Perspectives on Psychoanalysis as a Late Arrival to the Family of Sciences

PSYCHOANALYSIS HAS BEEN TRADITIONALLY defined from the standpoint of the practitioner—as a method of treatment based on a particular theory of psychic functioning.1 This definition has led to the idea that psychoanalysis is as much an art as it is a science, and, as such, that the means of its therapeutic efficacy are largely unspecifiable.

This state of affairs is roughly equivalent to defining medical science from the standpoint of a surgeon. The surgeon is clearly an artlist as well as a technician. But the labors of a surgeon do not constitute the definition of medical science, nor does a groundbreaking surgical technique constitute the whole of medical research.

I believe that psychoanalysis has been slow to develop as a scientific discipline because its theory is so firmly wedded to practice, that uncontaminated research is virtually precluded. That is, psychoanalytic research functions almost exclusively as the observation of therapeutic practice from the standpoint of psychoanalytic theory. For example, a psychoanalytic research project may seek to determine whether a good therapeutic alliance leads to a good therapeutic outcome; or whether a negative transference contributes to or hampers a patient's progress. The theoretical concepts of alliance and transference are assumed from the outset, and certain behaviors on the part of the patient are designated as evidence that these conditions are present in the therapy under observation. Thus, the results of the research merely confirm assumptions already held, without subjecting them either to analysis or to possible refutation.