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In their thoughtful and constructively critical paper, Gunderson and Gabbard describe several scientifically oriented efforts that are needed if psychoanalytic treatment is to continue within the treatment system for mental disorders and be eligible for reimbursement by government agencies or insurance companies. These needs include a clarification concerning the proper indications for psychoanalytic treatment, as well as knowledge about the outcome of long-term therapies, about the importance of frequency of sessions and duration of treatment, and about specific interventions that may be harmful or helpful with certain diagnostic groups.
Why do we not have this knowledge already? Any prospective patient or analytic candidate should ask for it. Psychoanalysis in the narrow sense is about seventy years old, short-term psychotherapy even older. How can it be that we still lack “evidence-based” answers to these questions? This is not the place for a comprehensive discussion of the relationship between the psychoanalytic movement and research. But, since now both the IPA and the American Psychoanalytic Association want to promote empirical research on long-term treatments, we should identify the main obstacles that inhibit such research among us.
We in fact share many of these obstacles with clinical research in general. One is the negative attitude toward research. As clinicians, we like to think we know enough. We know that our treatment method is working, and we think that clinical experience is a good enough basis for practice. And, of course, when we act as clinicians toward a patient, we certainly have to behave as if we clearly know the best thing to do. Doing research, by contrast, implies uncertainty; to “re-search” is to look once more at established truths and to look for the unknown. The research attitude may therefore be threatening to clinicians, especially psychoanalysts, despite the fact that in work with patients we use exactly the same working model as d