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The basic problem of psychoanalysis in the 21st century is the extension of the clin-ical skills of psychoanalytic listening and its implications for the complexity of our models. In order to throw light on this issue, I will begin by discussing the treatment of a patient who has had multiple analyses. If psychoanalysis still has the same foundations based on the transfer-ence and listening to associativity, the models of these processses must be given greater com-plexity and expanded. The extension of the skills of psychoanalytic listening to the narcissistic sufferings which have an important impact on identity requires us to refine new tools which involve a deeper understanding of early childhood and, in particular, primary forms of symboli-zation; it also requires a broadening of the frame of reference of listening so that it is no longer based only on the attention paid to instinctual life but also to the responses of significant ob-jects to instinctual drive movements. Finally, these questions lead to the further issue of a pos-sible extension of the analytic settings in relation to the specific type of associativity of analysands.