This article discusses the question of the basis of changes in psychoanalytic concepts, theory, and treatment. Illustrative examples discussed include the “widening scope” of the use of “parameters” in psychoanalytic treatment; the rejection of the “Enlightenment Vision” and the concomitant de-emphasis on the role of insight; the concept of “narrative truth”; and the “totalistic” re-conceptualization of the meaning of countertransferase. I then discuss the relationship between research and clinical practice and argue that if it is to grow, psychoanalysis must be open to and attempt to integrate findings from other related disciplines.