This is the most thorough, revealing, and illuminating account of the inner workings of psychoanalytic institutions that has ever been written. It comprises ground-breaking, in depth, recent political histories of the four leading psychoanalytic institutes in the United States_New York, Boston, Chicago, and Los Angeles_based on the author's extensive field work. Kirsner also provides dramatic insights into what psychoanalysts and their institutions have contributed to what has gone wrong with psychoanalysis.