In this study we critically review the formal research literature pertinent to the outcomes of psychoanalysis and the factors influencing these outcomes. Our inquiry was conducted from a psychoanalytic perspective. We found the research yield consistent with the accumulated body of clinically derived psychoanalytic knowledge, e.g., patients suitable for psychoanalysis derive substantial therapeutic benefit; analyzability and therapeutic benefit are relatively separate dimensions and their extent is relatively unpredictable from the perspective of initial evaluation among seemingly suitable cases. The studies all contain clinical and methodological limitations which are no more substantial than in other forms of psychotherapy research, but they have not substantially advanced psychoanalytic knowledge. This raises challenges for the further development of formal research strategies native to psychoanalysis.
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References
1.
AbendS. (1986). Some problems in the evaluation of the psychoanalytic process. In The Science of Mental Conflict: Essays in Honor of Charles Brenner, ed.RichardsA. D.RichardsA. D.. Hillside, N.J.: Analytic Press, pp. 209–228
2.
AbramsS. (1987). The psychoanalytic process: a schematic model. Int. J. Psychoanal., 68:441–452
3.
AlexanderF. (1937). Five-Year Report of the Chicago Institute for Psychoanalysis:1932–1937.Chicago: Chicago Institute for Psychoanalysis
4.
AppelbaumS. A. (1977). The Anatomy of Change.New York: Plenum Press
5.
BachrachH. (1983). On the concept of analyzability. Psychoanal. Q., 52:180–204
6.
BachrachH. (1989). On specifying the scientific methodology of psychoanalysis. Psychoanal. Inq., 9:282–304
7.
BachrachH.BachrachH. (1978). Analyzability: a systematic review of the clinical and quantitative literature. J. Amer. Psychoanal. Assn., 20:881–920
8.
BachrachH.WeberJ.BachrachH.WeberJ. (1985). Factors associated with the outcome of psychoanalysis (clinical and methodological considerations): Report of the Columbia Psychoanalytic Center Research Project (IV). Int. Rev. Psychoanal., 43:161–174
9.
BaekelandR.BaekelandR. (1975). Dropping out of treatment: a critical review. Psychol. Bull., 82:738–783
10.
BerkR.OukerR.GoldartN.SwerdloffB.BerkR.OukerR.GoldartN.SwerdloffB. (1964). A profile study of the applicant not accepted for treatment at analytic clinics. Psychiat. Q., 30:1–17
11.
BerzinsJ.BednarR.BerzinsJ.BednarR. (1975). The problem of intersource consensus for measuring therapeutic outcome: new data and multivariate perspectives. J. Abnorm. Soc. Psychol., 84:10–19
12.
BradlowP. (1987). On prediction and the manifest content of the initial dream reported in psychoanalysis. In The Interpretation of Dreams in Clinical Work, ed.RothsteinA.. Madison, Conn.: Int. Univ. Press, pp. 155–178
CohenJ. (1969). Statistical Power Analysis for the Behavioral Sciences.New York: Academic Press
15.
CooperA.KarushA.EasserR.CooperA.KarushA.EasserR. (1966). The adaptive balance profile and the prediction of early treatment behavior. In Developments in Psychoanalysis at Columbia University, ed.GoldmanG.GoldmanG.. New York: Haffner, pp. 183–214
16.
CoriatI. (1917). Some statistical results of the psychoanalytic treatment of the psychoneuroses. Psychoanal. Rev., 4:209–216
17.
EisslerK. R. (1953). The effect of the structure of the ego on psychoanalytic technique. J. Amer. Psychoanal. Assn., 1:104–143
18.
ErleJ. (1979). An approach to the study of analyzability and analysis: the course of forty consecutive cases selected for supervised analysis. Psychoanal. Q., 48:198–228
19.
ErleJ.ErleJ. (1979). Problems in the assessment of analyzability. Psychoanal. Q., 48:48–84
20.
ErleJ.ErleJ. (1984). Observations on assessment of analyzability by experienced analysts. J. Amer. Psychoanal. Assn., 32:715–737
21.
FeldmanF. (1968). Results of psychoanalytic case assignments. J. Amer. Psychoanal. Assn., 16:274–300
22.
FenichelO. (1930). Statistisher Bericht über die therapeutische Tatigkeit 1920–1930. In Zehn Jahre Berliner Psychoanalytishes Institut.Vienna: Int. Psychoanal. Verlag, pp. 13–19
23.
FenichelO. (1945). The Psychoanalytic Theory of Neurosis.New York: Norton
24.
FiresteinS. (1978). Termination in Psychoanalysis.New York: Int. Univ. Press
25.
FiresteinS. (1984). The dilemma of analyzability. In Psychoanalysis: The Vital Issues, ed.PollockG.PollockG.. New York: Int. Univ. Press, pp. 227–248
26.
FiskeD. (1970). The planning of research on effectiveness of psychotherapy. Arch. Gen. Psychiat., 22:22–32
27.
FreudA. (1954). The widening scope of indications for psychoanalysis: discussion. J. Amer. Psychoanal. Assn., 2:607–620
28.
FreudS. (1914). On narcissism. S. E., 14
29.
FreudS. (1933). New introductory lectures on psychoanalysis. S. E., 22
30.
FreudS. (1937). Analysis terminable and interminable. S. E., 23
31.
GarfieldS.GarfieldS. (1986). Handbook of Psychotherapy and Behavior Change: An Empirical Analysis.New York: Wiley
32.
HamburgD. (1967). Report of the ad hoc committee on central fact-gathering data of the American Psychoanalytic Association. J. Amer. Psychoanal. Assn., 15:841–861
33.
HorwitzL. (1974). Clinical Prediction in Psychotherapy.New York: Aronson
34.
HuxsterH.LowerR.HuxsterH.LowerR. (1975). Some pitfalls in the assessment of analyzability in a psychoanalytic clinic. J. Amer. Psychoanal. Assn., 23:90–106
35.
JonesE. (1936). Decannual Report of the London Clinic of Psychoanalysis, 1926–1936
36.
KantrowitzJ. (1987). Suitability for psychoanalysis. In The Yearbook of Psychoanalysis and Psychotherapy.New York: Guilford Press, pp. 403–415
37.
KantrowitzJ.KatzA.KantrowitzJ.KatzA. (1990a). Follow-up of psychoanalysis five to ten years after termination: I. Stability of change. J. Amer. Psychoanal. Assn., 38:471–496
38.
KantrowitzJ.KatzA.KantrowitzJ.KatzA. (1990b). Followup of psychoanalysis five to ten years after termination: II. Development of the self-analytic function. J. Amer. Psychoanal. Assn., 38:637–654
39.
KantrowitzJ.KatzA.KantrowitzJ.KatzA. (1990c). Followup of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match. J. Amer. Psychoanal. Assn., 38:655–678
40.
KantrowitzJ.KatzA.PaolittoF.SashinJ.KantrowitzJ.KatzA.PaolittoF.SashinJ. (1987a). Changes in the level and quality of object relations in psychoanalysis: followup of a longitudinal prospective study. J. Amer. Psychoanal. Assn., 35:23–46
41.
KantrowitzJ.KatzA.PaolittoF.SashinJ.KantrowitzJ.KatzA.PaolittoF.SashinJ. (1987b). The role of reality testing in the outcome of psychoanalysis: followup of 22 cases. J. Amer. Psychoanal. Assn., 35:367–386
42.
KantrowitzJ. (1989). The patient-analyst match and the outcome of psychoanalysis: a pilot study. J. Amer. Psychoanal. Assn., 37:893–920
43.
KantrowitzJ.SingerJ.KantrowitzJ.SingerJ. (1975). Methodology for a prospective study of psychoanalysis: the role of psychological tests. Psychoanal. Q., 44:371–391
44.
KarushA. (1956). People who seek help: a diagnostic survey. In Changing Concepts in Psychoanalysis, ed.RadoS.RadoS.. New York: Grune & Stratton, pp. 69–84
45.
KarushA.EasserR.CooperA.KarushA.EasserR.CooperA. (1964). The evaluation of ego strength: a profile of adaptive balances. J. Nerv. Ment. Dis., 130:332–349
46.
KernbergO. (1972). Psychotherapy and psychoanalysis: final report of the Menninger Foundation Psychotherapy Research Project. Bull. Menninger Clin., 36:3–275
47.
KesselL.KesselL. (1933). The value of psychoanalysis as a therapeutic procedure. J. Amer. Med. Assn., 101:1612–1615
48.
KleinH. (1960). Changes in and after psychoanalytic treatment. In Current Approaches to Psychoanalysis, ed.HochP.HochP.. New York: Grune & Stratton, pp. 151–175
49.
KnappP. (1960). Suitability for psychoanalysis: a review of one hundred supervised analytic cases. Psychoanal. Q., 29:459–477
50.
KnightR. P. (1941). Evaluation of the results of psychoanalytic therapy. Amer. J. Psychiat., 98:434–446
51.
KrisM. (1957). The use of prediction in a longitudinal study. Psychoanal. Study Child, 12:175–189
52.
KuhnT. (1977). The Structure of Scientific Revolutions (2nd ed.). Chicago: Univ. Chicago Press
53.
LazarN. (1973). The nature and significance of changes in patients in a psychoanalytic clinic. Psychoanal. Q., 42:579–600
54.
LuborskyL. (1962). Clinicians judgments of mental health: a proposed scale. Arch. Gen. Psychiat., 7:407–417
55.
LuborskyL. (1984). Principles of Psychoanalytic Psychotherapy: A Manual for Supportive-Expressive Treatment.New York: Basic-Books
56.
LuborskyL.Crits-ChristophP.MintzJ.LuborskyL.Crits-ChristophP.MintzJ. (1988). Who Will Benefit from Psychotherapy? Predicting Therapeutic Outcomes.New York: Basic Books
57.
MintzJ.LuborskyL.MintzJ.LuborskyL. (1979). Measuring the outcomes of psychotherapy: findings of the Penn Psychotherapy Project. J. Consult. Clin. Psychol., 47:319–344
58.
NormanH.BlackerK.OremlandJ.NormanH.BlackerK.OremlandJ. (1976). The fate of the transference neurosis after termination of a satisfactory analysis. J. Amer. Psychoanal. Assn., 24:471–498
59.
OberndorfC. (1943). Results of psycho-analytic therapy. Int. J. Psychoanal., 24:107–114
60.
OremlandJ.BlackerK.OremlandJ.BlackerK. (1975). In completeness in “successful” psychoanalyses: a followup study. J. Amer. Psychoanal. Assn., 23:819–844
61.
Panel (1953). The traditional psychoanalytic technique and its variations. E. Zetzel, reporter. J. Amer. Psychoanal. Assn., 1:526–537
62.
Panel (1958). Variations in classical psychoanalytic technique. Int. J. Psychoanal., 39:200–242
63.
Panel (1960). Criteria for analyzability. S. A. Guttman, reporter. J. Amer. Psychoanal. Assn., 8:141–151
64.
Panel (1963). Analysis Terminable and Interminable—twenty-five years later. A. Pfeffer, reporter. J. Amer. Psychoanal. Assn., 11:131–142
65.
Panel (1964). Theory of psychoanalytic therapy. L. Altman, reporter. J. Amer. Psychoanal. Assn., 12:620–631
66.
Panel (1968). Indications and contraindications for psycho-analytic treatment. Int. J. Psychoanal., 49:254–275
67.
Panel (1976). Current concepts of the psychoanalytic process. S. Morgenstern, reporter. J. Amer. Psychoanal. Assn., 24:181–195
68.
Panel (1977). Psychic change in psychoanalysis. A. Compton, reporter. J. Amer. Psychoanal. Assn., 25:669–678
69.
Panel (1979). Conceptualizing the nature of the therapeutic action in psychoanalysis. M. Scharfman, reporter. J. Amer. Psychoanal. Assn., 27:627–642
70.
PfefferA. Z. (1959). A procedure for evaluating the results of psychoanalysis: a preliminary report. J. Amer. Psychoanal. Assn., 7:418–444
71.
PfefferA. Z. (1961). Followup study of a satisfactory analysis. J. Amer. Psychoanal. Assn., 9:698–718
72.
PfefferA. Z. (1963). The meaning of the analyst after analysis. J. Amer. Psychoanal. Assn., 11:229–244
SargentH.HorwitzL.WallersteinR.SargentH.HorwitzL.WallersteinR. (1968). Prediction in Psychotherapy Research. Psychol. Issues, Monogr. 21. New York: Int. Univ. Press
75.
SashinJ.EldredS.SashinJ.EldredS. (1975). A search for predictive factors in institute supervised cases: a retrospective study of 183 cases from 1959–1966 at the Boston Psychoanalytic Society and Institute. Int. J. Psychoanal., 56:343–359
76.
SchlessingerN. (1984). On analyzability. In Psychoanalysis: The Vital Issues, ed.GedoJ.GedoJ.. Madison, Conn.: Int. Univ. Press, pp. 249–274
77.
SchlessingerN.SchlessingerN. (1974). Assessment and followup in psychoanalysis. J. Amer. Psychoanal. Assn., 22:542–567
78.
SchlessingerN.SchlessingerN. (1975). The psychoanalytic process: recurrent patterns of conflict and change in ego functions. J. Amer. Psychoanal. Assn., 23:761–782
79.
ShevrinH. (1984). The fate of the five metapsychological principles. Psychoanal. Inq., 4:33–58
80.
StewardI. (1989). Does God Play Dice?New York: Basil-Blackwell
81.
StoneL. (1954). The widening scope of indications for psychoanalysis. J. Amer. Psychoanal. Assn., 2:567–594
82.
SwerdloffB. (1963). The Predictive Value of the Admission Interview. Doctoral Dissertation, Columbia University
83.
Symposium (1937). On the theory of therapeutic results of psychoanalysis. Int. J. Psychoanal., 18:125–189
84.
Symposium (1948). On the evaluation of therapeutic results. Int. J. Psychoanal., 29:7–33
85.
Symposium (1950a). On the criteria for termination of an analysis. Int. J. Psychoanal., 31:200–204
86.
Symposium (1950b). On the termination of psycho-analytical treatment. Int. J. Psychoanal., 31:191–199
87.
Symposium (1956). Problems of transference. Int. J. Psychoanal., 37:367–395
88.
TichoE. (1970). Differences between psychoanalysis and psychotherapy. Bull. Menninger Clin., 34:128–138
89.
TysonA.TysonA. (1971). Problems in the selection of patients for psychoanalysis: comments on the application of concepts of ‘indications’, ‘suitability’ and ‘analyzability’. Brit. J. Med. Psychol., 44:211–228
90.
WaelderR. (1963). Psychic determinism and the possibility of prediction. Psychoanal. Q., 32:15–24
91.
WaldhornH. (1967). Indications for Psychoanalysis, ed.JosephE.. Kris Study Group Monograph of the New York Psychoanalytic Institute.New York: Int. Univ. Press
92.
WallersteinR. S. (1986). Forty-two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy.New York: Guilford Press
93.
WallersteinR. S.WallersteinR. S. (1971). Issues in research in the psychoanalytic process. Int. J. Psychoanal., 52:11–50
94.
WeberJ.BachrachH.WeberJ.BachrachH. (1985a). Factors associated with the outcome of psychoanalysis: report of the Columbia Psychoanalytic Center Research Project (II). Int. Rev. Psychoanal., 12:127–141
95.
WeberJ.BachrachH.WeberJ.BachrachH. (1985b). Factors associated with the outcome of psychoanalysis: report of the Columbia Psychoanalytic Center Research Project (III). Int. Rev. Psychoanal., 12:251–262
96.
WeberJ.BradlowP.MossL.WeberJ.BradlowP.MossL. (1974). Predictions of outcome in psychoanalysis and analytic psychotherapy. Psychiat. Q., 40:1–33
97.
WeberJ.ElinsonJ.WeberJ.ElinsonJ. (1966). The application of ego strength scales to psychoanalytic clinic records. In Developments in Psychoanalysis at Columbia University, ed.GoldmanG.GoldmanG.. New York: Hafner
98.
WeberJ.ElinsonJ.WeberJ.ElinsonJ. (1967). Psychoanalysis and change. Arch. Gen. Psychiat., 17:687–708
99.
WeinshelE. (1984). Some observations on the psychoanalytic process. Psychoanal. Q., 53:63–92
