This article describes three attitudes toward psychic pain and suffering, and their clinical implications are explored and illustrated. When analyst and patient differ fundamentally in their understanding of the place of suffering in psychic life, treatment destructive clashes may result. The attitude that pain should be reduced as quickly as possible has a significant impact on the analyst's focus in treatment, most especially on the timing of interpretations of defense. A different orientation is that pain is an inevitable part of human experience and is best accepted rather than avoided. A third possibility embraces suffering as not only unavoidable, but as a primary source of wisdom and personal identity.