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The motivation necessary for a patient to accept the recommendation to enter psychoanalysis depends on a sufficient, ongoing level of distress experienced as internal, and the capacity to view an analyst as psychically safe and analysis as potentially leading to relief. In this paper I focus on the appropriate role of the analyst as psychotherapist in fostering such motivation and the process of its evolution.
Some factors that tend to foster the motivation for psychoanalysis include knowledge of its availability and potential benefits; an accepting external environment to support its conduct; the awareness that one's responses to external stresses are related to longstanding internal neurotic distress; and some experience of temporary relief and controllable regression obtained with an interested consultant, psychotherapist, or psychoanalyst.
The experienced clinician will recognize the process I describe as one that naturally involves establishing a treatment environment in which the patient's awareness is focused on his internal experience and conflict, and in which he can experience a safe and reversible regression. In this treatment environment the patient's motivation for analysis can be assessed and resistances to analysis can be voiced and explored. In some cases where these resistances