If a model of the mind is to have clinical utility, it should portray pathology in a manner consistent with what is encountered in our consulting rooms. This model should inform and guide the therapeutic efforts of practitioners to help their patients gain the insight and self-awareness that will lead to partial or complete resolution and consequent diminution of symptomatology and suffering. These remarks apply to all insight-oriented therapies, whether they be psychoanalysis or psychoanalytically oriented therapies. Accordingly, we make no sharp distinctions between psychoanalysis and psychoanalytically oriented psychotherapy, and we are in sympathy with Wallerstein (1989), who concluded that “though the differences between psychoanalysis and expressive psychotherapy … are there and real, the boundaries and the seemingly specific deployments are … much less clear-cut … (p. 20).” Not only is it hard to specify the theoretical differences but, confirming what is commonly known, Wallerstein indicated that when psychoanalysts discuss informally what they actually do the blurring of modalities appears to be far more widespread than one would expect from presentations at official settings.