Attention is drawn to some possible consequences of our usual consultation and referral procedures in psychoanalysis. Using four clinical illustrations, it is suggested that the consultant may play a much more significant role in the patient's psychic life than we might expect. He may have an important part in the transference neurosis that subsequently develops; he may be drawn into fantasies in relation to the treating analyst that mobilize very powerful transference resistances. Not only can these retard the development of the analytic process, but they can potentially prevent an analysis from occurring. This type of material seems regularly to be excluded from the analysis by the patient. Although the analyst knows that something is interfering, he

cannot determine what it is until the patient is able to tell him.