The two decades after World War II were the golden age of psychoanalysis in America. Sigmund Freud was a cultural hero and every analyst had a full case load--"and those with middle-European accents had two-year waiting lists" regardless of professional competence, recalls Kramer,a practicing psychoanalyst and a clinical professor at the Robert Wood Johnson Medical School. Then, in the mid-1960s, something happened. "Analysts' waiting lists became shorter, then disappeared. Gaps appeared in appointment books, and fees stopped climbing."

What had happened, Kramer argues, was that psychoanalysis had finally advanced beyond Freud's early "dammed-up libido" theory--but the public had not. That simple theory traced certain neuroses to the frustration of sexual impulses. Introduced to America by Freud himself during a visit in 1909, this theory had a profound impact, first in intellectual circles and high society and later, after World War II, among the middle class. From there it was an easy leap to the notion that the repression of "natural" impulses, sexual or otherwise, was the root of all human problems. To everybody from Greenwich Village bohemians in the 1920s to restless college students in the 1950s, Freudian psychoanalysis represented all that was progressive and forward looking.

Meanwhile, psychoanalysis itself moved on. Freud jettisoned the "dammed-up libido" theory by 1926, and other thinkers, including his daughter Anna Freud, helped move the discipline in new directions. In modern psychoanalysis, Kramer explains, adaptation is the key to mental health. The healthy individual is the person who "has reached an equilibrium between the gratification of his instinctual

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