BRITISH JOURNAL OF PSYCHOTHERAPY

EDITORIAL

Volume 13, Number 1, Autumn 1996, pp.1-2

Psychoanalysis and the psychotherapies based on it have proliferated without the benefit of scientific validation for 100 years, growing into a world-wide movement of tremendous cultural significance. Yet, we constantly face the embarrassment of not having a body of research firmly demonstrating its scientific basis. When Eysenck threw down the gauntlet in 1953, declaring that there was no scientific evidence for the value of the psychotherapies, that they were no more effective than 'spontaneous remission' in control groups and calling for the end of psychotherapy training, he did us a favour by stimulating research studies. Over the next 30 years, outcome trials and statistical wars took place. By the 1980s it was agreed by researchers that psychotherapy did not just exist in the eye of the beholder: it was an actual phenomenon. The psychological treatments as a whole were found to have a 'modestly positive effect' compared with no treatment, but research was unable to distinguish between types of therapy at outcome: in the words of the Dodo in a widely-read research review, 'Everybody has won and all must have prizes' (Luborsky et al. 1975), as all types of therapy were found to be equally effective using the crude research tools available. More sophisticated process research is needed but, in order to look at the processes distinctive to analytic work, it would be necessary to intrude into the sessions by tape or video recordings to gather evidence, which is looked upon with horror by clinicians in Britain because of the confidential and intimate nature of the treatment.

So how do we solve this dilemma? Do we struggle on attempting to find acceptable scientific evidence for psychoanalytic principles, or do we look at science itself and argue that it is changing, evolving new scientific models that could make valid inquiry into intersubjectivity and the interpersonal human ecology possible? In March 1996 the BJP third joint conference with the Freud Museum took place, which brought together five distinguished speakers who have been thinking and working in the area of the scientific status of psychoanalysis. We present their papers in this issue, beginning with Joseph Schwartz, previously a physicist, who looks at the scientific status of science itself. Then we have papers by David Smith and Karl Figho that discuss problems of applying the scientific method to clinical realities, followed by a paper by the philosopher James Hopkins from King's College, London, who strikingly demonstrates by using the analytical tools of philosophy that, when carefully examined, psychoanalytic reasoning and scientific reasoning employ exactly the same rules of inference. The final conference paper is by Peter Fonagy, professor of psychoanalysis at University College London, whose paper spoke of the changing influence of psychoanalytic thought as indicated by the decline in citations in learned journals. Prof. Fonagy points a way forward for research without which child analysis is imperilled. The conference was chaired by Dr Michael Conran, who offers his chairman's comments.
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Psychoanalysis has made us keenly aware of the effects of early infant feeding patterns on later personality and character. Gertrud Mander writes of the influence of Truby King on generations of babies between and after the wars, which laid a groundwork for the inner system of repression and denial of infant feelings of need and dependency. Next, a paper by Jane Haynes and Jan Wiener addresses the issue of money, so often avoided by psychotherapists. They write about the knotty problems surrounding the charging of fees for what is essentially an intimate and loving relationship.

Interest in Sandor Ferenczi still burns brightly, a thought-provoking and rich vein of humanity from the history of psychoanalysis that continues to inform contemporary debate. Piers Myers's paper takes up Ferenczi's view that patients are extremely keen observers of the process of analysis and of the analyst himself. It introduces the question of how we handle material that clearly has to do with foibles, weaknesses or personal problems of the therapist. In the work of Freud and Ferenczi we have two contrasting treatment and conceptual models, discussed in the paper by Carla Russell, who suggests that Ferenczi' 5 socalled 'deviant' methods describe an analyst who is active, emotionally present and responsive, maintained by those who think Ferenczi's valuable ideas were before their time as a superior way of reaching interpersonal truth to Freud's restrained and objective attitude.

The Clinical Commentary in this issue contains three thoughtful responses on clinical material from our contributors: Richard Carvalho, analytical psychologist, Leon Kleinberg, psychoanalyst, and Joanna Ryan, psychoanalytic psychotherapist.

It is with regret that we announce that Melanie Hart must step down from the position of Book Reviews Editor: we are most grateful for her excellent work. A new Book Reviews Editor has been appointed. We are pleased to have Carol Topolski taking up the post with the next issue. Carol comes from a varied background in English, film censorship, social work and counselling. She writes on domestic violence and has trained in analytic psychotherapy at the BAP.

Reference
Luborsky, L., Singer, B. & Luborsky, L. (1975) Comparative studies of the psychotherapies: 'Everybody has won and all must have prizes'. In Archives of GeneralPsychiatry 32:995-1008.

©Jean Arundale. Mounted by Chris Evans (Email:C.Evans@sghms.ac.uk) on 21.iv.97, last updated 23.iv.97