You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Evidence-based medicine and quality assurance are steering instruments with growing importance in the health care system. This is of course connected to an increasing awareness of costs. These steering instruments affect the psychoanalytical field, even if they are foreign to most analysts.
In Sweden a method for quality assurance is about to be established in the psychotherapeutic field in a way that is congruent with our field and that strengthens the professional integrity of the analyst. This method has also been accepted by colleagues in other medical disciplines as for instance psychiatry and by the official Swedish health authorities. Regarding evidence-based medicine the situation is different. It is a method that has been connected to statistical methods, to large randomised studies and to meta-analyses of these studies. In our field, results from such studies must be supplemented. We need to present the current situation of psychotherapeutic outcome research. But we must be aware that these studies alone do not give a correct description, since the development of our field has always been based on the study of individual cases. Psychoanalysts are more interested in the patient as a subject than as an object, more interested in the particular than in the general. Furthermore, we lack a common taxonomy. Taken together this makes the transformation of experience from the clinical practice into statistical figures difficult.
A better base for decision-making in our field could be acquired by paying closer attention to clinical experience and to the testimony of all the patients who have benefited from psychoanalytical treatment. This should be complemented with an overview of the development of psychoanalytical theory and the way in which it affects how we listen to our patients and to ourselves during a session. We also need to describe the ongoing discussion on the body-mind question and its impact on the dualistic world-view, which up till now has dominated o