Otto Rank (April 22, 1884 – October 31, 1939) was an Austrian psychoanalyst, writer, and teacher. Born in Vienna as Otto Rosenfeld, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, an editor of the two most important analytic journals, managing director of Freud's publishing house and a creative theorist and therapist. In 1926, Otto Rank left Vienna for Paris. For the remaining 14 years of his life, Rank had a successful career as a lecturer, writer and therapist in France and the U.S. (Lieberman & Kramer, 2012).

In the Vienna Psychoanalytic Society

In 1905, at the age of 21, Otto Rank presented Freud with a short manuscript on the artist, a study that so impressed Freud he invited Rank to become Secretary of the emerging Vienna Psychoanalytic Society. Rank thus became the first paid member of the psychoanalytic movement, and Freud's "right-hand man" for almost 20 years. Freud considered Rank, with whom he was more intimate intellectually than his own sons, to be the most brilliant of his Viennese disciples.

Rank was one of Freud's six collaborators brought together in a secret "committee" or "ring" to defend the psychoanalytic mainstream as disputes with Adler and then Jung developed. Rank was the most prolific author in the "ring" besides Freud himself, extending psychoanalytic theory to the study of legend, myth, art, and other works of creativity. He worked closely with Freud, contributing two chapters on myth and legend to later editions of The Interpretation of Dreams. Rank's name appeared underneath Freud's on the title page of Freud's greatest work for many years. Between 1915 and 1918, Rank served as Secretary of the International Psychoanalytical Association which Freud had founded in 1910. Everyone in the small psychoanalytic world understood how much Freud respected Rank and his prolific creativity in expanding psychoanalytic theory.

In 1924, Rank published Das Trauma der Geburt (translated into English as The Trauma of Birth in 1929), exploring how art, myth, religion, philosophy and therapy were illuminated by separation anxiety in the “phase before the development of the Oedipus complex” (p. 216). But there was no such phase in Freud’s theories. The Oedipus complex, Freud explained, was the nucleus of the neurosis and the foundational source of all art, myth, religion, philosophy, therapy – indeed of all human culture and civilization. It was the first time that anyone in the inner circle had dared to suggest that the Oedipus complex might not be the supreme causal factor in psychoanalysis. Rank was the first to use the term “pre-Oedipal” in a public psychoanalytic forum in 1925 (Rank, 1996, p. 43). In a 1930 self-analysis of his own writings, Rank observes that "the pre-Oedipal super-ego has since been overemphasized by Melanie Klein, without any reference to me" (ibid., p. 149n).

After some hesitation, Freud distanced himself from The Trauma of Birth, signalling to other members of his inner circle that Rank was perilously close to anti-Oedipal heresy. Confronted with Freud’s decisive opposition, Rank resigned in protest from his positions as Vice-President of the Vienna Psychoanalytic Society, director of Freud’s publishing house, and co-editor of Imago and Zeitschrift. His closest friend, Sándor Ferenczi, with whom Rank collaborated in the early Twenties on new experiential, object-relational and "here-and-now" approaches to therapy, vacillated on the significance of Rank's pre-Oedipal theory but not on Rank's objections to classical analytic technique.

The recommendation in Freud’s technical papers for analysts to be emotionless, according to Ferenczi and Rank (1924), had led to "an unnatural elimination of all human factors in the analysis" (pp. 40–41), and to "a theorizing of experience [Erlebnis]" (p. 41): the feeling experience of the intersubjective relationship, two first-person experiences, within the analytic situation. "The characteristic of that time," remembers Sándor Radó, who was in analysis with Karl Abraham from 1922 to 1925, "was a neglect of a human being's emotional life." Adds Rado: "Everybody was looking for oral, pregenital, and genital components in motivation. But that some people are happy, others unhappy, some afraid, or full of anger, and some loving and affectionate -- read the case histories to find how such differences between people were then absent from the literature." (Roazen & Swerdloff, 1995, pp. 82–83)

All emotional experience by human beings was being reduced by analysis to a derivative, no matter how disguised, of libido. For Freud, emotion was always sexual, derived from a dangerous Id that must be surgically uprooted: "Where Id was [Wo es war]," Freud said famously, "there ego shall be [soll ich werden]" (S.E., 22:80).

“Libido,” according to Freud’s 1921 work on Group Psychology and the Analysis of the Ego (S.E., 18: 90), “is an expression taken from the theory of the emotions.” Emotion is the cause of neurotic disorder. Increases in emotion, according to Freud, are unpleasurable. Cure, for Freud, means analyzing, "working through" and eventually uprooting the emotions of the patient, “like the draining of the Zuyder Zee” (Freud, S.E., 22:80). The analyst makes the unconscious conscious by providing cognitive insight to the patient, thereby subduing the pressing drive for the irrational, for emotions—for the Id—to emerge from the patient’s unconscious.

In a 1927 lecture, Rank (1996) observes that “surgical therapy is uprooting and isolates the individual emotionally, as it tries to deny the emotional life” (p. 169), the same attack he and Ferenczi had leveled against psychoanalytic practice in their joint work. Reducing all emotional experience—all feeling, loving, thinking, and willing—to sex was one of Freud's biggest mistakes, according to Rank, who first pointed out this confusion in the mid-twenties. Emotions, said Rank, are relationships. Denial of the emotional life leads to denial of the will, the creative life, as well as denial of the interpersonal relationship in the analytic situation (Rank, 1929–31).

For Freud, said Rank in Will Therapy (1929–31), "the emotional life develops from the sexual sphere, therefore his sexualization in reality means emotionalization" (p. 165), two experiences that psychoanalysts continued to conflate for half a century after Freud’s death. Until the end of the 20th century, psychoanalysis had no theory of emotional experience and, by extension, no theory of emotional intelligence. Weinstein (2001) identified over two dozen articles in the major psychoanalytic journals lamenting the absence of a theory of emotions. "[S]uch comments persisted through to the 1990s" (Weinstein, 2001, p. 40).

"The emotional impoverishment of psychoanalysis," wrote Ernest Becker (1973) in The Denial of Death, which was strongly influenced by Rank's ideas, "must extend also to many analysts themselves and to psychiatrists who come under its ideology. This fact helps explain the terrible deadness of emotion that one experiences in psychiatric settings, the heavy weight of the character armor erected against the world" (p. 195n).

Written privately in 1932, Ferenczi’s Clinical Diary identified the “personal causes for the erroneous development of psychoanalysis” (Ferenczi, 1995, p. 184). According to Ferenczi, "… One learned from [Freud] and from his kind of technique various things that made one’s life and work more comfortable: the calm, unemotional reserve; the unruffled assurance that one knows better; and the theories, the seeking and finding of the causes of failure in the patient instead of partly in ourselves … and finally the pessimistic view, shared only with a few, that neurotics are a rabble [Gesindel], good only to support us financially and to allow us to learn from their cases: psychoanalysis as a therapy may be worthless" (Ferenczi, 1995, pp. 185–186).

But terrified at the prospect of losing Freud's approval, Ferenczi aborted his enthusiasm for The Trauma of Birth and began to distance himself personally from Rank – whom he shunned during a chance meeting in 1926 at Penn Station in New York. "He was my best friend and he refused to speak to me," Rank said (Taft, 1958, p. xvi).

Ferenczi's rupture with Rank cut short radical innovations in practice, and left no one in the inner circle who would champion relational, pre-Oedipal or "here-and-now" psychotherapy. Classical psychoanalysis, along the lines of Freud's 1911-15 technical writings, would now be entrenched in training institutes around the world. The attack leveled in 1924 by Ferenczi and Rank on the increasing "fanaticism for interpretation" and the "unnatural elimination of all human factors" from the practice of analysis would be forgotten.

Relational, expressive and "here-and-now" therapy would not be acceptable to most members of the American Psychoanalytic Association or the International Psychoanalytic Association for half a century. "[T]hose who had the misfortune to be analyzed by [Rank] were required to undergo a second analysis in order to qualify" for membership in the American Psychoanalytic Association (Lieberman, 1985, p. 293). As far as classical analysis was concerned, Rank was dead.

Post-Vienna life and work

In May 1926, having made emotional relationship in the "here-and-now" central to his practice of psychotherapy, Rank moved to Paris where he became a psychotherapist for artists such as Henry Miller and Anaïs Nin and lectured at the Sorbonne (Lieberman, 1985).

Nin was transformed by her therapy with Rank. On her second visit to Rank, she reflects on her desire to be “re-born,” feelingly, as a woman and artist. Rank, she observes, helped her move back and forth between what she could verbalize in her journals and what remained unarticulated. She discovered the quality and depth of her feelings in the wordless transitions between what she could say and what she could not say. “As he talked, I thought of my difficulties with writing, my struggles to articulate feelings not easily expressed. Of my struggles to find a language for intuition, feeling, instincts which are, in themselves, elusive, subtle, and wordless” (Nin, 1966, p. 276).

According to Rank, all emotional life is grounded in the present. In Will Therapy, published in German in 1929-31, Rank uses the term “here and now” for the first time in the psychotherapeutic literature: “Freud made the repression historical, that is, misplaced it into the childhood of the individual and then wanted to release it from there, while as a matter of fact the same tendency is working here and now” (Rank, 1929–31, p. 39). Instead of the word Verdrängung (repression), which laid stress on unconscious repression of the past, Rank preferred to use the word Verleugnung (denial), which focused instead on the emotional will to remain ill in the present: “The neurotic lives too much in the past [and] to that extent he actually does not live. He suffers … because he clings to [the past], wants to cling to it, in order to protect himself from experience [Erlebnis], the emotional surrender to the present” (Rank, 1929–31, p. 27).

In France and later in America, Rank enjoyed great success as a therapist and writer from 1926 to 1939. Traveling frequently between France and America, Rank lectured at universities such as Harvard, Yale, Stanford, and University of Pennsylvania on relational, experiential and “here-and-now” psychotherapy, art, the creative will, and “neurosis as a failure in creativity” (Rank, 1996).

Just as Erik Erikson was the first analyst to focus on identity and adulthood, Rank was the first to propose that separation from outworn thoughts, emotions and behaviors is the quintessence of psychological growth and development. In the late 1920s, after he left Freud’s inner circle, Rank explored how human beings can learn to assert their will within relationships, and advocated a maximum degree of individuation (or "difference") within a maximum degree of connectedness (or "likeness"). Human beings need to experience both separation and union, without endlessly vacillating between the two poles.

Foreshadowing the central themes of Piaget, Kohlberg, McClelland, Erikson and Robert Kegan, Rank was the first to propose that human development is a lifelong construction, which requires continual negotiation and renegotiation of the dual yearnings for individuation and connection, the will to separate and the will to unite. Decades before Ronald Fairbairn, now credited by many as the inventor in the 1940s of modern object-relations theory, Rank's 1926 lecture on "The Genesis of the Object Relation" marks the first complete statement of this theory (Rank, 1996, pp. 140–149). By 1926 Rank was persona non grata in the official psychoanalytic world. There is little reason to believe, therefore, that any of the other writers credited with helping to invent object relations theory (Melanie Klein or Donald Winnicott, for example) ever read the German text of this lecture, published as Zur Genese der Object-beziehung in Vol. 1 of Rank's Genetische Psychologie (1927, pp. 110–22).

Rank died in New York City in 1939 from a kidney infection, one month after Freud's physician-assisted suicide on the Jewish Day of Atonement. "Komisch" (strange, odd, comical), Rank said on his deathbed (Lieberman, 1985, p. 389).

Influence

Rollo May, a pioneer of existential psychotherapy in the United States, was deeply influenced by Rank’s post-Freudian lectures and writings and always considered Rank to be the most important precursor of existential therapy. Shortly before his death, Rollo May wrote the foreword to Robert Kramer's edited collection of Rank’s American lectures. “I have long considered Otto Rank to be the great unacknowledged genius in Freud’s circle,” said May (Rank, 1996, p. xi).

In 1936 Carl Rogers, the most influential psychologist in America after William James, invited Otto Rank to give a series of lectures in New York on Rank’s post-Freudian models of experiential and relational therapy. Rogers was transformed by these lectures and always credited Rank with having profoundly shaped "client-centered" therapy and the entire profession of counselling. "I became infected with Rankian ideas," said Rogers (Kramer, 1995).

The New York writer Paul Goodman, who was co-founder with Fritz Perls of the Gestalt method of psychotherapy, one of the most popular in the world today, and one that makes Otto Rank's "here-and-now" central to its approach, described Rank’s post-Freudian ideas on art and creativity as “beyond praise” in Gestalt Therapy (Perls, Goodman and Hefferline, 1951, p. 395). According to Ervin Polster (1968), a pre-eminent Gestalt therapist, "Rank brought the human relationship directly into his office. He influenced analysts to take seriously the actual present interaction between therapist and patient, rather than maintain the fixed, distant, 'as though' relationship that had given previous analysts an emotional buffer for examining the intensities of therapeutic sensation and wish. Rank's contributions opened the way for encounter to become accepted as a deep therapeutic agent" (p. 6).

Rank also affected the practice of action-oriented and reflective therapies such as dramatic role-playing and psychodrama. "Although there is no evidence of a direct influence, Rank's ideas found new life in the work of such action psychotherapists as Moreno, who developed a psychodrama technique of doubling ... and Landy [director of the drama therapy program at New York University], who attempted to conceptualize balance as an integration of role and counterrole" (Landy, 2008, p. 29).

Rank was the first to see therapy as a learning and unlearning experience. The therapeutic relationship allows the patient to: (1) learn more creative ways of thinking, feeling and being in the here-and-now; and (2) unlearn self-destructive ways of thinking, feeling and being in the here-and-now. Patterns of self-destruction ("neurosis") represent a failure of creativity not, as Freud assumed, a retreat from sexuality.

Rank's psychology of creativity has recently been applied to action learning, an inquiry-based process of group problem solving, team building, leadership development and organizational learning (Kramer 2007; 2008). The heart of action learning is asking wicked questions to promote the unlearning or letting go of taken-for-granted assumptions and beliefs. Questions allow group members to “step out of the frame of the prevailing ideology,” as Rank wrote in Art and Artist (1932/1989, p. 70), reflect on their assumptions and beliefs, and reframe their choices. The process of “stepping out” of a frame, out of a form of knowing – a prevailing ideology – is analogous to the work of artists as they struggle to give birth to fresh ways of seeing the world, perspectives that allow them to see aspects of the world that no artists, including themselves, have ever seen before.

The most creative artists, such as Rembrandt, Michelangelo and Leonardo, know how to separate even from their own greatest public successes, from earlier artistic incarnations of themselves. Their “greatness consists precisely in this reaching out beyond themselves, beyond the ideology which they have themselves fostered,” according to Art and Artist (Rank, 1932/1989, p. 368). Through the lens of Otto Rank’s work on understanding art and artists, action learning can be seen as the never-completed process of learning how to “step out of the frame” of the ruling mindset, whether one’s own or the culture’s – in other words, of learning how to unlearn.

Comparing the process of unlearning to the “breaking out” process of birth, Rank was the first psychologist to suggest that a continual capacity to separate from “internal mental objects” – from internalized institutions, beliefs and neuroses; from the restrictions of culture, social conformity and received wisdom – is the sine qua non for lifelong creativity.

In a 1938 lecture, Rank said: "Life in itself is a mere succession of separations. Beginning with birth, going through several weaning periods and the development of the individual personality, and finally culminating in death – which represents the final separation. At birth, the individual experiences the first shock of separation, which throughout his life he strives to overcome. In the process of adaptation, man persistently separates from his old self, or at least from those segments off his old self that are now outlived. Like a child who has outgrown a toy, he discards the old parts of himself for which he has no further use ….The ego continually breaks away from its worn-out parts, which were of value in the past but have no value in the present. The neurotic [who cannot unlearn, and, therefore, lacks creativity] is unable to accomplish this normal detachment process … Owing to fear and guilt generated in the assertion of his own autonomy, he is unable to free himself, and instead remains suspended upon some primitive level of his evolution"(Rank, 1996, p. 270).

Unlearning necessarily involves separation from one’s self-concept, as it has been culturally conditioned to conform to familial, group, occupational or organizational allegiances. According to Rank (1932/1989), unlearning or breaking out of our shell from the inside is “a separation [that] is so hard, not only because it involves persons and ideas that one reveres, but because the victory is always, at bottom, and in some form, won over a part of one’s ego” (p. 375).

In the organizational context, learning how to unlearn is vital because what we assume to be true has merged into our identity. We refer to the identity of an individual as a “mindset.” We refer to the identity of an organizational group as a “culture.” Action learners learn how to question, probe and separate from, both kinds of identity—i.e., their “individual” selves and their “social” selves. By opening themselves to critical inquiry, they begin to learn how to emancipate themselves from what they "know" – they learn how to unlearn.

In 1974, the cultural anthropologist Ernest Becker won the Pulitzer prize for The Denial of Death (1973), which was based on Rank’s post-Freudian writings, especially Will Therapy (1929–31), Psychology and the Soul (1930) and Art and Artist (1932/1989). The feeling of anxiety, writes Rank in Will Therapy (1929–31), divides into two currents, running in opposite directions: one toward separation and individuation; the other toward union and collectivity. The outbreak of neurosis typically comes from the streaming together of these two fears—which Rank also calls the "fear of living" [Lebensangst] and the "fear of dying" [Todesangst] – “which, even in The Trauma of Birth, I had designated as the fear of both going forward and of going backward” (Rank, 1929–31, p. 124). A crisis "seems to break out at a certain age when the life fear which has restricted the I’s development meets with the death fear as it increases with growth and maturity," writes Rank in Will Therapy (1929–31). "The individual then feels himself driven forward by regret for wasted life and the desire to retrieve it. But this forward driving fear is now death fear, the fear of dying without having lived, which, even so, is held in check by fear of life" (pp. 188–189).

The "fear of life" is the fear of separation and individuation. The "fear of death" is the fear of union and merger—in essence, the loss of individuality. Both separation and union, however, are desired as well as feared since the "will to separate" correlates with the creative impulse and the "will to unite" with the need for love. To respond obsessively just to one need—by choosing to separate "totally" or to merge "totally"—is to have the other thrown back at one's self.

According to Rank (1929–31), "Birth fear remains always more universal, cosmic as it were, loss of a connection with a greater whole [einen größeren Ganzen], in the last analysis with the 'All' [dem All] ... The fear in birth, which we have designated as fear of life, seems to me actually the fear of having to live as an isolated individual, and not the reverse, the fear of loss of individuality (death fear). That would mean, however, that primary fear [Urangst] corresponds to a fear of separation from the whole [vom All], therefore a fear of individuation, on account of which I would like to call it fear of life, although it may appear later as fear of the loss of this dearly bought individuality as fear of death, of being dissolved again into the whole [ins All]. Between these two fear possibilities these poles of fear, the individual is thrown back and forth all his life, which accounts for the fact that we have not been able to trace fear back to a single root, or to overcome it therapeutically" (ibid., p. 124).

On a microcosmic level, therapy is a process of learning how to give and take, surrender and assert, merge and individuate, unite and separate—without being trapped in a whipsaw of opposites. Therapist and client, like everyone else, seek to find a constructive balance between separation and union. In psychological health, the contact boundary that links I and Thou "harmoniously [fuses] the edges of each without confusing them," Rank wrote in Art and Artist (1932/1989, p. 104). Joining together in feeling, therapist and client do not lose themselves but, rather, re-discover and re-create themselves. In the simultaneous dissolution of their difference in a greater whole, therapist and client surrender their painful isolation for a moment, only to have individuality returned to them in the next, re-energized and enriched by the experience of "loss."

"[T]he love feeling," Rank observes in a lecture delivered in 1927 at the University of Pennsylvania, "unites our I with the other, with the Thou [dem Du], with men, with the world, and so does away with fear. What is unique in love is that—beyond the fact of uniting—it rebounds on the I. Not only, I love the other as my I, as part of my I, but the other also makes my I worthy of love. The love of the Thou [des Liebe des Du] thus places a value on one's own I. Love abolishes egoism, it merges the self in the other to find it again enriched in one's own I. This unique projection and introjection of feeling rests on the fact that one can really only love the one who accepts our own self [unser eigene Selbst] as it is, indeed will not have it otherwise than it is, and whose self we accept as it is." (Rank, 1996, p. 154)

On a macrocosmic level, taking the experience of love as far as humanly possible, to the boundary of the spiritual, Rank compared the artist's "giving" and the enjoyer's "finding" of art with the dissolution and rediscovery of the self in mutual love. "The art-work," says Rank in Art and Artist, "presents a unity, alike in its effect and in its creation, and this implies a spiritual unity between the artist and the recipient" (Rank, 1932/1989, p. 113). It is in art, and its correlative, love, that microcosm meets macrocosm, the human meets the spiritual. At the height of the individuating impulse, the "will to separate," artists feel most strongly the longing for attachment, the "will to unite." Although artists begin the creative process by separating from their fellow human beings and liberating themselves from conforming to the past, escaping from the anxiety of influence, eventually the creative impulse merges into a desire for a return to "a greater whole," to "the ALL" (Rank, 1929–31, p. 155) -- in human terms, to the "collective" that alone has the power to immortalize the artist with the approval it grants the artwork:

"For this very essence of man, his soul, which the artist puts into his work and which is represented by it, is found again in the work by the enjoyer, just as the believer finds his soul in religion or in God, with whom he feels himself to be one. It is on this identity of the spiritual ... and not on a psychological identification with the artist that [aesthetic pleasure] ultimately depends... But both of them, in the simultaneous dissolution of their individuality in a greater whole, enjoy, as a high pleasure, the personal enrichment of that individuality through this feeling of oneness. They have yielded up their mortal ego for a moment, fearlessly and even joyfully, to receive it back in the next, the richer for this universal feeling (Rank, 1932/1989, pp. 109–110).

In one of his most poetic passages, Rank suggests that this transcendent feeling implies not only a "spiritual unity" between artist and enjoyer, I and Thou, but also "with a Cosmos floating in mystic vapors in which present, past, and future are dissolved" (Rank, 1932/1989, p. 113)--an identity with "the ALL" that once was but is no more. The healing nature of artistic experience, Rank believed, affirms difference but, paradoxically, also "leads to the release from difference, to the feeling of unity with the self, with the other, with the cosmos" (Rank, 1929–31, p. 58). In art, microcosm meets macrocosm. Of the uncanny feeling of emotional unity we experience in surrendering ourselves—giving up temporarily the burden of our difference—to the Other in art, Rank writes in Art and Artist: "[It] produces a satisfaction which suggests that it is more than a matter of the passing identification of two individuals, that it is the potential restoration of a union with the Cosmos, which once existed and was then lost. The individual psychological root of this sense of unity I discovered (at the time of writing The Trauma of Birth, 1924) in the prenatal condition, which the individual in his yearning for immortality strives to restore. Already, in that earliest stage of individualization, the child is not only factually one with the mother but beyond that, one with the world, with a Cosmos floating in mystic vapors in which present, past, and future are dissolved. The individual urge to restore this lost unity is (as I have formerly pointed out) an essential factor in the production of human cultural values" (Rank, 1932/1989, p. 113).

No one has expressed the conflict between the will to separate and the will to unite better than Ernest Becker (1973), whose award-winning The Denial of Death captured the largest—macrocosmic—meaning of separation and union for Rank: "On the one hand the creature is impelled by a powerful desire to identify with the cosmic forces, to merge himself with the rest of nature. On the other hand he wants to be unique, to stand out as something different and apart" (Becker, 1973, pp. 151–152). "You can see that man wants the impossible: He wants to lose his isolation and keep it at the same time. He can't stand the sense of separateness, and yet he can't allow the complete suffocation of his vitality. He wants to expand by merging with the powerful beyond that transcends him, yet he wants while merging with it to remain individual and aloof ..." (ibid., p. 155).

On a microcosmic level, however, the lifelong oscillation between the two "poles of fear" can be made more bearable, according to Rank, in a relationship with another person who accepts one's uniqueness and difference, and allows for the emergence of the creative impulse—without too much guilt or anxiety for separating from the other. Living fully requires "seeking at once isolation and union" (Rank, 1932/1989, p. 86), finding the courage to accept both simultaneously, without succumbing to the Angst that leads a person to be whipsawed from one pole to the other. Creative solutions for living emerge from the fluctuating, ever-expanding and ever-contracting, space between separation and union. Art and the creative impulse, said Rank in Art and Artist, "originate solely in the constructive harmonization of this fundamental dualism of all life" (1932/1989, p. xxii).

On a macrocosmic level, the consciousness of living—the dim awareness that we are alive for a moment on this planet as it spins, meaninglessly, around the cold and infinite galaxy—gives human beings "the status of a small god in nature," according to Ernest Becker: "Yet, at the same time, as the Eastern sages also knew, man is a worm and food for worms. This is the paradox: he is out of nature and hopelessly in it; he is dual, up in the stars and yet housed in a heart-pumping, breath-gasping body that once belonged to a fish and still has the gill marks to prove it ... Man is literally split in two: he has awareness of his own splendid uniqueness in that he sticks out of nature with a towering majesty, and yet he goes back into the ground a few feet in order blindly and dumbly to rot and disappear forever. It is a terrifying dilemma to be in and to have to live with" (Becker, 1973, p. 26).

Through the influence of Ernest Becker's writings, Rank's eternal dialectic between "life fear and death fear" has been tested experimentally in Terror Management Theory by Skidmore College psychology professor Sheldon Solomon, University of Arizona psychology professor Jeff Greenberg, and University of Colorado at Colorado Springs psychology professor Tom Pyszczynski.

The American priest and theologian, Matthew Fox, founder of Creation Spirituality and Wisdom University, considers Rank to be one of the most important psychologists of the 20th century. See, especially, Fox's book, Creativity: Where the Divine and the Human Meet (Jeremy P. Tarcher, 2002), paperback: ISBN 1-58542-329-7.

Stanislav Grof, a founder of transpersonal psychology, based much of his work in prenatal and perinatal psychology on Rank's The Trauma of Birth (Kripal, 2007, pp. 249–269).

In 2008, the philosopher Maxine Sheets-Johnstone published The Roots of Morality (Pennsylvania State University Press), which contains an analysis of Rank's argument that "immortality ideologies" are an abiding human response to the painful riddle of death. Sheets-Johnstone compares Rank's thought to that of three major Western philosophers—René Descartes, Martin Heidegger and Jacques Derrida: "Because immortality ideologies were originally recognized and in fact so named by Rank, a close examination of his writings on the subject is not only apposite but is itself philosophically rewarding ... Rank was a Freudian dissident who, in introducing the concept of immortality ideologies, traced out historical and psychological roots of 'soul-belief' (Seelenglaube)... [My chapter] points up the extraordinary cogency of Rank's distinction between the rational and the irrational to the question of the human need for immortality ideologies" (Sheets-Johnstone, 2008, p. 64). Sheets-Johnstone concludes her book on a note reminiscent of Rank's plea for the human value of mutual love over arid intellectual insight: "Surely it is time for Homo sapiens sapiens to turn away from the pursuit of domination over all and to begin cultivating and developing its sapiential wisdom in the pursuit of caring, nurturing and strengthening that most precious muscle which is its heart" (ibid., pp. 405–06).

Today, Rank can be seen as one of the great pioneers in the fields of humanistic psychology, existential psychotherapy, Gestalt therapy and transpersonal psychology.