Toward a More Subjective View of Analyzability

The acceptance or rejection of a patient for psychoanalytic treatment is often based on factors other than some generally accepted criteria for analyzability. Further, psychoanalysts do not always acknowledge publicly to the patient, or even to themselves, the personal reasons why certain patients are deemed to be analyzable or unanalyzable. In spite of the literature in this area, diagnostic concerns, and past experience with patients, each time a given analyst accepts or rejects a patient for analysis it has largely to do with the analyst's own theoretical viewpoints plus the specific interplay between that analyst and that prospective patient. Although objective assessment of the patient's analytic promise may be the aim, psychoanalysts often accept or reject patients based on theoretical preconceptions and/or as countertransference reactions to patients' transferential evocation of rejection or acceptance.

As every analyst knows, each patient's fundamental ways of relating to others are brought to the very first session or consultation. In each new situation the patient unconsciously tries to organize a repetition of the earliest and/or most basic pattern of relatedness with his or her parents. Those patients who suffer most from various forms of parental rejection, for example, are likely to evoke similar rejection on the part of the analyst. This can take the form of not being found suitable as an analysand. Similarly, those patients who have received the most love and healthy interest from their parents are usually found to be the most desirable analytic patients. The patient who is not found suitable for analysis may be greatly helped, for instance, if the analyst early on addresses the meaning of the patient's provocation of rejection. This would require the analyst to reflect upon and not act out the countertransference wish not to work with an individual. It necessitates that the assessment of analyzability be seen as a