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Change – what prevents it, what nurtures it, and what maintains it – is a current that runs throughout the history of psychoanalytic theorizing. While knowledge, in the form of insight, remains an important antidote to repetition, awareness of the here-and-now process of the clinical experience has taken a new place in more recent theoretical understanding. In looking at these questions of change, this commentary offers some additional theories to those already expressed by Safran.