Can Analysts Agree? The Problems of Consensus and the Psychoanalytic Mannequin: II. Empirical Tests

Abstract

The present investigation reports on the execution of an empirical strategy for testing agreement in complex clinical psychoanalytic propositions, and for testing whether stereotypical assumptions are overridden (revised) by the specific character of the patient's narrative. The findings reveal that, in general, for the several domains of psychoanalytic formulation, psychoanalyst judges reach superior levels of ordinal agreement, and modest to good levels for agreement on magnitude. Moreover, formulations based on verbatim psychoanalytic sessions pass the “test of the mannequin” in most domains, i.e., surpass stereotypical psychoanalytic assumptions about the patient's dynamics. The mannequin concept, here operationalized, introduces a new and epistemically crucial consideration for the making of psychodynamic formulations. Other novel contributions of these studies include the development of operationalized measures of (reconstructive) historical linkage, and the introduction of magnitudinal agreement in this empirical area.

Get full access to this article

View all access options for this article.

References

Bernfeld, S. (1941). The facts of observation in psychoanalysis. J. Psychol., 12:289–305.

Bernstein, A. L. (1964). A Handbook of Statistics Solutions for the Behavioral Sciences. New York: Holt, Rinehart & Winston.

Caston, J. (1980). Manual on how to diagnose the plan. Mt. Zion Hasp. & Med.Cntr. Bull., 4:31–55.

Caston, J. (1986). The reliability of the patient's unconscious plan. In The Psycho analytic Process: Theory, Clinical Observations, and Empirical Research, ed. J. Weiss & H. Sampson . New York: Guilford Press, pp. 241–256.

Caston, J. (1993). Can analysts agree? The problems of consensus and the psychoanalytic mannequin: I. A proposed solution. J. Amer. Psychoanal. Assn., 41:493–511.

Gill, M. M. & Hoffman, I. (1982). A method for studying the analysis of aspects of the patient's experience of the relationship in psychoanalysis and psychotherapy. J. Amer. Psychoanal. Assn., 30:137–167.

Horowitz, L. M. , Inouye, D. & Siegelman, E. Y. (1979). On averaging judges' ratings to increase their correlation with an external criterion. J. Consult. Clin. Psychol., 47:453–458.

Horowitz, M. (1979). States of Mind. New York: Plenum Press.

Jones, E. & Windholz, M. (1990). The psychoanalytic case study: toward a method for systematic inquiry. J. Amer. Psychoanal. Assn., 38:985–1015.

10.

Lawlis, G. F. & Lu, E. (1972). Judgment of counseling process: reliability, agreement, and error. Psychol. Bull., 78:17–20.

11.

Luborsky, L. (1977). Measuring a pervasive psychic structure in psychotherapy: the core conflictual relationship theme. In Communicative Structures and Psychic Structures, ed. N. Freedman & S. Grand . New York: Plenum, pp. 501–526.

12.

McCall, R. B. (1980). Fundamental Statistics for Psychology. New York: Harcourt Brace Jovanovich.

13.

Peterfreund, E. (1983). The Process of Psychoanalytic Therapy: Models and Strategies. Hillsdale, NJ: Analytic Press.

14.

Reichenbach, H. (1951). The Rise of Scientific Philosophy. Berkeley, CA: Univ. Calif. Press.

15.

Seitz, P. (1966). The consensus problem in psychoanalytic research. In Methods of Research in Psychotherapy, ed. L. A. Gottschalk & A. H. Auerbach . New York: Appleton-Century-Crofts, pp. 209–225.

16.

Siegel, S. (1956). Nonparametric Statistics. New York: McGraw-Hill.

17.

Spence, D. P. (1982). Narrative Truth and Historical Truth: Meaning and Interpretation in Psychoanalysis. New York: Norton.

18.

Tinsley, H. E. A. & Weiss, D.J. (1975). Interrater reliability and agreement of subjective judgments. J. Counsel. Psychol., 22:358–376.

19.

Weiss, J. , Sampson, H. & Mt. Zion P Group (1986). The Psychoanalytic Process: Theory, Clinical Observations, and Empirical Research. New York: Guilford Press.