Psychoanalytic treatments and empirical research on their efficacy: A commentary

Abstract

The author summarizes the problems inherent in nomological approaches examining the efficacy of psychoanalysis as a form of treatment. He argues that nomologically oriented research operates with assumptions lacking empirical foundation and, moreover, that studies of this type merely give the impression of the effectiveness of psychoanalytic therapies while overlooking the specificity of the psychoanalytic method. He suggests that research into psychoanalytic treatments should not be subjected to a nomological conception of science, and that structural analysis of treatment courses should be examined and systematized within the frame of psychoanalytic treatment theory relative to their outcome. Given this approach, and provided that the theory of treatment is based on conceptual common ground, such studies would enable a prognostic conclusion that psychoanalytic treatments are successful, providing that the sequences generalized in the treatment theory do actually take place in treatments that take patients’ individuality into account.

Key words:

• psychoanalytic treatments
• nomological approach
• efficacy research
• epistemology

Acknowledgments

I would like to thank Judith Zepf for her painstaking work in re-editing the original manuscript.

Author

Siegfried Zepf, MD, is former director of the Institute of Psychoanalysis, Psychotherapy and Psychosomatic Me­dicine of the University of Saarland, and a training analyst of the German Psychoanalytic Society (DPG).

Notes

1 The term “efficacy” relates to the question of whether a treatment works under ideal conditions, that is, under conditions where bias is excluded as far as possible, whereas the terms “efficiency” and “effectiveness” relate to the pragmatic question of whether a treatment works in routine clinical care (Howard, Moras, Brill, Martinovich, & Lutz, 1996).

2 Mainly with a view to showing that the unsolved problems arising out of the subsuming of empirical psychoanalytic research practice within the nomological ideal of science have not only just been recognized, but also long been known and remained methodologically unresolved, I have substantially based my argument on the work of earlier authors.

3 This is reason why I object to Luyten, Blatt, and Corveleyn’s (2006) plea to bridge the gap between positivism and hermeneutics in psychoanalytic research by accepting a methodological pluralism.