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Spence, D.P. (1999). Response. Int. J. Psycho-Anal., 80(1):177.
(1999). International Journal of Psycho-Analysis, 80(1):177
Donald P. Spence
I want to thank Dr Burland for his thoughtful reply to my editorial and for his clarification of his initial observations. What he was claiming —that his sample of some 450 cases manifested ‘almost without exception … a step-by-step regression into a revisitation of their past, in memory, in the transference, and in current reality …’ (Burland, 1997, p. 469)—seemed almost too good to be true; hence my comment. But if, on the other hand, it is true, it would provide impressive evidence for a general theory of psychoanalytic action and the data cries out to be made public.
Two questions arise almost immediately. First, how can we check the validity of the reports by the candidates and second, how can we test Dr Burland's observation that each case followed the same regressive sequence? I see no direct answer to the first but it might be possible to ask independent judges, with similar training and experience, to review each of the summaries and rate them on the degree to which they conformed to Dr Burland's model. If a high degree of concordance was found, it would not only reinforce Dr Burland's initial impression but would increase the likelihood that the candidates' reports had faithfully captured their clinical work. This last point follows from the assumption that it would be highly unlikely that the candidates were aware of Dr Burland's healing sequence at the time they wrote up their cases (and he himself, as we know, was surprised by the commonality).
If the sample survives these tests, then we have greater reason to believe that the concordance observed by Dr Burland is more than one man's opinion. We can then proceed to ask more searching questions of the data and learn, in more detail, just how the pattern of working through is related, in each case, to therapeutic action and psychoanalytic outcome. Does this inherent process of self-healing show itself in all successful cases? If broken off prematurely, does it lead to treatment failure? Does the analyst sometimes get in the way and prevent the process from taking its natural course? Does the sequence appear regardless of the analyst's orientation?
In more general terms, we need to find ways of documenting Dr Burland's surprise and saving it for future generations. If his commonality is truly theory-disconfirming, we have all the more reason to capture it and understand it better so that we can find it again in the future.
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