ABSTRACT
The idea that those seeking psychoanalytic treatment need to be carefully selected was first proposed by Freud. On the basis of a meeting, variously called an assessment, a consultation, or an evaluation, the clinician assesses the prospective patient. The early descriptions of patient qualities relevant for engagement in psychoanalytic psychotherapy provide evidence of a state of confusion that still continues to be the case. The idea that diagnosis on its own can be misleading was highlighted in a paper by Zetzel, "The So-called Good Hysteric", in which she described four categories of patients who had been diagnosed as hysterics. Considerable clinical and research effort has been devoted to the search for patient qualities that are relevant for decisions about psychotherapeutic treatment. Relevant factors include adaptive functioning, severity of illness, severity of symptoms, diagnosis, ego strength, reality testing, sublimatory potential, adaptive regression, defence, thinking, intellectual abilities, and capacity for verbalization.
