The author compared patients who make creative use of the transference to effectuate structural change to other patients whose analyses appear to be interminable. Multiple preconditions were judged to be necessary: we must assume a capacity for symbolic transformation—an ability to shift from fantasy to reality and from reality to fantasy. This in turn requires a capacity to tolerate the ambiguity and paradox of the mutliple realities implicit in the psychoanalytic process, the ambiguity of actuality and illusion, the paradox of time—that the past is in the present and that the present can alter what is past. Finally, the resolution of the transference presupposes a certain capacity to tolerate psychic pain and to resolve that pain through the process of mourning.