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The conversion from psychotherapy to psychoanalysis is a topic of formidable dimensions, engaging as it does, the perennial issue of defining the two modes of treatment in terms of theory and technique. Shifting definitions of psychoanalysis both as process and treatment have contributed to the complexity of the discussion.
In a survey on psychoanalytic practice, Shapiro et al. (1981) reported that one eighth of the analytic cases had previous psychotherapy. The numbers of psychotherapists have been increasing at an accelerating rate in the interim, and clinic experience at intake demonstrates an accompanying rise in frequency of previous psychotherapy among prospective analysands. Practically speaking, the “pure, uncontaminated” analytic case is apt to become an endangered species. Furthermore, there is a growing opinion (Panel, 1987) that some cases give positive indications for previous psychotherapy. The question, then, is, what theoretical and technical considerations determine an appropriate conversion.
In this paper, I consider the topic of conversion from psychotherapy to psychoanalysis in the broadest context, whether the conversion is conducted by the same analyst or after referral to another analyst. I offer two case examples from my own clinical