Inspiring Inquiries: Introduction to Falkenström Et Al.

Two admirable strengths characterize the following very original paper by Frederik Falkenström and his colleagues. First, the topic—continuing development following psychoanalysis or long-term psychotherapy—is rarely addressed using empirical research designs. Second, they have carried out a bold and outstanding inquiry, guided by a commitment to apply complementary narrative and quantitative methods in rigorously and deeply tracking the changing lives of former psychotherapy patients for two years following termination.

Analysts and psychotherapists have long been aware of changes— sometimes stunning, sometimes subtle—that patients initiate and experience at various points after formal completion of their therapy. Sometimes we learn of these changes when a patient returns for a follow-up consultation. At other times we hear about, or perhaps even witness, continuing or new development in close friends and significant others. And in another personal way, we learn about these surprising moments and patterns through self-observation, at times years after completing our own therapy or analysis. It has been a challenge to identify these changes and then discover the mechanisms underlying them. What proximal and distal triggers leading to growth or deterio-ration may possibly be linked with prior long-term psychodynamic therapy or psychoanalysis? To what extent do changes after termination reflect continuing internal rearrangements or external life changes the person has constructed based on insights gained in treatment?

In answering these questions, we ordinarily must depend on anecdotal reports from colleagues, our own personal experience, and hearing from the subset of patients who return for further consultation. In other words, we are at the mercy of serendipity in learning of subsequent growth or, on occasion, dismaying deterioration following a long therapy or analysis. Without a longitudinal study, including all patients