Psychoanalysis and Empirical Research: The Example of Patients Who Lack Psychological Mindedness

In psychoanalytic therapy the paucity of inner experiences … amounts to a severe impasse.

Alexithymia is possibly the most important single factor diminishing the success of psychoanalysis and psychodynamic psychotherapy.

At the threshold of the twenty-first century, psychoanalysis is being challenged increasingly to validate its theories and to demonstrate its therapeutic effectiveness through controlled outcome studies (Cooper, 1990; Edelson, 1988; Kaplan, 1981; Richards, 1990). The need to evaluate psychoanalytic theories empirically is especially important because theoretical concepts strongly influence clinical technique as well as the criteria used to select patients considered suitable for analysis.

One psychoanalytic concept that has strongly influenced clinical practice for several decades is the concept of psychological mindedness. Experienced clinicians generally hold the view that the prospects of successful psychoanalytic treatment are greatly enhanced if the patient is psychologically minded (Coltart, 1988; Gedo, 1988; Giovacchini, 1986; Luborsky and Spence, 1971). Surprisingly, however, there is a paucity of empirical data to support this conclusion. Indeed, in reviewing the literature, one finds that there has been little attempt to validate the construct of psychological mindedness; furthermore, studies evaluating its utility as a predictor of treatment outcome have