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Shapiro, T. (2017). Studying What Factors Mediate Change in Psychoanalysis and Psychoanalytic Psychotherapy: How Systematic Study Helps to Determine Old Questions. Psychoanal. Inq., 37(3):202-210.

(2017). Psychoanalytic Inquiry, 37(3):202-210

Studying What Factors Mediate Change in Psychoanalysis and Psychoanalytic Psychotherapy: How Systematic Study Helps to Determine Old Questions

Theodore Shapiro, M.D.

Introduction

To approach the issues raised in the five articles offered in this issue, I must first establish my own historical view of whether it is possible to study dynamic psychoanalytic psychotherapy with existing methods and measurement scales and to determine if such study provides a better scientific answer to the question of what makes the patient better, more adaptive as well as less symptomatic. The queries are as old as psychoanalysis itself and derive from Freud’s (1893–1895) eager attempt to establish psychoanalysis as a cure for hysteria. Indeed, what became of that enterprise is a huge edifice of psychoanalytic theory and a new theory of mind that has dominated a century of Western thought, and may even be bigger than the therapeutic question. Nonetheless, the treatment was born out of an attempt to change people and help them lose their symptoms—this is what occupies us in this issue. Let me answer, with a cautious statement, that I believe it is possible to study psychoanalytic treatments to some limited extent, and that the enterprise is worthwhile, as well as socially responsible and professionally necessary in a world seeking evidence-based treatments.

The therapy known as psychoanalysis has developed and changed over time and spawned many who have offered variations in the approach. To some, these new treatments are no longer recognized as psychoanalytic; others lie close enough to the core ideas to qualify as variant forms within the

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