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The prospect of finding cases and building an analytic practice can be daunting. The aphorism “Analysands aren't found, they're created” expresses a reality of current psychoanalytic practice. Gone are the days when there was consensus that analysis is the treatment of choice for neurosis. We are training to be analysts at a time when psychoanalysis is suspect in the eyes of many. For the patient who comes to treatment without a psychoanalytic context the recommendation often seems strange. Even educated people ask, “Do people still do that?” when I mention I'm training to be an analyst. Some patients still seek analysis, but more frequently the prospective patient is shopping, looking for what treatment will do for him or her. Most patients expect brief, once-a-week therapy and have little idea of the potential of analysis or what the endeavor requires of them.
How then do we find our cases? Traditionally the analyst evaluates a patient and, if objective criteria indicate analysis, the recommendation is made and the patient's resistance addressed. While at some institutes initial control cases are selected and screened for analyzability by experienced analysts, ultimately finding cases and building an analytic practice is up to the individual candidate-analyst.
Often we convert psychotherapy cases to analysis. In a sense all cases are conversions as successful analysis requires converting the patient from whatever idea of cure they come with to an analytic