ABSTRACT
By now, the reader can see how the highly motivated neurotic patient who is willing and able to attend four or five sessions a week, on the couch, is a rarity in typical private practice settings. Many studies show that this type of ideal case represents a small and decreasing number. Vaslamatzis and Rabavilas (2001) echo some of my ideas when they note:
The development of psychoanalysis has traditionally been based on “neurotic” patients (usually hysteric, obsessive-compulsive, or depressive) and the classic analytic setting. However, since 1960 there has been a gradual shift in the population who seek psychoanalytic therapy. Patients with a history of trauma, unstable relationships, and chaotic erotic lives, with narcissistic vulnerabilities and psychosomatic symptoms among the problems, now request psychoanalytic help.
(pp. xi-xii)