This article discusses some of the considerations necessary for determining who needs psychoanalysis and when it should be used in conjunction with other modes of intervention. Clinical case material is used to illustrate particular kinds of patients who may need interventions in addition to psychoanalysis, such as those whose destructive wishes are being acted on in ways that are more gratifying than the process of talking would be. In addition, the paper offers comments on the presentations which were presented on days prior to this one at the 1997 Annual Cape Cod Conference, specifically on subjects like Kagan's research about high-reactive temperament in infants, the pros and cons of self-analysis, and the problem of separation of mother and child as it relates to the ability to use aggression constructively.