Can analysts agree? The problems of consensus and the psychoanalytic mannequin: II. Empirical tests

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.