This chapter presents three sessions of psychoanalytic case material which are from the four times a week (Monday to Thursday) analysis of a late forty-year-old female medical doctor in a field unrelated to mental health. It aims to elaborate Dr Holmes’ analytic thinking, not her declared model to which she shows explicit allegiance, that again is the more ordinary way we tend to tease apart our clinical work, but rather point to hidden assumptions behind features of her work. Dr Holmes’ implicit theory of change appears to have at its core the idea that knowledge of the way unconscious mechanisms can function will lead to permanent change. The preconscious version of public theory which most analysts use is often an eclectic integration of many often incompatible ideas. Dr Holmes’ work is nevertheless quite markedly couched in the implicit value-system of her culture.