Both conceptual and institutional problems permeate psychoanalytic institutes. Although institutional problems are historically based, they also derive from confusions around ill-defined concepts that lead to arbitrariness, authoritarianism, and the stifling of creativity. Psychoanalysis is a humanistic discipline that is touted as a science but is organized as a religion. Problems surrounding the right to train pervade psychoanalytic schisms, and transmission comes through processes of anointment. Institutional "false expertise" invokes the aura of anointment where training analysts pass down received truth through an esoteric pipeline depending on genealogy instead of function. Quasireligious thinking and politics rush in to fill the gap between the level of claimed knowledge that affords qualification and the far lower level of real knowledge. Institutes should rely on evidence of candidates' performance and engage in open-ended inquiry. Psychoanalysis has fallen on hard times. Analytic practice has declined worldwide with the advances in other psychodynamic psychotherapies, behavioral, cognitive, and biological treatments together with the inroads of managed care and other health insurers. As an intellectual discipline, there is relatively little productivity in psychoanalysis, especially as compared