Psychoanalysis was first developed by Freud, when he started, in the mid-1890s, to use the free-association method to reveal the mental processes underlying the symptoms of his patients. Later he would claim that the four “pillars” of the discipline were his discovery of the repressed unconscious, the pervasive influence of sensual impulses in all mental life, the lingering influence of developmental history in the formation of the mind and its psychopathology, and the significance of the Oedipal Complex and incest taboo in all of this. 

In his prodigious writings, Freud elaborated several metapsychological models of human mental functioning, including different formulations of the “drives” that impel and lead us into inevitable conflicts with reality. He also contributed a wealth of insights on social and cultural topics. 

With the Nazi annexure of Austria in 1938, Freud emigrated to London where his daughter, Anna Freud, published her seminal work. She inspired a group of emigrant psychoanalysts in the United States (Heinz Hartmann, Ernst Kris, Rudolph Lowenstein, David Rapaport) to develop a psychoanalytic ego psychology, largely as a medical specialty. 

In London, between 1942 and 1944, a series of “controversial discussions” was organised in an effort to resolve theoretical and clinical differences between the followers of Anna Freud and those of Melanie Klein, who had developed a different approach to psychoanalysis, largely based on the exploration of the pre-Oedipal infant's struggle with inner forces of love and hate. Kleinian psychoanalysis became the predominant approach in many parts of Europe and South America, and its influence continues today. Out of the “controversial discussions,” an independent group of theorists and practitioners also developed in London and elsewhere, influenced by such thinkers as Ronald Fairbairn, Donald Winnicott, Michael Balint and John Bowlby. 

The predominance of ego psychology in the USA began to erode in the 1960s and object-relational theories became better known. Self-psychology, initiated mostly by the work of Heinz Kohut in Chicago, flourished in the later decades of the 20th century and the writings of an array of “neo-Freudians” (e.g., Erich Fromm, Karen Horney, Harry Stack Sullivan) were also influential. On the basis of these traditions, the interpersonal, relational, and intersubjective approaches to psychoanalysis developed — approaches that are increasingly popular, especially in North America. 

In France, starting in 1951, Jacques Lacan's seminars and writings heralded a “return to Freud” that included a critique of both ego psychological and Kleinian or object-relational approaches to theory and practice. Although Lacan was expelled from the IPA in 1963, for his experiments with unorthodox clinical technique, his perspectives became very popular in Europe and South America, producing a proliferation of Lacanian institutes for psychoanalytical training outside the auspices of the IPA. 

Other approaches to psychoanalytical theory and practice have developed both within and alongside the IPA since its beginning. For example, the analytical psychology of Carl Jung developed independently after Jung and Freud parted ways in 1913. Existential and phenomenological approaches have also continued to influence the field. Moreover, mostly in opposition to Lacanian doctrine, feminist and deconstructive approaches to psychoanalysis have developed since the late 20th century, drawing at least in part on (as well as in contradistinction to) a humanistic tradition that has adhered to psychoanalysis since its beginning. Additionally, the connection between psychoanalysis and the neurosciences, which greatly interested Freud in his earliest work before the mid-1890s, has developed substantially in the past two decades. 

Today psychoanalysis offers a rich panoply of theories and methods. Most psychoanalysts are directly or indirectly affiliated with the IPA, which Freud founded. However, there are many unaffiliated training institutes, some of which belong to the International Federation of Psychoanalytical Societies, which was founded in 1962, as well as several Lacanian organisations. Testimony to the ongoing strength of the discipline is the fact that there are over sixty Component Societies within the IPA, as well as over twenty Study Groups and Provisional Societies. In the English language alone, there are over forty scientific and professional journals devoted to psychoanalytical theory and practice, and equally strong traditions in German, French, Spanish and Italian. Perhaps most encouragingly, psychoanalytical training institutes have been founded outside the traditional strongholds — in Australia, Asia and Africa. 

In addition to the direct impact of psychoanalysis on clinical practice, the indirect impact of psychoanalysis on contemporary life and thought culture cannot be overestimated. Psychoanalysis has had enormous influence on the life and social sciences and humanities, as well as the fields of education, the arts and politics. 

Although Freud had proudly announced the establishment of a South African Psychoanalytical Society in 1935 (in the Postscript to his “Autobiographical Study”), the advent of Apartheid in 1948 and the subsequent death of Wulf Sachs — in quick succession — put a premature end to the fledgling Society. Thereafter, for six decades, South Africans wishing to undertake accredited psychoanalytical training had to do so abroad. Such training was greatly facilitated from the 1960s onward by the generous funding of an industrialist named Sydney Press, who hoped the beneficiaries of his funding would return to establish an IPA Component Society in South Africa. However, since psychoanalytical training typically extends over several years, practical considerations and the unfavourable political situation in South Africa meant that few indeed returned when qualified — all but one of those that did, later changed their minds. The exception was Katherine Aubertin, who had trained in Paris and returned in 1986, but was not funded by Mr. Press. However, in the wake of the momentous political developments of the early 1990s, a group of expatriates in London, realising the potential implications of these developments for psychoanalysis in South Africa, formed the South African Psychoanalysis Trust (SAPT). The SAPT had the sole aim of bringing South African psychoanalysis into line with international norms and standards through the establishment of an accredited training institute. 

The SAPT realised from the outset that psychoanalysis as a mode of treatment (perhaps especially in a developing country) cannot flourish in the absence of the wider practice of psychoanalytical psychotherapy and applied psychoanalysis. However, since these already existed in South Africa, and since the reverse is also true (i.e., psychoanalytical psychotherapy and applied psychoanalysis cannot flourish in the absence of psychoanalysis proper), they decided to focus their efforts solely on the formation of an IPA-affiliated institute. The further alignment of psychoanalytical psychotherapy training programmes in South Africa with the international norms and standards would — it was thought — naturally flow from this step, as would many other potential benefits related to the broader application of psychoanalytical knowledge. 

The SAPT did significant groundwork. Perhaps most significant were the two international conferences it organised in South Africa. At the first of these, held in 1997, David Sachs (a Philadelphia-based relative of Wulf Sachs, who was then Chair of the New Groups Committee of the IPA) made an important announcement. He informed local delegates that the IPA had recently established procedures for psychotherapists working in countries in which the normal development of psychoanalysis had not been possible (such as in the former Soviet bloc), whose standards of training were nevertheless equivalent to those laid down by the IPA, to become 'Direct Members' of the IPA. This initiated a dialogue between Dr. Sachs and several local psychotherapists who met (or nearly met) the IPA's criteria -- in terms of personal training analysis, supervised control analyses and theoretical instruction -- on what would be required of them before they could become eligible for Direct Membership. Following the second conference, and shortly after London-trained psychoanalysts Mark and Karen Solms returned in 2002, the SAPT, having fulfilled its mandate, was dissolved. The baton was now passed to the Solms's to take the effort forward. The major immediate task was to attain the magical number of four IPA members living and working in South Africa. This number of members makes it possible for a local group to apply to the IPA for official 'Study Group' status, which is the first step toward the establishment of an accredited training institute. The passing of the baton also involved taking over the task of communicating with the IPA on behalf of the local colleagues who had been exploring the possibility of becoming Direct Members.  

The Solms's held meetings with representatives of local psychoanalytic organisations in both Cape Town and Johannesburg, asking how they might best collaborate in light of their SAPT-initiated plan to establish a training institute. This approach eventually led to the offering in 2003 (in Johannesburg) of a series of didactic seminars focusing on basic psychoanalytic concepts, led jointly by Katherine Aubertin and Mark Solms. This was followed by a second series of theoretical seminars in which these basic concepts were applied to a study of published clinical case reports. 

Following the retirement of Mme Aubertin in 2005, there were three significant developments. First, the Johannesburg seminar group was transformed into a clinical seminar group in which the members' own case material was presented and discussed in light of the theoretical groundwork of the earlier seminars. This group was led jointly by Mark and Karen Solms. Second, a parallel group was formed in Cape Town. It rapidly became necessary to create additional clinical seminar groups, in both cities, in order to accommodate the demand for membership and the inevitable boundary problems that arise in psychoanalytic organisations, where therapists and patients can also be colleagues. Third, and most importantly, all the Johannesburg and Cape Town groups were consolidated — in February 2006 — to form a single national organisation, called the South African Psychoanalysis Initiative (SAPI). 

This occurred at what later became the annual congress of SAPI at the Solms Delta farm in Franschhoek, where a two-day colloquium for SAPI members was held each February, attended by a gradually increasing number of international colleagues. (The colloquium venue now alternates annually between Johannesburg and Cape Town.) Alongside the seminal contributions of Jonathan Sklar from London, one of the early visiting colleagues at this colloquium was Gyuri Fodor from Vienna, who subsequently relocated to Cape Town (in 2008), thereby making a major contribution to the goal of qualifying for IPA Study Group status. Since 2008, SAPI has also organised a second annual get-together for its combined membership; this is an 'Education Day' which is held each September, traditionally alternating between Johannesburg and Cape Town.

The founding aims of SAPI were identical with those of the SAPT, namely the establishment of an accredited training institute in South Africa. SAPI Members had always paid a set annual fee both to fund the travel fares of the psychoanalysts conducting their clinical seminars (SAPA psychoanalysts receive no personal remuneration for any teaching work for both SAPI and SAPA) as well as to gradually build up the substantial funds needed to cover the costs of the IPA accreditation process. These costs are high for the reason that, following an initial 'Site Visit' which is funded by the IPA itself, three members nominated by the IPA New Groups Committee form a 'Sponsoring Committee' which is required to visit the applicant group in order to oversee its progression from Study Group (with a minimum of four local IPA members), to Provisional Society (once a minimum of 10 members has been reached), to Component Society (when fully independent status is achieved) at which point the Sponsoring Committee is dissolved.  

Since only members who meet the IPA's training standards may apply for IPA Study Group status, it became necessary for SAPI to establish a subsidiary entity made up of its IPA-accredited members. This was done after the first Site Visit in 2009, during which it was agreed that Susan Levy (who had in the interim completed two control analyses under supervision and also attended the full training seminars of the Institute of Psychoanalysis in London via telephone) had met the criteria for equivalence. She was therefore recommended for Direct Membership, which meant that the hurdle of having four IPA members had been crossed and we were finally eligible for Study Group status. This status was officially bestowed on us at the IPA's 46th Congress in Chicago in July 2009, immediately after the ratification of Susan Levy's membership. 

Thenceforth the IPA members of SAPI became known as the South African Psychoanalytical Association (SAPA). In order to maintain the intended nested relationship between SAPA and SAPI, it is a constitutional requirement of SAPA that all its members shall also be members of SAPI. The IPA-accredited training programme, the establishment of which was the raison d'être of SAPI, could now be implemented by this subset of members who qualify for SAPA membership; and the completion of the training programme then became the mechanism by which SAPI members qualify as SAPA members. In short, although SAPI and SAPA are two separate entities in law, the latter organisation is in reality a subset of the former one.  

The second visit by our IPA sponsors took place in March 2010. During this visit several SAPI members were interviewed (jointly by members of SAPA and the IPA Sponsoring Committee) and 11 were accepted as the first official cohort of candidates for training in psychoanalysis. (To be historically correct, this was in fact the second such cohort; Wulf Sachs had five candidates in training analysis at the time of his death. Four of them subsequently completed their training in London.) Following this visit by the Sponsoring Committee, all the existing members of SAPA were also recommended for Regional Training Analyst status. This ensured that the analyses of the now-accepted candidates would be recognised as training analyses. 

Great care was taken to ensure that the Sponsoring Committee understood and supported our intention to embed the SAPA membership and training programme within the broader context of SAPI's ongoing educational and outreach activities. 

In December 2010, the Sponsoring Committee visited Johannesburg for the first time, and a second cohort of applicants for training was interviewed, as was a senior psychoanalyst who subsequently relocated to South Africa and became the second Training Analyst in Johannesburg: Barnaby Barratt, who had served for almost a decade as a Training Analyst with the Michigan Psychoanalytic Institute of the American Psychoanalytic Association. Since then, two further foreign-trained South Africans have also joined SAPA as direct members: Mary-Anne Smith and Elda Storck were conferred Training Analyst status in 2015. Alan Levy joined SAPA for 4 years and was also conferred Training Analyst status but had to return to England in 2015. Kate Aubertin and Irene Chait were accepted as direct members in 2016 and at the same time our first graduates, Heather Jones Petersen and Vincenzo Sinisi, made us exceptionally proud as the first qualified psychoanalysts to have come through the training solely within SAPA in South Africa.

In addition, we are privileged that representatives of both SAPA and SAPI were present at an historic meeting in November 2009, at which the broader South African Psychoanalytic Confederation (SAPC) was formed, and of the role they played in the process that led up to it. The SAPC brought together, for the first time, all of South Africa's psychoanalytic organisations, and laid down minimum standards of training, personal treatment and supervision — and an ethical code — for practitioners wishing to be recognised as 'Psychoanalytic Psychotherapists'. SAPA now belongs to an inclusive confederation of like-minded organisations, which, despite their differences, are taking forward the important task of normalising South African psychoanalysis as a whole, in line with international standards of clinical practice.

Founded in 2009, the South African Psychoanalytical Association is the first organisation on the African continent to be affiliated with the IPA. The IPA conferred Component Society status to SAPA in July 2023.