Building a Bridge Over Troubled Water: Response to Commentaries

We very much appreciate the thoughtful and thought-provoking comments by Donald Spence and Richard Almond on our target paper. These two comments are all the more noteworthy because they are by two psychoanalysts familiar with both sides of the divide and thus—each in their own way—illustrate the potential to bridge the two cultures within psychoanalysis. Because of the affinity of these commentators with both clinical work and research, however, their remarks also reveal some tension, suggesting that bridging the gap, far from being easy, is a task that will occupy psychoanalysts for years to come. Turning now to the commentaries in specific detail, we begin by addressing Spence's comments, which will allow us to elaborate on the use of case study methods and other procedures to study individual cases systematically, as well as to discuss some additional issues concerning the relevance of psychoanalytic research. Next, we discuss the commentary by Almond, which focuses mainly on problems concerning the translation of psychoanalytic research to clinical practice, and ways to facilitate this process.

Spence eloquently describes the numerous pitfalls associated with the traditional case study method, and points to many of the dangers for psychoanalysis associated with the failure to develop more sophisticated methods of investigation. Needless to say, we fully concur with his plea for alternative, more systematic ways to study individual cases that can enrich the traditional case study method. Too often psychoanalysts respond to claims for the effectiveness of other forms of treatment—claims based on high-tech research and meta-analyses—with