Response to Safran: The Development of Critical Psychoanalytic Sensibility

Jeremy D. Safran feels that my views regarding the relative merits of case studies and systematic empirical research are unnecessarily polarizing. I feel that, on the contrary, I'm offering bridges between my perspective and those of researchers on psychoanalytic process and outcome in two ways. One is through my own constructivist critique of traditional positivist case studies and theorizing based upon clinical experience. The second is through conceptualizing the place of systematic research within a constructivist paradigm. I am arguing that its place can be no different than that of case studies. Both generate possibilities for any particular analyst or analytic therapist to have in mind as he or she works with a particular patient at a particular moment. Safran locates the destructive effects of scientism with “biologically oriented researchers and cognitive therapists.” In my view, it might be convenient if the problem could be located exclusively with them, but the fact is that psychoanalytic researchers, as I demonstrate, are working largely within the same paradigm as their adversaries in the research world. That paradigm erroneously privileges systematic research as hypothesis-testing, whereas case studies are relegated to the status of anecdotal, hypothesis-generating work. I describe what I call “nonlinear constructivist learning” as the kind of “generalization” that case studies can yield and that is optimal for our field.