The ethical challenge in psychoanalytic conversations is about listening as an act of witnessing, with a willingness to surrender when called for, with a tempered reliance on the power of empathy, and with a commitment to protect the open future of the patient by refraining from reductionist interpretations, and formulations. This requires an embrace of our own vulnerability and a willingness to consider that the patient holds truths about us. These values signify, alongside our clinical expertise and clinical convictions, our ethical clinical minds at work. Holding all of this is our challenge in the face of clinical and economic pressures that encourage us toward certainty, decisiveness, and evidentiary practice.