The person best able to undergo psychoanalysis is someone who, no matter how incapacitated at the time, is basically, or potentially, a sturdy individual. This person may have already achieved important satisfactions—with friends, in marriage, in work, or through special interests and hobbies—but is nonetheless significantly impaired by long-standing symptoms: depression or anxiety, sexual incapacities, or physical symptoms without any demonstrable underlying physical cause. One person may be plagued by private rituals or compulsions or repetitive thoughts of which no one else is aware. Another may live a constricted life of isolation and loneliness, incapable of feeling close to anyone. A victim of childhood sexual abuse might suffer from an inability to trust others. Some people come to analysis because of repeated failures in work or in love, brought about not by chance but by self-destructive patterns of behavior. Others need analysis because the way they are—their character—substantially limits their choices and their pleasures. And still others seek analysis definitively to resolve psychological problems that were only temporarily or partially resolved by other approaches.
Whatever the problem—and each is different—that a person brings to the analyst, it can be properly understood only within the context of that person’s strengths and life situation. Hence, the need for a thorough evaluation. to determine who will benefit—and who will not—from psychoanalysis.