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The author feels that the fear of change and its principal manifestation, the fear of treatment, have not been given enough attention, having often been grouped under the general heading of resistance. The development of a comprehensive theory of resistance may have deflected our attention from the clinical manifestations (fear) seen in individual patients. Castelnuovo-Tedesco points to the necessarily ambivalent attitude that everyone brings to analysis since it involves stirring up old drives more or less put to rest, and disturbing our narcissistically invested vision of ourselves. He then gives twenty-seven clinical examples of patients expressing fear of change. There are several common elements: treatment will result in a negative outcome or loss rather than a gain; treatment will be a passive/submissive experience; treatment will inevitably end in disappointment; the patient is too far gone to help or there is apprehension about what large changes the patient will experience passively. Castelnuovo-Tedesco feels that the phenomena of fear of change are present in all patients to some extent in all phases of analysis, and that the analyst should be attuned to them and help bring them to consciousness so that the possibility of change will be preserved.