This spring members of The American received a letter signed by its officers and myself requesting assistance in identifying foundations and philanthropic individuals who might support a multisite collaborative research program on psychoanalytic therapy processes and outcomes. This program, vital to the future of psychoanalysis as a science of the mind, is also of real potential in securing our acceptance as a therapeutic enterprise and the public's willingness to support it economically.
The immediate stimulus to creating the program was the prospect for substantial funding that arose when a member of The American, who had become president of a newly formed private foundation, potentially interested in supporting empirical research on the efficacy of psychoanalysis, approached Homer Curtis, then president of The American. In response, Curtis asked me to organize and chair a consortium of established psychoanalytic researchers. In a preliminary meeting between the president of the foundation and officers of The American, in which I also participated, it was ascertained that the foundation would be receptive to an application at the level fo approximately half a million dollars per year over a five-year span. With this, I undertook to organize the consortium and to prepare a grant application under auspices of The American.
In almost no time, fifteen research groups, representing every known psychoanalytic project studying the processes and outcomes of psychoanalytic therapy, were recruited to the consortium. In alphabetical order, the principal (and co-principal) investigators are (1) Wilma Bucci of Adelphi University, New York; (2) Hartvig Dahl of SUNY Health Science Center, Brooklyn, New York; (3) Stuart Hauser of Harvard Medical School and Boston University; (4) Mardi Horowitz of the University of California, San Francisco; (5) Leonard Horwitz of the Menninger Foundation, Topeka, Kansas; (6) Enrico Jones of the University of California, Berkeley; (7) Judy Kantrowitz of the Boston Psychoanalytic Society and Institute;
(8) Otto Kernberg and Harold Koenigsberg of Cornell Medical Center, Westchester Division; (9) Lester Luborsky and Paul Crits-Cristoph of the University of Pennsylvania; (10) Christopher Perry and Steven Cooper of Cambridge Hospital and Harvard Medical School; (11) Herbert Schlesinger of the New School for Social Research, New York; (12) George Silberschatz and John Curtis of Mt. Zion Hospital, San Francisco; (13) Donald Spence of Rutgers University; (14) Sherwood Waldron, Jr., of the New York Psychoanalytic Institute and Society; and (15) Robert Wallerstein of the University of California, San Francisco.
This group, the Multi-Site Collaborative Program of Psychoanalytic Therapy Research, first met in an all-day session at the meeting of The American in May 1990 and has met in an all-day session at each meeting of The American since. Together it hammered out the structure of a collaborative research program which I worked up into a formal research proposal. It was submitted to the foundation in time to be considered at a fall 1990 meeting, with funding possibly to begin in January 1991.
The consortium comprises an array of distinguished investigators who have devoted lifetimes of productive work to empirical psychoanalytic therapy research, some senior enough that their working careers will extend no more than 5 to 10 years. They each would apply methods and instruments of their own device to a common data base of audiotaped and transcribed psychoanalytic hours—chosen according to consensually established criteria—so that in an annual weeklong meeting the data, the findings, and the conclusions of each could be contrasted and compared with the data, findings, and conclusions of each of the others. This process of seeking congruences and divergences holds promise of a quantum leap in our knowledge of the psychoanalytic change process and its attainable outcomes. As things stand today, investigators use their own concepts and instruments on whatever data base is at hand, with no opportunity for real comparison or contrast.
Were the proposal to be funded, each of 14 of the groups would receive approximately $25,000 per annum (one of them, being amply funded, is willing to forgo the money). This bare-bones funding of the components would account for around $350,000 of the total annual expense. The balance of the budget would cover the expenses of the annual week-long meeting of the consortium (about $25,000) and the expenses of the central supporting staff, including a full-time program administrator and supporting secretarial staff under my supervision at the University of California, San Francisco, and an archival staff at the Menninger Foundation, Topeka, Kansas, under Alice Brand Bartlett's supervision, responsible for transcribing, sanitizing, coding, cataloguing, and setting up retrieval mechanisms for our growing library of audiotaped analyses.
Unfortunately, the proposal has not yet been funded. The foundation's president met with the group in December 1990 and relayed both a number of questions his board had about the grant proposal and also the news that the foundation was at the moment less well funded than had been anticipated; some major pledges had not been paid in the promised time. The board's questions were responded to in that session, and the group was encouraged to resubmit the proposal scaled down to two years, on the understanding that on the basis of work accomplished, and with the expected improved financial status of the foundation two years hence, a subsequent three-year renewal application could be entertained. This invited reapplication was (after a year's delay) also denied, this time without explanation. The consortium and the officers of The American have reluctantly concluded that this foundation is not a viable funding source.
In the meantime, the consortium is organized and meets twice annually during the meetings of The American. In December 1991 consultation was held with a nationally recognized expert in the statistics of sequential interactions over time, an area crucial to the research strategies of many consortium members. In May 1992 the group met with National Institute of Mental Health officials concerned with federal research support for psychosocial and psychotherapy research. Today the consortium stands poised, ready to inaugurate this promising and important program, lacking only funding.
At this point there are no evident funding sources for this major research effort. If none are found, the continued existence of this consortium and its collaborative research program is problematic. The letter that went out this spring to members of The American has as yet yielded no leads, and despite the May 1992 meeting with NIMH, federal funding does not appear to be a really viable alternative. Ever since the structural reorganization of the NIMH several years back, the climate has been increasingly more difficult for any kind of “psychosocial” research, and especially so for “psychodynamic” research. Many of the members of our consortium have over their careers enjoyed substantial research support from NIMH; at the moment, however, only one does, and that person is currently the only recipient of an NIMH research grant for psychodynamic therapy research. At present it seems counterproductive to invest the enormous amount of time and energy necessary to fashion a properly competitive NIMH research application.
Hardly more likely to succeed is a fund-raising appeal to members of The American. The Fund for Psychoanalytic Research, which the majority of members already supports, funds a diversified array of psychoanalytic research programs (not just therapy research) but brings in only some $60,000 per year on average. Even were all of that to be deflected into support for the multi-site collaborative program, it would cover only a small fraction of our budget. I, along with the other members of the consortium, await other ideas on funding possibilities.