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. The result is a fascinating series of portraits of these institutes—their organizations, their cultures, their ways of mediating conflict, and how they have survived. In addition to archival research, the book is built on scores of interviews with prominent psychoanalysts who were often protagonists in the stories of their institutes.

Many themes emerge in Kirsner's gripping yet scholarly accounts. Most importantly, he demonstrates that issues surrounding the right to train are central to psychoanalytic disputes. Unfree Associations examines the problems of psychoanalysis, a humanistic discipline that has been touted as a science on the model of the natural sciences but has been organized institutionally as a religion. Interest in this book should not be confined to psychoanalysts. It is a rich set of case studies in the vicissitudes of group relations, with the ironic twist that the members of these organizations profess to have special insight into human nature and how people get along with one another.