ABSTRACT
It may seem to be an ironic switch, after decrying the “search for good patients,” to consider a possibly darker prospect. We are not many years beyond the time when psychoanalysis was widely held to be a panacea, the infallible cure for all ills of the spirit. Indeed, it was not only considered to be the best treatment—it was the only treatment. If we had suggested to a patient that a less expensive and less arduous treatment might do, we would also have to reassure him that we intended no implication that he was either too sick, not smart enough, or not worthy enough to be analyzed. We are no longer so single-mindedly ambitious about psychoanalysis, but we do regard it properly as a powerful treatment with a rather narrow range of applications in its native form. Fortunately it has given rise to a wide range of dynamically-inspired psychotherapies that extend its reach enormously. Still, when an analyst comes across a prospective patient who is bright and attractive, who is dissatisfied with a life that includes reasonable success at a career and who seems to have had a fair social adjustment, the first thought he is likely to have is, “why not analysis?” However, I will propose that some persons who look analyzable and who ask for analysis should not be taken into analysis without careful consideration. If one takes such a person into analysis, one may encounter particular difficulty in arriving at a psychoanalytic termination.
