Abstract
I have argued that psychoanalysis belongs to the healing tradition and is part of modernity and metropolis, which increases the demands on the self to be able to unfold and communicate in different milieus. Psychoanalysis accordingly differs from many other medical activities since it is not found in the field of goal directed actions, but in a field concerned with the subjective world. Psychoanalytic treatment deals with the capacity of the self to formulate and express thoughts in a truthful way. It differs in this way from goal directed activities, which communicate more easily with the systems world. Psychoanalysis, which has a more private character, is threatened by the systems world materialized in the rules of the socio-medical security systems. Many times they question such fundamentals in the psychoanalytic setting as regularity including frequency of sessions per week, initiation of therapy with an open end and confidentiality. When erroneously constructed the socio-medical security systems harm psychoanalytic practice and sometimes even make such treatments impossible. To avoid a decrease in the total amount of psychoanalytic experience and also for economic reasons the psychoanalytic community has been open to negotiations. In the present phase of the third medical revolution these questions are actualized. The psychoanalytic community is in a position similar to that of a minority group and the systems world behaves as majority society favoring treatment forms which are goal directed. In this situation it is necessary that analysts once more consider Freud's firm belief and readiness to claim his own view concerning in which way psychoanalytic treatment should be carried out without respect to the attacks from the surrounding academic society and medical establishment and his deep knowledge regarding the necessity for psychoanalysis to hold on to its own treatment standards in order to survive.

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