This paper addresses some of the methodological problems in assessing and understanding change in psychoanalysis, including the twin difficulties of not knowing precisely what transpires in an analytic session and not knowing to which of the many aspects of psychoanalytic process any particular change should be assigned. There are alternate models for understanding change. The most commonly used model is that of psychoanalytic growth with the analyst acting as a fostering maternal figure. An alternate model of change is of psychic repair with the analyst in a more physicianly role. Analysts also work with alternative models of trauma. In one model danger stems from the infant's own overwhelming affective states, while in the other model danger comes from parenting failures. Analysts also differ regarding the importance assigned to interpretation and insight rather than to the new relationships and altered experience. This paper elaborates these models and their implications for psychoanalytic technique and our understanding of psychic change.