The purpose of psychoanalysis is to improve the lives of its clients. But, in contrast to ‘suggestion-based’ therapies (ranging from Freud’s characterisation of therapeutic charisma and the placebo eﬀect to the homework ‘suggestions’ of CBT therapists), psychoanalytic psychotherapy avoids explicit eﬀorts to produce change, even if its implicit aims are no less ‘mutative’. This paradox follows logically from psychoanalysis’ theoretical base. People get into psychological trouble because of conﬂict between the conscious and unconscious mind. Direct appeals on the part of therapy to the suﬀerer’s consciousness will therefore merely activate resistance of the unconscious to change in the status quo and be counterproductive. The unconscious must be approached by stealth, and taken unawares. Diﬃculties based on paradox require paradoxical means if they are to be overcome.