Defining the Goals of a Clinical Psychoanalysis

The purpose of this brief communication is to point out the advantages of the analyst's and the patient's trying to define, as explicitly as possible from the very outset, the specific goals of their work together. I find that goal orientation facilitates analysis, including the analysis of transference. Elsewhere (Renik 2001), I have explained why I believe the goals of a clinical psychoanalysis are best formulated in terms of the patient's experience of therapeutic benefit; and as an illustrative example, I used the extreme case of a treatment that lasted only one session. Now I would like to describe how the same emphasis on defining specific therapeutic goals permitted successful establishment of a more extended clinical process. What follows is an account of my first meeting with a patient who eventually undertook analytic investigation at some length. There is nothing unusual or dramatic about the material. I intend it as an ordinary instance of a clinical analytic approach in which definition of the goals of analysis is a productive, ongoing task.

Sheila consults me because her previous therapies did not work out. She developed complex, emotionally charged relationships with her therapists and examined them carefully; she learned things about herself; but her life failed to change. What does she want to change about her life? I ask. She is not sure: not sure what she was