Psychoanalytic Inquiry. X, 1990: The Emotional Position of the Analyst in the Shift from Psychotherapy to Psychoanalysis. Alan Z. Skolnikoff. Pp. 107-118.

Skolnikoff focuses on the external and internal factors that influence the analyst's decision to shift from psychotherapy to psychoanalysis. Because analysis no longer enjoys its former prestige, and patients are harder to come by, he suggests that we have broadened the definition of who is analyzable, and blurred the distinction between psychoanalysis and psychotherapy. We have begun to refer to issues of external form (use of a couch, frequency of sessions) rather than to the nature of the process (resolution of internal conflict by transference interpretation) to distinguish between the two. He identifies some leading theoreticians who have shifted from these external factors to the nature of the therapeutic interaction in order to distinguish between analysis and therapy. Gill, Rangell, and Stolorow are mentioned as among those who feel analysis can be carried out face-to-face and at less frequent intervals. He next identifies several ways the emphasis on external factors (couch and frequency) may actually be used by both patient and analyst alike to hide transference and countertransference enactments.

Finally, he gives two examples from his own practice: one in which the external form was analytic (patient on the couch four times per week), with good therapeutic outcome but no analytic process; the other in which the patient was seen face-to-face infrequently in a true analytic process.