Psychoanalysis, psychoanalytic science, and psychoanalytic research--1986

The present standing of psychoanalysis as a science and the vitality of psychoanalytic research effort are reviewed. The two are interdependent, since the possibilities for empirical research rest on the necessary assumption that psychoanalysis is indeed enough a science to be susceptible to knowledge advance by the (research) methods of science. Concerning our status as a science, I review attacks on our scientific credentials (both from within our ranks and without) by the logical positivists, by the hermeneuticists (a rubric comprising a variety of hermeneutic, phenomenological, exclusively subjectivistic, and/or linguistically based conceptualizations of our field), and the most recent by the philosopher of science, Adolf Grünbaum. I try to demonstrate what I feel to be the failure of each of these assaults, and why I feel there is no reason to see psychoanalysis as anything other than a scientific psychology and, therefore, in theory amenable to empirical research approaches. I then review the history and the current status of these systematic research efforts in psychoanalysis, and the reasons why these have been far less in scope and in accomplishment than has been possible or than has been needed. Here I have focused especially on research involving technique and our theory of change and cure--i.e., research on the analytic process; on what changes take place (outcome) and how those changes come about or are brought about (process).     

Somatic response to stress, physical symptoms and health service use: The role of current stress

The study examined physical symptoms and health service utilization of subjects high or low on a measure of the tendency to experience stress somatically and high or low on a measure of current stress. High somatic responders reported greater numbers of symptoms than low somatic responders regardless of stress level. However, high somatic responders who were experiencing high levels of current stress reported significantly more symptoms than high somatic responders who were experiencing low levels of stress. These findings indicate that somatic response to stress reflects both a general tendency to focus on physical symptoms, and a specific tendency to focus more on physical symptoms when under stress. Analysis of health service records indicated that high somatic responders had more visits prompted by symptoms than low somatic responders, but did not differ in frequency of health service visits designed to maintain health. The findings further clarify the relationship between somatic response to stress, physical symptoms and health service use.     

On working through: a model from artificial intelligence

Working through is centrally important to clinical psychoanalysis. It is inadequately explained in analytic theory. An artificial intelligence model of the process is proposed. Models of problem solving show that the complexity of necessary computation is an important determinant of how a problem is solved. Not optimal, but only good enough solutions are usually found. The quality of solutions depends on the time and resources available. Generally it is far easier to use existing methods than to develop new approaches. When problems must be solved in an emergency fashion, as in trauma, poor solutions are likely to emerge. In studying the annealing of metals and other complex optimization problems, a process, the Boltzman algorithm, was discovered, which continues the search for better solutions while gradually developing a coherent structure of the overall solution. The algorithm provides a model both for psychoanalytic working through and for the normally ongoing process of psychological development and reworking whose deficiency is characteristic of much psychopathology. Working through in the analytic situation is the reactivation of this normal process, and a good analytic outcome is achieved when the process can continue without the analyst. Properties of the Boltzman algorithm clarify such concepts as "optimal" frustration and anxiety which correspond to working in the area where the stable but not rigid structures emerge in the algorithms operation. These studies are an example of how computer science and artificial intelligence are a potentially rich source for psychoanalytic theory.     

Usefulness of structural Rorschach data in identifying inpatients with depressive symptoms: a preliminary study

To explore the usefulness of various structural Rorschach data in identifying psychiatric inpatients with symptoms of depression, 54 adult inpatients were administered a Rorschach. Results indicated that the Comprehensive System, Rorschach Depression Index did not identify many of these individuals as depressed, but did identify most of the extratensive depressed individuals. Each variable included in the Depression Index and other potential, Rorschach correlations of depression were also investigated. Most of them were found to occur more often among these depressed patients than among nonpatients. Furthermore, adding other variables and using more liberal cutoffs may result in more accurate identification of patients with depressive symptoms.     

The utility of the Michigan Alcoholism Screening Test in the detection of alcoholics and problem drinkers

This study examined the vulnerability of the Michigan Alcoholism Screening Test (MAST), a widely used, direct alcohol inventory, to positive dissimulation. An earlier study by developers of the MAST suggested that most alcoholics were unable to alter their scores and thereby avoid detection by the instrument. But closer examination indicated that a standard scoring procedure was not employed. This study examined the ability of alcoholics to avoid detection by the MAST when using a standard scoring procedure. As predicted, alcoholics readily manipulated their MAST scores and avoided detection when so motivated. These results are discussed, indications and contraindications for use are included, and recommendations regarding future research are made.     

Factors associated with maintenance and relapse following self-management training

In this study, we examined factors associated with relapse and maintenance following a self-management training course. Thirty-five community professionals participated in a 3-week (30-hr) graduate-level extension course in self-management, which included a self-modification project. Results at a 10-week follow-up showed that end-of-class self-efficacy and outcome expectancy correctly classified over 80% of those who maintained gains in their projects versus those who relapsed. The professionals in the relapsed group also reported significantly more difficulty with anticipated high-risk situations than did those in the maintenance group.     

Gender-bound definitions of mental health

Fifteen male and 15 female American therapists-in-training (clinical and counseling psychology graduate students) were asked to take the Minnesota Multiphasic Personality Inventory (MMPI) under each of two instructional sets. In one set, they were instructed to respond to the items as a healthy male would respond, and in the other, as a healthy female would respond. The MMPI profiles obtained from male and female subjects were not significantly different, indicating that these male and female therapists-in-training did not differ in their perceptions of healthy men and women. When the data for male and female subjects were combined, however, healthy women were perceived differently than healthy men on several scales, although the MMPI profiles obtained under both instructional sets were well within normal limits.