Education (ACGME) has launched a competency movement that is causing a paradigm shift in psychiatric training. Psychiatry, like all medical specialties, is expected to attest to the specific competencies of its graduates. 1 In particular, the Residency Review Committee for Psychiatry (RRC) has defined the need for competency in several of the psychotherapies, 2 thereby generating, in turn, much discussion about how to develop this set of skills. The American Association of Directors of Psychiatric Residency Training (AADPRT) has provided specific guidelines for competency in each type of psychotherapy, including, most controversially, psychodynamic psychotherapy. 3 These guidelines state that the competent resident will "demonstrate understanding of the concept of the unconscious" and also of "the multiple and complex meanings" underlying behavior. Toward this end, the resident should be able to establish an alliance with the patient that allows for "an inquiry into the patient's inner life." Finally, the AADPRT guidelines specify that the resident should be able to recognize, utilize, and manage aspects of transference and countertransference, and to "utilize selfreflection to learn about his/her own responses to patients."One of the difficulties of attaining such competence in psychodynamic psychotherapy is that physicians-in- Correspondence: Adam M. Brenner, MD, Department of Psychiatry, Brigham and Women's/Faulkner Hospitals, 221 Longwood Ave., Mezzanine level,