On: What happens in a psychoanalysis?: A view through the lens of the analytic process scales (APS)

Dear Sirs,

A methodological problem which Waldron et al. (2004) failed to deal with confounds the conclusions of their careful, sophisticated study with analytic process scales (APS). The audiotapes of three treatments by analysts were selected from a sample of 18 taped treatments. Sessions were selected from the beginning, middle and end of each treatment for assessment using the APS. Discussing their findings, they write, ‘A number of hypotheses about what happens in psychoanalysis … can be tested, based upon examining the sequence of APS scores’ (my italics). Clearly, choosing the term ‘APS’ and the subsequent discussion about ‘what happens in psychoanalysis’ indicates the authors consider that they are measuring analytic process. However, the only basis they report for considering these treatments to be psychoanalytic treatments rather than psychotherapeutic treatments is that they were conducted by psychoanalysts. We would all agree, however, that not every treatment by an analyst is psychoanalysis, and not every treatment is psychoanalysis in every session, and from beginning to end.

Unfortunately, there are no agreed-upon independent criteria for psychoanalytic treatment, which the investigators seem to acknowledge when they write, ‘A definition of psychoanalytic process combining clinical breadth with scientific clarity has not been available’, and add, ‘Systematic investigation is needed to determine what may differentiate psychoanalysis from other psychoanalytic psychotherapies’. Despite these caveats, from the name of their scales and from their discussion about what happens in psychoanalysis, the implication is unmistakable that they believe they are measuring ‘analytic process’. However, in the absence of any independent criteria for psychoanalysis, it is not possible to determine if they are measuring analytic process or psychotherapeutic process in the treatments they are examining. They have developed a reliable, quantitative method for assessing ‘what