The role of working through in bringing about psychoanalytic change

In reviewing psychoanalytic case summaries while serving on the Committee on Certification of the American Psychoanalytic Association, the author gradually became aware that there was a recognisable similarity in what the analysands experienced in spite of variations among psychoanalysts as to how they conducted the analyses. Based on this observation, the author turned to his own clinical practice where more detailed process data was available, and focused his attention in particular on what the analysand does during a psychoanalysis. A detailed explication is offered of his findings, with a focus on the nature of 'working through'. A clinical vignette is given to highlight that what the analysand experiences is an essential ingredient in attempting to understand how structural change occurs in psychoanalysis.