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When the question of converting from psychotherapy to psychoanalysis arises, the focus ordinarily is on the patient—especially the patient's capacity or readiness for the change. My focus, in contrast, is on the analyst's state of mind when confronting this circumstance. And because the analyst does live in the real world and is affected by it, it seems reasonable to start with a few observations on the external factors impinging on him or her.
The most conspicuous of these is the change in the general attitude of the public and broad mental health community toward psychoanalysis viewed in comparison to psychotherapy. It is not necessary to compare the current climate of opinion with that of the midcentury when psychoanalysis was the treatment of choice for anyone with the necessary time, money, and patience and when patients undergoing all sorts of therapy referred to their “analyses.” We need only compare today's climate with that of a decade or so ago to find differences in the way both analysts and patients feel about analysis.
The general public, prospective patients, and thoughtful people in related disciplines are now questioning whether psychoanalysis