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In a brief addendum to his book, Psychoanalytic Technique and the Creation of Analytic Patients (1995), Dr. Rothstein emphasizes that more patients deserve a trial of analysis than would typically be selected based on traditional methods of evaluation. Moreover, he believes that the shortfall is only partly due to evaluation methods that are too restrictive; an additional factor is the analyst's lack of conviction about the (therapeutic) efficacy of psychoanalysis, so that otherwise potentially suitable patients are eliminated by an analyst who is reluctant, ambivalent, or short on enthusiasm for either the method or the patient. He further asserts that restricting selection of patients for analysis further than he does is based on countertransference issues.
Perhaps this is simply a provocative way to emphasize that you will have more patients in analysis if you believe it a useful or even optimum treatment so that you can recommend it unambivalently for suitable patients. But beyond getting patients into analysis, it is difficult to know how his patients do, beyond some brief vignettes in the book, especially since he believes that “analysts have been excessively concerned with outcome” (1995, p. 120), and adds, “I suggest that if an analytic couple can work together productively for four or five years that the analysis is successful” (p. 121). Aspects of therapeutic benefit such as symptom relief or changes in work or object relations are not discussed.
Part of the difficulty is that Rothstein disdains evaluation, but he evaluates nevertheless. First, he evaluates and excludes certain