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A lay analysis is a psychoanalysis performed by someone who is not a trained physician; a person who performs such an analysis is a lay analyst.
'The term was first used by Freud in The Question of Lay Analysis (1927), where he vigorously asserted that in the practice of psychoanalytic treatment, what mattered was good training, independent of diplomas obtained beforehand'.[1] It was this feature of the psychoanalytic movement - its independence of a medical monopoly - that 'most keenly engaged Freud's interest, and indeed emotions, during the last phase of his life'.[2]
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From the beginnings of the psychoanalytic movement, Freud had 'warmly welcomed the incursion into the therapeutic field of suitable people from walks of life other than the medical...lay or non-medical psychoanalysts[3]: Theodor Reik was one such notable analyst. In Freud's view, psychoanalysis was a full-fledged professional field and could have its own standards independent of medicine. Indeed, in 1913 he wrote '"The practice of psychoanalysis has far less need for medical training than for educational preparation in psychology and free human insight. The majority of physicians", he added, a little mischievously, "are not equipped for the work of psychoanalysis"'.[4]
Thus Freud saw psychoanalysis as "a profession of lay curers of souls who need not be doctors and should not be priests"; and this new usage of "lay" (to include non-physicians) is the origin of the term, "lay analysis."[5] 'Some of the greatest names in psychoanalysis were laymen - Anna Freud, Eric Ericson, Ernst Kris, to name the most celebrated'.[6]
When in the 1920s Reik became embroiled in legal challenges over his right to practice psychoanalysis, Freud rose ardently to his defence, writing Lay Analysis in support of his position; and adding privately that 'the struggle for lay analysis must be fought through some time or another. Better now than later. As long as I live, I shall balk at having psychoanalysis swallowed by medicine'.[7]
However, embroiled in a struggle for psychoanalytic respectability, the plurality of Freud's followers were not at one with him on this issue: 'while he orchestrated a brave campaign, his victories were sporadic and limited. The question became highly contentious',[8] opposition being especially powerful in the States. Indeed 'tension over the question of lay analysis persisted until the advent of the Second World War',[9] a split with the American Association on the issue only being prevented in the 1920s when 'the New York psychoanalysts...grudgingly permitted lay analysts to work with children'.[10]
However in 1938, the American Psychoanalytic Association (APsaA) formally began limiting membership of the association to physicians who had first trained as psychiatrists and subsequently undergone a training analysis at a (then European) psychoanalytic institute. The move 'formally initiated a half-century of official cleavage between the Americans and the remainder of the IPA which tormented the organization until its final healing...in 1987'.[11]
During that period, many in the States believed that 'American psychoanalysis is a great cut above psychoanalysis elsewhere in the world...the laxness and sloppiness of English, European, and South American analysis. There are other people, naturally, who...[debate] whether too much wasn't lost by this strategy - whether too many good people who are unwilling to go through medical training aren't being lost to analysis'.[12] The policy was somewhat softened by the readiness of the APsaA to grant waivers over the decades to a number of individuals: these included, for example, Erik Erikson and David Rapaport.[13] There was also 'the National Psychological Association for Psychoanalysis, founded in 1946 by Reik...specifically to accommodate non-doctors'.[14]
However only when lawsuits were brought in the 1980s under 'antidiscrimination and antitrust statutes...[alleging] "restraint of trade"'[15] was the official American position finally altered, and the question of lay analysis resolved - on a footing of which Freud himself might actually have approved.