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“My point is not that everything is bad, but that everything is dangerous”
It is a precarious time for the practice and fate of psychoanalysis. Pressures within and outside the field are demanding greater accountability and proven effectiveness for analytically informed psychotherapies. Implicit in such demands is a call for the systematic establishment of a knowledge base derived through scientific investigation in order to justify particular treatment decisions. The debate surrounding the role and utility of science in the practice of psychoanalysis began with its inception, though it seems to be reaching a fevered pitch in our contemporary climate of evidence-based medicine, managed care, and a general populace expecting scientifically verified treatments. Fierce disputes related to how the field should or should not respond to these demands exacerbate tensions that threaten to fracture the underlying integrity of psychoanalysis (Chiesa, 2010; Cooper, 2008).
At the heart of this division are questions regarding whether or not psychoanalysis can be subject to scientific inquiry (Popper, 1963; Grünbaum, 1984). If so, what type of science is best applied (Wallerstein, 2009)? Or is psychoanalysis completely outside the discourse of science and therefore best thought of as hermeneutic practice (Hoffman, 2009)? These pivotal questions set the stage for a hotly contested debate, with the identity of psychoanalysis and how best to practice it hanging in the balance. With so much at stake, intense anxieties are aroused and defended against through staunchly held positions or by blithely ignoring the issues. Taking any such position undermines the potential for a constructive debate and movement towards a more vibrant, relevant, and secure field. Fortunately, there exist some attempts to find middle ground; for example, Luyten, Blatt and Corveleyn (2006) as well as Wallerstein (2009) argue for a methodological pluralism that employs both quantitative and qualitati