Bernstein discusses some of the elements contributing to motivation for psychoanalysis, factors that foster this motivation, and psychotherapy as a preliminary step. He feels this preparatory work helps the patient to control anxiety about unconscious wishes and to establish a sense of safety about the analytic situation. He does not feel that there have to be any contraindications to converting from psychotherapy to psychoanalysis with the same analyst, as long as this possibility was considered by the analyst upon beginning treatment. Several case vignettes are presented to illustrate his hypothesis. Factors identified as important in fostering the development of motivation are: the influence of the recommendation of analysis, an internal focus of distress, recognition of limitations caused by neurotic misery, the parallel of fears in life and fears in treatment, some comfort with analytic regression, dissatisfactions with the limitations of psychotherapy, and a desire to intensify the treatment.