Psychoanalytic approaches and outcome research: Negative capability or irritable reaching after fact and reason?

1. This paper is a modified version of a talk given in 2007 as the Annual Research Lecture, Institute of Psychoanalysis.

Abstract

Keats famously proposed ‘negative capability’ as a key attribute of those who are original in science and literature. Bion directed the attention of psychoanalysts to some of the implications of this stance for the psychoanalytic method. Although the methods of formal outcome study have very different antecedents they also aim at the ideal of ‘research equipoise’. In relation to experience with the Tavistock Depression Study3 this paper explores how these different approaches may be comparable, and how much in conflict, in an environment where there are many pressures operating, and where both types of research are conducted for economic, social and political motives as well as to sustain. It is suggested that the explicit recognition of these issues may help both researchers and clinicians to address the important practical matters concerning the design, planning and conduct of research into outcome in psychoanalytic psychotherapy.

Keywords:

• negative capability
• research equipoise
• psychological therapy outcome research
• explanation and understanding

Notes

1. This paper is a modified version of a talk given in 2007 as the Annual Research Lecture, Institute of Psychoanalysis.

2. D.T. [[email protected]] is a training analyst of the British Psychoanalytic Society and clinical director of the Tavistock Adult Depression Study.

3. The Tavistock Adult Depression Study (Publication ID M0001169680 at http://www.nihr.ac.uk) is examining the efficacy of medium-term (60 sessions) weekly psychoanalytic psychotherapy v. treatment as usual in 125 patients with treatment-resistant depression. Eligibility criteria include at least two failed treatments as well as a diagnosis of major depressive disorder. The trial, which is funded by the Tavistock & Portman NHS Foundation Trust along with individual covenants and small grants from the International Psychoanalytic Association, is due to report in 2012–2013. Complex trials of this kind depend upon the work and commitment of a large team of people. The core TADS research team is: Clinical Director, David Taylor; Principal Investigator Prof. Peter Fonagy (formerly Phil Richardson); Prof. David Shapiro provided valuable consultation and advice; Researchers: Senior Researchers: Felicitas Rost (formerly Adam Campbell, Susan McPherson, & Jo-anne Carlyle): Junior Researchers: Rebecca Johnson (formerly Lucy Gibson, Donna Oxley, Rachel Tucker, Lucy Chan, Peter Cairns); Research Administration: Sharon Novara; Res. Clinician: Rachel Thomas; Susan McPherson, & Jo-anne Carlyle continue to support the Trial as Hon. TADS Researcher. TADS research affiliates are Drs. Niloufar Noktehdan & Hiroshi Amino, & Maxine Dennis. Clinicians/Therapists: Helen Barker, Mary Bradbury, Cyril Couve, Stephen Dreyer, Marcus Evans, Caroline Garland, Liz Gibb, Francesca Hume, Birgit Kleeberg, Julian Lousada, Michael Mercer, David Millar, Matthew Patrick, Maria Rhode, Phil Stokoe, Nollaig Whyte. We have received great support over a long period from the Chair (Prof. Sir David Goldberg) and members of the TADS External Steering Committee (Dr Sue Blake, Dr Marta Busziewicz, John Cape, Paul McCrone, and Prof. Irwin Nazareth).

Additional information

Notes on contributors

David Taylor

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