The Course of 253 Analyses From Selection to Outcome

Two studies of the clinical work of experienced psychoanalysts are presented. Study I is a retrospective study of all the anaThe history of each treatment as reported and evaluated by the analyst is examined in terms of: nature of the population, the analyst's view of the case when the initial recommendation was made, duration of treatment, therapeutic benefit, rating of analyzability at termination of treatment, nature of the termination, and cases changed to psychotherapy. Some old shibboleths are challenged as perspective on both the limitations and achievements of psychoanalysis emerges from the findings of the study.

For many years, analysts have attempted to develop methods of studying analytic treatments that would illuminate the nature of the process and the efficacy of treatment. It has been difficult to organize studies that would report a substantial number of experienced analysts' completed cases and provide such fundamental information as duration of treatment, characteristics of the population for whom it was recommended, type and extent of therapeutic benefit provided, and a comparative appraisal of the patient at onset and termination: did an analytic process develop? It has been hard to enlist analysts and, in some studies, patients, in such lengthy, demanding reporting of their work. Also, questions persist as to what constitutes analytic data: how is it to be collected, how evaluated, how related to assessment and outcome? How should the differences in research and clinical perspectives be understood?