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In this paper, Judith Fingert Chused describes her struggles with uncertainty and fear (not unusual psychic companions for an analyst at work), with special focus on work with patients who make it very difficult, if not impossible, for an analyst to forge an intimate relationship with them. She recognizes that many of us who become psychoanalysts have a wish and a need to help people within the context of intimacy. In some analyses, genuine intimacy never occurs or does so only sporadically. Patients who cannot genuinely work together with an analyst (because they cannot “tolerate ‘working with’” (p. 838) often feel unhelped by the analyst and the analytic treatment, Chused writes, even after many years of analytic work. “So for me,” Chused tells us,
… the hardest part of the work is not the patients who complain of what I am doing wrong, but the patients whom I believe I have not helped enough—those who, if not damaged, have wasted years of their lives in a treatment that provided insufficient benefit. [p. 837]
She refers to such patients as those who “got neither what they wanted nor what they needed, who left analysis not much better than when they entered” (p. 838). Chused illustrates, through her description