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F. Busch's effort to distinguish psychoanalysis from psychotherapy elaborates that “the goals and treatment outcomes differentiate the two forms of treatment”. He points out that the “methods of working become distinguished based upon these factors”. In his view “the process of knowing is as important as what is known”. It is easy for me to agree that, in relatively successful psychoanalytic treatments, what can be achieved is a way of knowing, and not simply knowing. Whether the parameters of psychotherapy make it unlikely that the psychotherapy patient can reach this goal depends on the way a treatment format is installed. The shorter a treatment the less likely this capacity may develop. The interesting comparison resides in the comparison of long-term psychoanalytic treatments with low and high frequency as the German catamnestic project (Leuzinger-Bohleber et al., 2003) has studied. They found that, in high-frequency patients, the capacity for self-reflection and the internalization of the function of the analyst was more comprehensive, the reflection of what has changed more differentiated and the development of potential resources more creative than in long-term psychoanalytic therapy of low frequency. As these treatments were performed by well-trained analysts we might take home the message from this study that long-term treatments (average of 4 years' treatment in both groups) do achieve similar similar symptomatic outcome, but the more intensive version provides better chances of developing the self-analytic function.
These findings of the German study correspond only partially to the findings from the Stockholm study by Falkenström and his collegues that Busch cites. They carefully studied a random sample of 2 × 10 patients from psychoanalysis and long-term psychotherapy (out of the total sample) and identified categories of different types of post-treatment developments. Results indicate that the variation within treatment groups was large, and that deve