ABSTRACT
The description of the transformations or changes that occur in patients over the course of their analysis is of great theoretical and practical importance. A guide or heuristic is proposed for observing and describing these changes, using three successive levels of analysis and named, for this reason, “three-level model for observing patient transformations”. This chapter examines and discusses the concepts that are most useful to answer the key questions: to what extent has the patient clinically improved during analysis? What are the main dimensions of the changes and what are the hypotheses that can best explain them? The study of transformations of the patient has two wide avenues available for its progress: clinical observation and systematic empirical research of processes and results. Empirical research has provided firm evidence in favour of the effectiveness of psychoanalytical treatments and even result in changes in brain functioning.
