October 15, 1990

We are appreciative of the careful and thoughtful review the San Francisco group has given our study. As the authors note, we ourselves have addressed most of their criticism in our articles. A few points, however, should be clarified. First, and most important, we do not interpret our findings as indicating the inefficacy of psychoanalysis. Rather, we believe our findings indicate that we cannot predict in advance which patients will benefit. Our study has shown that the level of psychopathology does not determine the outcome of treatment. At the time this study was begun (1972), we were taught that the success of analysis was based on the patient's psychology and that, given adequate skill and experience, analysts were interchangeable.

We now believe that psychoanalysis is a two-person enterprise, and the effect of this interaction makes it impossible to predict the