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Let me begin by asserting two propositions that many in our field think of as opposed to each other but which I regard as adequately capturing the hybrid nature of the discipline known as psychoanalysis: First, psychoanalysis is a hermeneutic discipline, a method by which we come to understand and interpret human meanings, in particular unconscious meanings. Second, psychoanalysis is a scientific discipline, an attempt to link the meanings that humans create to basic emotional and motivational systems, systems that are in turn linked to brain function and structure. In the context of this review, I can only assert, not argue the validity of these two propositions, but I mention them for some important reasons, given that I am reviewing a lengthy book on the state of scientific evidence with regard to psychodynamic psychotherapy, a term here taken to mean, as in the book under review, psychoanalysis and the various forms of psychotherapy that are derived from psychoanalytic principles.
One reason is that there is increasing conflict within the field of as to what kind of discipline is psychoanalysis. Is it a hermeneutic discipline, perhaps a wisdom tradition or part of the humanities? Or is it a science, part of the effort to understand the natural world? Representatives of these two divergent perspectives, often leaders in the field (e.g., Eagle & Wolitzky, 2011; Hoffman, 2009), seem to talk past each other, with rigid positions sometimes drawn about an essentially metatheoretical debate, rather than about what I regard as more properly psychoanalytic issues like the relative roles of relational (attachment), sexual, and selfobject (narcissistic) needs in human development or the relative roles of relationship, clinical technique, and accuracy of interpretation in the outcome of an analysis. No doubt there are many reasons for this state of affairs, but I think that any analytic clinician will recognize that rigidity often indicates defense against anxiety, and I sus