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Fonagy, P. Tallandini-Shallice, M. (1993). On Some Problems of Psychoanalytic Research in Practice. Bul. Anna Freud Centre, 16(1):5-22.
  

(1993). Bulletin of the Anna Freud Centre, 16(1):5-22

On Some Problems of Psychoanalytic Research in Practice

Peter Fonagy and Maria Tallandini-Shallice

The Epistemic Problem: The Place of Clinical Data in the Case Study

Data generated in the clinical psychoanalytic setting bears the dual epistemic burden of confirming (a) the analyst's understanding of the patient and (b) general psychoanalytic hypotheses concerning the nature of human development, psychological abnormality and the existence and the characteristics of numerous psychic mechanisms.

Freud's conviction that what ultimately benefits the patient is the discovery of the truth led him to place perhaps undue emphasis upon clinical data, in particular the patient's response to interpretation, cumulatively or singly, as an indicator of the validity of the psychoanalytic enterprise. ‘After all, his conflicts will only be successfully solved and his resistances overcome if the anticipatory ideas he is given tally with what is real in him’ (Freud, 1917, p. 452).

Grünbaum (1984, 1986) examined this argument in detail and found it, as philosophers had before him - for example Hooke, 1959; Farrell, 1981) - crucially flawed. More simply stated, the problem is that, by and large, clinicians are epistemically dependent on their patients’ responses to interpretations and other aspects of the analytic encounter to validate their view of their cases. Their criteria for confirmatory responses may vary from reliance on symptomatic improvement as a primary indicator, to a more sophisticated search for confirmation in the patients’ associations (Freud, 1937, p. 263).

The permissive nature of such strategies has resulted in an accumulation of successful case reports, which appear to support an array of psychoanalytic propositions as well as diverse therapeutic methods.

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