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The aim of this panel was to discuss this question in the framework of the international, multi-center research project: ‘A randomized controlled study of psychoanalysis and other psychotherapies’, which is being developed by the Long-term Psychoanalysis and Psychotherapy Research Group (LPPRG). The project is a controlled-outcome comparative study of four psychotherapies: cognitive-behavioral, psychodynamic, psychoanalysis and a supportive-therapy control group. Chairs of the different teams are: J. Christopher Perry (Montréal), Brian M. Robertson (Westmount), Paul Crits-Christoph (Philadelphia, PA), Per Hoglend (Oslo), R. Willem Trijsburg (Amsterdam), Thijs de Wolfe (Amsterdam) and Jean-Nicolas Despland (Lausanne).
In the introduction, the moderator (and discussant) proposed to set the question in the broader context of the crisis of psychoanalysis which Fonagy (2002) describes as the difficulty of psychoanalysis to build ‘a solid knowledge base’ in light of the lack of an ‘organizing paradigm’ and ‘an absence of shared assumptions’. In this sense, the three papers are a demonstration of the strong reaction to the crisis, accepting the challenge for systematic observation and comparison of the psychoanalytic process and its consequences in the psychoanalytic practice. The group addresses many prejudices common among the psychoanalytic community; such as establishing therapeutic goals; assessing clinical progress; comparing psychoanalysis with other therapies; and recording psychoanalytic treatments.
In his paper ‘Structural changes’, Thijs de Wolfe asked fundamental questions such as: When do we speak of structural changes? What can we understand for psychical structure? And how will this structure be modified in the therapeutic process?
Regarding psychoanalytic treatment, he put himself in an intersubjective perspective, where the process will be understood as mutual interactions and where the individuals are built from their inner patterns. These inner patterns are