The role of the patient-analyst “match” in the outcome of psychoanalysis 1

In trying to explain the nature of change in psychoanalysis, three factors are commonly stressed: the process of psychoanalysis, the role of the analyst in creating the therapeutic action, and the psychological characteristics of the patient. I believe that the “match” or “fit” between patient and analyst is a fourth critical element. This mesh of the analyst’s personal qualities with those of the patient has rarely been a special focus of attention, although most analysts when making referrals do consider it; few assume that equally well-trained analysts are completely interchangeable. Instead whether the referring analysts formulate their assumptions or not, most look for a match or fit between patient and analyst. I provide four case illustrations.