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What is therapeutic change? I believe that it is very difficult to be precise about the changes which a patient undergoes in analysis to achieve peace of mind and satisfaction with life. Because the mind is exceedingly complex we are not able to ascertain changes that occur silently as a result of the imponderables of a very intimate and unique relationship. What we can observe is how our accompanying the patient in a painful journey to his innermost core of experience, convictions, horrors, shame, guilt, worthlessness gives the analysand the courage to describe, name, face, and search for a resolution of the private unconscious conflicts ensuing from them. The analyst's companionship is disciplined and demanding, insisting that the patient be unrelenting in the effort to understand the complexities of his/her conflicts, whether they be pre-Oedipal or Oedipal. The analyst's task is to aid the analysand to assume responsibility for his/her participation, real or fantasized, in the entanglements that inhibit psychic freedom. The analyst's critical participation consists in being there, in deep emotional contact with the analysand at each moment of the journey. The necessary interpretation of internal conflicts results from the painstaking and delicately built process of collaboration, at times paradoxical, to jointly arrive at an understanding that makes sense to both partners. The key element in change, however, requires the patient to carry out private psychical actions (Freud 1914a)1 of renunciation and mourning of that which feels to him either needed or wanted but which he cannot have. Most of these conflicts of need and desire gather intensity around transferential issues. The persistent exploration of the transference and its progressive working through is the essential in vivo experience to achieve lasting change and conviction in the analysand.