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It seems that the calling card of any respectable and respected psychoanalyst must include words that convey humility and a sober assessment of the limits of what he or she can accomplish: after name, address, and phone number come the words “And please don't expect too much.” Bion is said to have stated that the psychoanalyst must make the best of a bad job. It is commonplace, in short, to hear a psychoanalyst lay claim to the mantle of struggle, ignorance, and doubt.
There is something disingenuous about such a self-introduction because, at least as far as the contemporary psychoanalytic literature goes, such humility-as-inherent-limitation is, often enough, merely the first phase of what usually evolves into a favorable, often enthusiastic clinical report. The typical trajectory of the psychoanalytic case vignette takes a familiar form, and it is the form, roughly speaking, of the short story:
It is a dark and stormy night: the protagonist is in some kind of trouble.
There's a problem: the patient is difficult, or the analyst is confused.
Then something happens in which the character acts blindly and the stakes are raised.
There's an enactment, a mutually created resistance, an impasse. This part usually lasts a while.