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Empirical Research Shows Benefits of Psychoanalytic Psychotherapy

By Dr. Matthew Paldy

Shore (2003) suggests that interdisciplinary research in the fields of biology, neurochemistry, and developmental psychology can complement each other and shed more light on human socioemotional development and therefore inform psychoanalytic thought and its anchoring in science, developmental psychology, and biology of attachment and affect. For example, cross-disciplinary research on mutual gaze interactions between mother and infant, neurobiology of attachment bond formation, and the biological development of an infants’ orbitofrontal cortex have significant implications for clinical models of psychoanalysis, which generally focus on “human emotional development and functioning” (Shore, 2003). A metaphor for the connectedness of various disciplinary research efforts can be thought of as the that of a tree and branches. A theory can be viewed as the trunk of a tree, and research efforts as the added branches, twigs, leaves, and buds:

Tree Metaphor Empirical support -> Leaves Hypotheses -> Branches Theory -> Trunk Related interdisciplinary theories -> Roots (body of knowledge in psychoanalysis)

Using the tree metaphor we can see how interdisciplinary research contributes to the health of the underlying theory in question. Kuhn (1962) supports this incremental view that related empirical studies are important, saying that the “backbone of normal science lies in the slow accumulation of narrow studies.” Shore’s view of relatedness among disciplines includes, for example, Kohut’s (1968) writing on the importance of mother-infant mirroring interactions and how it is supported by Fridlund’s (1991) neurobiological research conclusions that psychoanalytic transference processes are evident in the patient’s quick “appraisal of the therapist’s face in movements…around the eyes and from prosodic expressions from the mouth.” Here we can see the complementary and supportive intersection of neurobiology and psychoanalytic research.

Social science research (and psychoanalytic research in particular) often relies on information gathered from human subjects as the its basis. The use of human subjects, versus for example, research in the hard sciences such as physics, introduces unique experimental factors. The interaction of the subject and experimental setting can lead to findings that result from factors other than those considered by the researcher. In most behavioral studies the subjects are aware of their role in the research and often respond differently than if they were unaware of the experiment. The experimental factors responsible for this change in behavior have been termed the “demand characteristics of the experimental setting” and are defined as the mixture of various hints and cues that govern the subject’s perceptions of his or her role in the research and of the researcher’s hypothesis (Orne, 1962, in Rosenthal & Rosnow, 1991). Subjects who are aware of the researcher’s hypothesis may attempt to behave altruistically and give results they believe the researcher desires. These demand characteristics are evident in the mother-infant studies described by Shore (2003) in that the mother and infant may be aware of being observed, and the mothers may attempt to present themselves as competent and psychologically healthy to the researcher (Cook & Campbell, 1979, p.67). This may affect their interaction with their infants and subsequent observational conclusions by researchers. Demand characteristics can also induce behavior in experimental subjects such as increased cooperation and alertness. Such behaviors, known as the good subject effect, introduce threats to the internal validity (E.g., the truthfulness of conclusions about causal relationships) of research findings.

In psychoanalytic research, although the physical setting is relatively more simple than in complex organizational and workplace studies, demand characteristics can pose threats to validity and can result in the confounding of causal interpretations (E.g., that the treatment is effective or not). As we touched on in class, the Hawthorne Studies showed that an experiment’s physical setting can inadvertently interact with the behavioral variables being studied and can lead to erroneous results. The intended treatment in the Hawthorne Studies – greater illumination of working conditions – was mistaken for the inadvertent treatment of greater managerial concern for the employees’ working conditions. Experimental demand characteristics do not always result in “positive” responses from research subjects. For example, psychoanalytic treatments in a are part of a research study may introduce experimental demand characteristics that induce “negative” responses from patients resulting from the resentment of researchers as authority (coercive) figures. Argyris (1968) concluded that behavioral researchers, in their pursuit of experimental rigor, could induce unintended negative consequences in the experimental setting. Aspects of rigorousness such as exerting tight control over experimental variables and conditions can result in absenteeism, resentment, hostility, and a lack of cooperation and commitment in experimental subjects. It is not hard to see how a psychoanalyst who participates in a research study may attempt to be more rigorous in his/her treatments and induce similar reactions in patients to those found by Argyris. Patients who know they are part of a study may be experience feelings of decreased interpersonal power because they are aware of being experimental subjects. The relationship between analyst and patient may assume some of the negative characteristics frequently associated with that between manager and employee, such as a resentment of the implication of authority and/or control. It is therefore important for researchers to factor these considerations into their interpretations of findings and causal inferences, such as a conclusion that the treatment itself resulted in changes in the patient’s symptoms when in fact the demand characteristics of the experimental setting may have had a confounding effect.

References
Argyris, C. (1968). Some unintended consequences of rigorous research. Psychological Bulletin, (70) 185-197.

Cook, T. & Campbell, D. (1979). Quasi-experimentation: Design & analysis issues for field settings. Boston: Houghton Mifflin.

Rosenthal R. & Rosnow, R. (1991). Essentials of behavioral research: methods and data analysis. New York: McGraw Hill.

Schore, A. N. (2003). Interdisciplinary research as a source of clinical models. Affect regulation and repair of the self. (pp. 3-32). New York: W.W. Norton & Company.

Kohut, H. (1968). The psychoanalytic treatment of narcissistic personality disorders: outline of a systematic approach. The Psychoanalytic Study of the Child. International Universities Press.

Kuhn, T. (1962). The Structure of scientific revolutions. Chicago: University of Chicago Press.

Fridlund, A. J. (1991). Sociality of solitary smiling: Potentiation by an implicit audience. Journal of Personality and Social Psychology, 60(2), 229–240.