Analytic Clinicians Find Empirical Research Valuable

In 2007 I created a power point presentation, in collaboration with Nancy McWilliams and James Hansell, entitled, “The Enduring Significance of Psychoanalytic Theory and Practice.” In the presentation I surveyed some of the seminal empirical studies of the effectiveness of psychoanalysis and psychoanalytic psychotherapy; I also included some empirical studies of psychoanalytic concepts, such as transference, unconscious conflict, and unconscious motivation.

The idea originally was conceived out of a need for a presentation for lay audiences and non-psychoanalytic clinicians, which could clear up some of the myths and misconceptions about psychoanalysis that have contributed to its waning respect and prominence in the last few decades. The presentation was made available on the Web sites of the American Psychoanalytic Association and Division 39 of the American Psychological Association. A piece in the newsletters of Division 39 and the American Psychoanalytic Association, that I wrote with Nancy McWilliams, generated many responses. It seemed that a number of individuals throughout the U.S. and Canada intended to make the presentation in various settings, including hospitals, community mental health centers, and undergraduate courses. This was good news; it was how we hoped people would use the presentation.

But then an event occurred that I had not expected, in terms of the value of this outreach tool. This past spring I made the presentation to the Weill Cornell psychiatry residency supervisory faculty at New York Presbyterian Hospital. (Many were psychoanalysts, graduates of the Columbia Psychoanalytic Institute and the New York Psychoanalytic Institute.) When I was asked to present I was at first surprised at the request, because I thought I would be preaching to the converted who already had knowledge of the studies I would cover. As it turned out, I was indeed preaching to the converted, but what also became clear was that nearly all the attendees were entirely unfamiliar with the empirical studies on psychoanalytic treatment and concepts.

Participants said they were thankful to have knowledge of such research so as to be able to respond better to questions and concerns about psychoanalytic treatments and concepts that might come from patients and/or their family members, supervisees, non-analytic clinicians, and anybody else who asked or offhandedly criticized. Also, the attendees noted that such empirical knowledge, which supported their day-to-day clinical work, served to boost their morale (evident in the palpable level of enthusiasm that evening). Psychoanalytic practitioners have faced various disparaging and demoralizing attacks on several fronts. It would therefore seem important for them to be informed of the number of research studies that supports the practice of psychoanalytic treatments and confirm many of the theoretical constructs that analytic clinicians depend on.

Attitudes toward psychoanalytic research vary greatly within our field. For the most part, it seems analysts are disinterested in and unaware of relevant research findings. Others are openly hostile and attacking. A relative few are actively interested in research and are conducting empirical studies. Joseph Schacter and Lester Luborsky published a paper in 1998 on the results of a poll of analysts about the percentage of research papers they read compared to the number of clinical papers they read. The analysts with higher degrees of conviction that their rationales and techniques were sound and effective reportedly read fewer research articles than less convinced analysts. About this finding they speculated that “analysts with high levels of confidence in their rationales and techniques may be defending against concerns that they have significant covert doubts about their rationales and techniques.” They went on to say “analysts' capacity to tolerate doubts about their work may seriously conflict with a sense or explicit belief that confidence in their analytic work is an important, perhaps essential, mutative force in their treatment. It seems very understandable that such a belief would press analysts to minimize or deny feelings of uncertainty about their work.”

But what if analysts learned that the empirical research on psychoanalytic treatments and concepts often supported the belief that these treatments and concepts are sound? Would most of them have a similar reaction to that of the Weill Cornell psychiatry residency supervisory faculty? Those individuals seemed to greatly appreciate learning about the research (which showed favorable outcomes for psychoanalysis and for psychoanalytic psychotherapy). They felt it was useful information to have, and it seemed to boost their morale when it came to practice.

Throughout my experience as a candidate at the New York Psychoanalytic Institute, I have reflected on the process of developing an identity as an analyst. This process has included developing confidence in psychoanalysis as an effective treatment method. Along the way, I have heard many times that the amount of experience you have conducting analysis invariably impacts the degree of confidence you have in practicing and recommending analysis. This made sense to me; seeing firsthand how analysis could be helpful would increase a beginning analyst's confidence. But if confidence in the treatment method is an important aspect of developing an identity as an analyst, wouldn't it also be helpful to be exposed to research that shows support for the effectiveness of analysis, as another means of gaining confidence, especially at a time when so many critics claim that analytic work is a waste of time, or even unethical?

In the last decade, many institutes have included courses on research as part of their adult psychoanalytic training curricula. This is an important shift in the psychoanalytic community toward developing an awareness of how exposure to research is valuable in helping candidates develop an analytic identity. I would also suggest that many non-candidate members of this organization could benefit from gaining knowledge of the empirical research on psychoanalytic treatment and concepts. Such information may not necessarily affect one's morale or confidence in the effectiveness of analytic work, but it might. It may also be used when talking with the uninformed or misinformed, or when discussing the relevance of analytic training in the 21st century with prospective candidates.

I hope to be able to present this data about empirical studies to as many analytic and non-analytic audiences as possible. Feel free to contact me regarding presentations at .