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Assessing progress in analysis interminable.

Lawrence Josephs1, Eric Anderson, Amy Bernard

  • 1Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, Long Island, NY 11530, USA. josephs@adelphi.edu

Journal of the American Psychoanalytic Association
|February 3, 2005
PubMed
Summary
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This case study demonstrates significant clinical improvement in a long-term psychoanalysis for a patient with schizoid personality disorder. Independent verification confirmed progress in character pathology, object relations, and mentalization, challenging assumptions about treatment limitations.

Area of Science:

  • Psychoanalysis
  • Psychotherapy Research
  • Clinical Psychology

Background:

  • Psychoanalytic treatment often faces challenges in demonstrating objective clinical improvement, particularly for patients with entrenched character pathology.
  • Traditional case studies, while rich in detail, often lack independent verification.
  • The need for rigorous methodologies to assess therapeutic outcomes in psychoanalysis is increasingly recognized.

Observation:

  • A case study of a schizoid patient in her mid-sixties undergoing lengthy psychoanalysis is presented.
  • The treating analyst's assessment of significant clinical improvement was independently verified.
  • Analysis of session transcripts over a four-year period provided objective data.

Findings:

  • The patient exhibited significant improvements in character pathology, object relations, and mentalization.

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  • Reductions in superego anxiety were also observed.
  • These findings suggest that even patients with seemingly intractable conditions can achieve substantial gains in psychoanalytic treatment.

    • Implications:

    • The study supports the potential for significant clinical improvement in patients with entrenched character pathology previously considered untreatable.
    • It highlights the value of "case study plus" methodology, combining qualitative depth with quantitative, independent verification.
    • This approach can enhance the scientific credibility of psychoanalysis by validating anecdotal clinical observations.