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With his classical six case reports, Freud set the model for scholarly writing of generations of psychoanalysts. In light of today's scientific criteria for a case study, however, except for the Schreber case, they fail in a very critical respect by not allowing an assessment of the material independently of Freud's processing of it. Thus, the here-and-now proceedings, in the sense of what took place, are confounded with the then-and-there hindsights, afterthoughts, and reflections in the analyst's mind. There is a risk that it ends up in fiction rather than fact. However clinically meaningful and inspiring this may feel, the psychoanalytic case reports are less than scientifically convincing to many readers, and this may have contributed to the current widespread distrust of psychoanalysis in psychology and psychotherapy.
The shortcomings of the psychoanalytic clinical case report are the point of departure of an important recent book edited by Horst Kächele, Joseph Schachter and Helmut Thomä, with contributions from the Psychoanalytic Process Research Group at the University of Ulm, Germany: From psychoanalytic narrative to empirical single case research. The editors are distinguished senior psychoanalysts and, importantly, among the very pioneers and advocates of what has somewhat erroneously been called empirical research in psychoanalysis — after all, the psychoanalyst's recall and reflections are empirical, too, in the sense of being based on observations. Relating to Freud's claim that, in analytical work, treatment and research coincide, the authors note that “a number of case-report-based theories have proven to be erroneous” (p. 3). As Spence (1994) has noted, interpretations unfortunately tend to reflect the analyst's expectations rather than the facts of the matter. Therefore, Weiss & Sampson (1986) have suggested that it is necessary to study the psychoanalytic process in a more formalized and systematic way.
The alternative offered by Kächele, Schachter