Nathan Lietes has written a book that challenges the cardinal contention of psychoanalysis, that only transference interpretations are effective. He examines the status of this contention at length and makes explicit a variety of reasons for affirming or denying it.

Although Leites does not question that transference and transference interpretations are “central” to psychoanalysis, he does question that “all is transference”. Leites uses an abundance of case material to examine the following questions: Are reactions toward the analysis reactions toward the analyst? Do reactions toward the analyst dominate the hour? Do reactions toward the analyst dominate the patient's life?

He concludes that while the answer to the above is no doubt yes “for many patients at many moments of their analysis,” there is also a high incidence of non transference reactions that take place in analysis. As a result of his study, Leites suggests that the belief in the sole effectiveness of transference interpretation be abondoned.