A prodigious history of American psychoanalysis from 1917 to 1985, wonderfully lucid and informative. Hale, whose first volume (Freud and the Americans: The Beginnings of Psychoanalysis in the United States, 1971) covered the years 1871 to 1917, here takes on the rich, complex modern period. Throughout, he captures a central paradox. Professionally, psychoanalysis was largely ``medicalized,'' with the American Psychoanalytic Association zealously limiting membership to psychiatrists (although Freud himself advocated the training of lay analysts). Yet culturally, America more than any other country saw the ``earliest, widest and most thoroughgoing applications'' of psychoanalytic treatment and the Freudian worldview. In fact, one of the primary virtues of Hale's book is its exploration of psychoanalytic thinking and practice in such fields as education, criminology, social work, and pediatrics, as well as among quite diverse literary and cultural figures (e.g., during the 1920s, Eugene O'Neill, Edna St. Vincent Millay, Max Eastman, and Mabel Dodge). The author is equally strong on the conceptual evolution of classical and neo-Freudianism, with a particularly clear, succinct, chapter on American ego psychology. Addressing the ``crisis'' in American psychoanalysis--its significantly diminished appeal to psychiatrists and patients alike since about 1965--Hale adduces at least a half-dozen causes, including the rise of psychopharmacology and other forms of somatic psychiatry; the growing popularity of behaviorist, cognitive, and other therapeutic modalities that focus more on symptom relief than insight; and the increasing criticism of Freud for aspects of his thought considered antifeminist and socioculturally conservative. During a period of considerable ignorance and confusion about what psychoanalysis was and is, Hale's book couldn't be more timely. Over 20 years in the making, this extraordinary contribution to American intellectual history was well worth waiting for.