As psychoanalytic therapy shifts from a conflict resolution theory to a model of self-realization, the analyst's vision of the patient takes on a more prominent role in the process. This article builds on H. Loewald's (1960/1980) concept of the analyst as “behind” because he or she can only build from the patient's spontaneous productions and yet “ahead” in that the analyst goes beyond the patient's material to construct an image of who the analysand can become. In this way, the future becomes a prominent component of the analytic process. The famous case of Anna O. is used to demonstrate the deleterious effects of failing to include the analyst's vision in the treatment process. This case is contrasted with the contemporary treatment of a young woman, a case that illustrates the use of the analyst's vision in the conduct of psychoanalytic treatment.