Between a Rock and Hard Science: How Should Psychoanalysis Respond to Pressures for Quantitative Evidence of Effectiveness?

Can psychoanalysis address the press for empirical evidence of effectiveness, which our contemporary culture appears to demand, without compromising or relinquishing our ways of knowing and working with patients? Can we develop research methods that are consistent with a psychoanalytic view of treatment and change? And can we use research in ways that honor both the scientific method and the psychoanalytic method?

My opinions on these questions are framed by the contexts within which I work—academic psychology and private practice. As a member of the faculty of an undergraduate psychology department, I am often confronted with colleagues' and students' questions, misconceptions, and doubts about psychoanalysis, including whether our treatments are effective. I see that psychoanalysis is routinely dismissed in academic psychology as outdated, irrelevant, and even potentially harmful. As a practitioner, I am disconcerted that the form of treatment I know, believe in (dare I say it “speaks” to me?), and practice is not considered validated. I am concerned by recent movements, such as that undertaken by the American Psychological Association, to develop guidelines for practice that may exclude forms of treatment that are effective and unique. I believe systematic research is one way to bolster the standing of psychoanalysis in the field and in the wider world, in that it provides a type of evidence that is increasingly valued and even deemed essential.