Dr. Eisman continues with statements which seem not to be accurate. He
writes of the published material on psychoanalytic outcome research
>In my opinion, research with inadequate controls may be described with the
>word "research", but such studies prove nothing. I am
>not saying that there aren't psychoanalysts doing research, I am saying
>that much of this research does not pass muster as being adequate to
>answer the questions which the research projects pose. they get published
>in psychoanalytic journals,
>but they are not sophisticated enough to be published in other journals.
>IN MY OPINION, THERE IS NO REASON WHY SOPHISTICATED RESEARCH CAN NOT BE DONE.

Point by point --- 1) As others have commented the comparison of treatment
vs. control population is not the only legitimate means for doing outcome
research. Any methodology is only useful insofar as it gives credible and
useful information. For complex interventions like psychoanalysis control
designs are rarely the strongest means of studying outcomes. However, there
are at least two control design studies in the psychoanalytic literature.
Most recently Peter Fonagy and Margaret Target have published historical
control outcome studies of children treated at the Anna Freud Center. 2)
Although, not surprisingly, most research on psychoanalysis is published in
analytic journals, research on psychoanalytic outcome has also been
published in the most prestigious and competitive non-analytic
publications. The Fonagy study just mentioned appears in articles in The
Journal of the American Academy of Child and Adolescent Psychiatry.
Publications on analytic outcome and research have appeared in recent years
in journals such as J. Clinical & Consulting Psychol. and Amer. J.
Psychiatry. 3) Having spent about six years struggling with the issue of
the "doablity" of outcome research in psychoanalysis I am convinced (others
disagree) that meaningful studies of analytic outcomes comparing
populations of treated and untreated individuals would be nearly impossible
for a variety of reasons that are outlined in our book. I think that anyone
who has examined the field carefully would see the reasons for this (
essentially too many variables, too much difficulty monitoring the nature
of the treatment, etc.) and while they might disagree with the possibility
of doing the research it would become apparent that it would be devilishly
difficult.


> >
> > I am sorry that Dr. Eisman has bought the insurance companies' blather
> > about only reimbursing for treatment that has documented efficacy in
> > controlled clinical trials. Much of medical practice, procedures like
> > appendectomies, have no such data. The insurance companies are in the in
> > the business of making money and use whatever excuses they can get away
> > with for not distributing it. It hardly makes sense to attack colleagues
> > for not pleasing these companies or failing to live up to their made up
> > standards.
> >
>
>If a case CAN to be made for psychoanalysis as therapy for mental illness,
>then it
>should be made. Being circumspect in communications with insurance companies
>vis-avis psychoanalytic treatment just attenuates the position of
>psychoanalysis.
>This was my point. If a therapist believes he/she should be doing
>psychoanalysis,
>they should pursue the validity of the treatment with the insurance
>company. not
>weasel out.

I made no suggestion that anyone "weasel out" of anything. However, I one
point I too was optimistic that insurance companies meant what they said,
i.e. if you could show them it worked they would pay for it. This turned
out to be nonsense and now the insurance companies have even backed away
from this stance.
About other issues in psychoanalysis that are subject to research Eisman
writes,
>  But the most rigorous examinations have not confirmed the ideas.

My reading of the literature is very different. Like any theory that makes
empirical predictions some analytic ideas have been confirmed and others
shown to be incorrect through empirical investigations.

Robert M. Galatzer-Levy, M.D.            Telephone 312 922 5077
122 South Michigan Avenue                 Fax 312 922 5084
Chicago, Illinois 60603                        E-Mail [log in to unmask]