In his introduction to the second edition of An Open Door Review of Outcome Studies in Psychoanalysis, the editor, Fonagy, sums up our knowledge to date: “It is nevertheless impossible to ignore the fact that whenever the effectiveness of the method is fairly and appropriately assessed, it yields effect sizes comparable with other therapeutic approaches” (p. ix). This observation is meant to be encouraging, but a more cautious interpretation of these data would be to say that as psychoanalysts are increasingly expected to demonstrate the value of our time-consuming and costly approach, there is a lot of work to be done. In this volume, Fonagy and his collaborators from the research committee of the International Psychoanalytical Association sketch out a rough map of the work that has already been done, especially the ongoing research into what patients gain from psychoanalysis and how those gains are made.

Before he presents the studies themselves—and they fill more than three-quarters of the book—Fonagy sets out a crucial framework. He begins with