Nicolle: Psychoanalytic Psychotherapy, Psychoanalysis and Research. Workshop
at the Oxford Conference
Two 90 minutes sessions will be dedicated in Oxford to the complex issues of research in our psychoanalytic and analytic psychotherapy fields.
Like Freud in his time, each analyst may at times feel torn between two different positions: on the one hand the unique path of his own analytical work with a unique analysand or patient and on the other hand, the will to assess, to compare, to search and find some communicable abstracted generalisation of analytical experience and outcome.
As we know,
these two approaches can neither be totally dissociated from each other,
nor assimilated to each other, and, they require different and often opposite
There are other analytical milieus, where "psychoanalytical psychotherapy" is understood as "psychotherapy with a psychoanalyst" and viewed as a "complex psychoanalysis" and not as a simpler or shorter one. Therefore, a basic assumption is that psychotherapy issues are real psychoanalytical issues. Consequently, research on psychotherapy processes tends to be seen in the same way as any other psychoanalytical research, where the subject of the research determines the methodology. In other words, the analytical subject matter requires an analytical setting and analytical methodology.
This latter approach to research is historically framed into clear analytic methodologies, which are in themselves implied by genuinely psychoanalytic epistemological bases. These include: contradictory comparison, discussion and assessing of analyst's or therapist's own interventions or no-intervention, interpretations, silence in diverse supervision situations, long-term follow-up and analytic evaluation of intersubjective processes, maximal integration of patient's transference and of analyst-researcher's countertransferential positions, striving towards the maximal integration of latent elements (including institutional ones).
Besides, overwhelming social, economical and cultural processes have occurred since the late '40, which have exerted a huge influence on our practices and conceptions. Among these we can count, on the one hand a form of integration, and consequent expansion, more or less free of charge, of psychoanalytical psychotherapy into the health systems of many countries, together with a relatively unquestioned equation with purely medical treatments. On the other hand, some elements of the analytical theories (often "politically correctly" termed "psychodynamic") became part and parcel of the theoretical background of nearly every clinical psychologist, psychopathologist, developmental clinician or social worker.
- once evidence of real progress have in the last 10-15 years - come to
reveal an opposite face and some perverse effects. Psychotherapists in
the public sector are pressured by health or insurance authorities to
quantify and prove the effectiveness of their "treatments" in
the way all medical practitioners are. Scholars are pressured to produce
and publish "research results" to prove the "scientific"
(i.e. quantitatively-based) quality of their teaching and clinical work.
This situation results in a series of serious questions, to which some answers seem quite clear and others not at all. Is the problem of insurance company or national health system pressure a serious and 'hot' one? Surely yes. Has any one of us ever based one of his (her) interventions or no-intervention in a psychotherapy session solely on the data from a randomised controlled sample trial? Indeed not. It could be true that new analytic research settings have to be elaborated today. But, are we so sure that the devaluation and at times rejection of the genuine psychoanalytical research methodology is not primarily an effect of ideology and the result of the analysts' ambivalence? Are we so sure that tests, questionnaires, controlled conditions and randomisation do ensure that we get a step farther in the "analytical matter"? Can we expect to benefit from differentiating more clearly between these two approaches to research, namely "psychoanalytical clinical research" on the one hand, and "outcome research" on the other? If yes, is this from an epistemological or from a political point of view? How do we safeguard the living link between clinical experiencing and research? Faced with these objective difficulties, is it possible and reasonable to foresee a clearer research policy for the EFPP?
These issues and other core questions will be addressed in the Workshop sessions on Psychoanalytic Psychotherapy, Psychoanalysis and Research that will take place at the Oxford Conference, and will be co-chaired by O. Nicolle (Centre V. Smirnof de Psychothérapie and Centre National de la Recherche Scientifique - Paris) and Prof. Ph. Richardson (The Tavistock and Portman NHS Trust - London). EFPP researchers from various countries will present their own approaches, questions, and opinions.
|last modified: 2001-07-25|