When an individual is suffering from a mental disorder or emotional conflict and they make a move to seek out help, the psychoanalyst’s office is almost never at the top of the list. Once a patient chooses to begin treatment with a psychoanalyst, other obstacles to a long-term, frequent, in-depth approach arise. Typical patients seen in the analysis have severe pathology and are far from the stable neurotics that are assumed to be the suitable patient for psychoanalytic treatment. The typical patient in psychoanalytic treatment is struggling with rather profound pathology and as such tends to create a significant standoff with the analyst when analytic contact is forming. The psychoanalytic profession has a shallow and precarious hold within the public health arena. This chapter focuses on the psychoanalytic literature that explores the aim and goal of treatment, since this is where much of the political debates and theoretical disputes centre.