Can psychoanalytic research integrate and improve knowledge for clinical practice?: Some reflections and an example1

This paper argues that scientific research in psychoanalytically-based disciplines has beneficial effects for psychoanalysis and its practitioners. First, systematic collection of relevant data yields comprehensive information about several key aspects of clinical practice that would otherwise evade awareness. Second, well-conducted studies may increase our knowledge concerning the effectiveness of psychoanalytic therapy, which is more than ever in urgent need of validation. Third, data generated from clinical case studies, upon which psychoanalysis relies to build its rationale and further clinical development, is not considered an acceptable method of scientific scrutiny; alternative, extra-clinical ways of studying psychoanalytic claims are needed to integrate clinical findings. Fourth, in the current unfavourable climate for psychoanalytically-based treatment, it is vital that bridges with other disciplines are built through the development of a set of empirically derived knowledge. This would strengthen our claims and create fertile ground for cross-fertilisation and dialogue with allied fields such as general psychiatry and clinical psychology. Fifth, there is still grave uncertainty and disagreement as to which components of the psychoanalytic encounter are responsible for structural change. Reliance on clinical case studies has not advanced our ability to generalise findings and find consensus. In order to exemplify some of these points, the main findings of a prospective study of the psychoanalytically-informed treatment of personality disorder are presented and discussed.