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[…] I think I am well-advised, however, to call these rules «recommendations» and not to claim any unconditional acceptance for them. The extraordinary diversity of the psychical constellations concerned, the plasticity of all mental processes and the wealth of determining factors oppose any mechanization of the technique; and they bring it about that a course of action that is as a rule justified may at times prove ineffective, whilst one that is usually mistaken may once in a while lead to the desired end. These circumstances, however, do not prevent us from laying down a procedure for the physician which is effective on the average (S. Freud 1913, 122).
There are, however, many varieties of psychotherapy, and these should depend for their existence not on the views of the practitioner, but on the need of the patient or of the case. Let us say that, where possible, we advise psychoanalysis, but where this is not possible or where there are arguments against, then an appropriate modification may be devised. Of the many patients that come to me one way or another, only a very small percentage do in fact get psychoanalytic treatment, although I work at the centre of the psychoanalytic world (D.W. Winnicott, 1986, 101).
Among the open questions and the reflections on the issue of the evolution of psychoanalysis today, there appears to have emerged a change in demand by patients and as a result a different formulation of the analytical contract and of setting is created. How widespread are these changes, however, and to what extent are they accepted by psychoanalysts, both in Italy and abroad? What do they make of them? Is it legitimate to speak of a crisis in the field of psychoanalysis