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Milrod, B.L. Busch, F.N. (2003). Epilogue. Psychoanal. Inq., 23(2):405-408.

(2003). Psychoanalytic Inquiry, 23(2):405-408


Barbara L. Milrod, M.D. and Fredric N. Busch, M.D.

Even within this edition of Psychoanalytic Inquiry, whose contributors universally possess unusual research sophistication within the psychoanalytic community, tensions are evident. A central unstated point of contention that runs throughout the volume is: which is more important at this juncture for the continued existence and growth of the field of psychoanalysis, process research or outcome research? Sidney Blatt and John Auerbach find process research more compelling, although they do not dismiss outcome research. They note that

the primary focus on symptom reduction in current treatment outcome research reveals little about the nature of therapeutic change and … psychodynamic and psychoanalytic conceptualizations can inform and guide research that more fully explains how people change in the course of psychotherapy.

Joseph Weiss focuses his research on individual case process studies. Robert Wallerstein states,

This question of the comparative efficacy and reach of different treatment approaches can only really be put to the test by demonstrating what the authors properly call “structural change,” that is, change in underlying character organization,

and critiques the Klein et al. research group for demonstrating symptomatic change and not assessing structural change.

Demonstration of symptomatic change, however, would represent a crucial advance, not to be taken lightly, since unfortunately almost no one in the psychoanalytic community has done this! Other authors of papers clearly agree that study of outcome rather than process should be the primary focus of analytic research.

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