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The interpretive role of the analyst is the central factor in the psychotherapeutic effect of psychoanalysis. The analyst's attitude of care and acceptance, reflected in the manner of his or her interpretations, is critical. Some patients in their communication have a greater capacity than others to work around the analyst's blind spots. This too aids the therapeutic process. Collusions between patient and analyst to protect the latter, usually based on a transference fantasy, are the most formidable impediments to analysis.