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THE PURPOSE OF THIS PAPER is to clarify and consolidate some of the major concepts used in assessing clinical appropriateness for psychoanalysis. This paper is not so much a description of how to assess analyzability as it is a description of some psychological and environmental concepts and processes that interact in order for a patient to be analyzable or unanalyzable. If we have a thorough understanding of the various psychological and environmental factors that interact in order to make a patient analyzable or unanalyzable then the degree of analyzability at times may become readily apparent in the initial assessment sessions where at other times it cannot be pre-analytically assessed, i.e., it cannot be properly assessed until the patient has been in treatment for a significant amount of time. For the purpose of this paper, analyzability can be defined as a state of readiness that involves the capacity to cognitively and emotionally understand psychoanalysis plus the capacity for constructive psychological and behavioral change as a result of that understanding.
Most analysts would agree that the judgement of analyzability is often subjectively made. Many of these intuitively made judgements are most satisfying and have confirmed the wisdom of empathic intuition. Although we must remain respectful of empathic intuition, the assessment of analyzability is far too important a decision in the life of the patient to be made by the unreliable forces of intuition. It should instead be made with a cognitive and rational understanding of the relevant concepts at this stage of our knowledge. This knowledge may reveal that psychoanalysis is contraindicated and even dangerous to a specific patient's mental and physical well being.