Selecting a patient or initiating a psychoanalytic process

The defences provoked in the analyst by the anxieties associated with the difficult tasks of 'assessment' and 'selection' for psychoanalysis can result in a tendency to think in terms of 'hurdles to be cleared' by potential psychoanalytic patients, rather than 'opening the gates'. This can result in a diminution of the analyst's capacity to enlist and sustain a psychoanalytic stance. Only within a psychoanalytic frame can a meaningful psychoanalytic process unfold, at all stages of a potential patient's movement from their first contact through to, possibly, entering into an analysis. The author illustrates the value of this thinking by describing the work of the London Clinic of Psychoanalysis where there has been a shift of emphasis in psychoanalytic consultation towards working with individuals on their potential to initiate a psychoanalytic process, and away from the sole aim of 'selection of a suitable patient'. In this paper, the author notes that when institutional culture and practice supports psychoanalytic identity, this makes it more possible to recognize and articulate the anxieties provoked by the 'emotional storm' inevitable in psychoanalytic consultation, and the draw towards unhelpful enactment that may otherwise obscure the initiation of a psychoanalytic process that may or may not result in analytic treatment. Illustrative case material from the Clinic is presented

Clearance · Process (computing · Psychoanalysis · Psychoanalytic theory · Psychotherapist · Computer Science · Medicine · Mental Health and Psychiatry · Psychology · Psychotherapy Techniques and Applications · Transactional Analysis in Psychotherapy

• Choreographies in the beginnings of psychoanalytic psychotherapy sessions with an adult male patient

  Open Access•Päivi Aho-Mustonen, Henrik Enckell et al.•International Forum of…•2025

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• The first interview

  Open Access•Bernard Reith•The International Journal of…•2014

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• The analyst's anxieties in the first interview

  Open Access•Mette Møller•The International Journal of…•2014

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• Delving into the ‘emotional storms’

  Open Access•Alejandra Pérez, Penelope Crick et al.•The International Journal of…•2015

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• Consenting and Assenting to Psychoanalytic Work

  Open Access•Allannah Furlong•Journal of the American…•2020

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• The Analyst’s Trust in Psychoanalysis and The Communication of That Trust in Initial Interviews

  Open Access•Robbert Wille•The Psychoanalytic Quarterly•2012

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• A Perspective on Doing a Consultation and Making the Recommendation of Analysis to a Prospective Analysand

  Arnold Rothstein•The Psychoanalytic Quarterly•1994

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• Initiating Psychoanalysis

  Open Access•Kate Pugh•The International Journal of…•2013

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• Creating analysts, creating analytic patients

  Open Access•Howard B Levine•The International Journal of…•2010

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• The analyst's anxieties in the first interview

  Open Access•Mette Møller•The International Journal of…•2014

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• The profession of ferryman

  Open Access•Stefano Bolognini•The International Journal of…•2006

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• On the Efficacy of Psychoanalysis

  Open Access•Henry Bachrach, Henry M Bachrach et al.•Journal of the American…•1991

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• Why We Recommend Analytic Treatment for Some Patients and Not for Others

  Open Access•Eve Caligor, Barry L Stern et al.•Journal of the American…•2009

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• The Analyst's Reluctance To Begin a New Analysis

  Open Access•Lena Theodorou Ehrlich•Journal of the American…•2004

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