalysis, in turn, conferred on psychiatry a monopoly on eligibility for training. In the postwar years, when the American Psychoanalytic Association rejected Menninger's call to train psychiatrists in psychotherapy, the demand for psychoanalysis was rising. But today, most candidates cannot look forward to careers as analysts and that has profoundly affected the course of the debate. This discussion has focused on the situation in the United States, but the relevance of these issues is worldwide. For psychoanalysis, psychotherapy has come to appear as the powerful threat that could absorb and annihilate its distinctive features.
