The article headed "Programs Try to Restore Luster to Psychodynamic
Psychotherapy" in the June 18 issue reported that all graduating
psychiatry residents are now required to demonstrate competence in five core
psychotherapy treatment options, including psychodynamic psychotherapy.
One course being offered presents "some of the scientific evidence
underpinning psychodynamic psychotherapy." Scientific evidence may help
restore the prominence, popularity, and respect for psychodynamic
psychotherapy, but the scientific method has its limitations. It is based on
comparing groups. If individuals fit into groups that have been studied, there
is a statistical probability that the outcomes of the group studies apply to
an individual. Scientific method cannot study or evaluate a single unit, a
In contrast, psychoanalysis or psychodynamic psychotherapy of a single
patient is a method of studying and evaluating a single individual. The
analytic process has an internal, logical, and rational approach throughout.
Even in one session, a patient's statements at the beginning of a session are
compared with statements during and at the end of the session.
This same rational process applies throughout an analysis. Statements and
reports about mental pictures, feelings, and behaviors are continually
cross-checked and compared. Inductive reasoning proposes hypotheses that are
repeatedly confirmed or contradicted. In the latter case new hypotheses are
formed. Thus, the study of an individual is continually being developed. The
probabilities (to borrow a scientific term) of valid conclusions about an
individual are gradually increased.
While we are in debt to scientific methods for much knowledge and
information, and science-based treatment will always be important to treatment
of individuals, it is time for professionals to stop worshiping the scientific
method as if it were the only source of knowledge and information and accept
that it cannot study or evaluate a single individual and produces only
probabilities for an individual patient.
It is time to start appreciating the rational and logical approach of
psychodynamic psychotherapy for producing probable knowledge and information
about an individual patient.