From Psychoanalytic Narrative to Empirical Single Case Research : Implications for Psychoanalytic Practice book cover
1st Edition

From Psychoanalytic Narrative to Empirical Single Case Research
Implications for Psychoanalytic Practice

ISBN 9780881634891
Published July 22, 2008 by Routledge
496 Pages

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Book Description

Recognition of the need for empirical research and interest in its findings are growing in psychoanalysis. Many psychoanalysts now acknowledge that research is imperative to try to deal with the factors propelling the diminution in status and prestige of the discipline, as well as the number of patients in intensive psychoanalytic treatment. In addition, there is increased pressure to expose and acquaint candidates with analytic research in the course of their education.

From Psychoanalytic Narrative to Empirical Single Case Research revivifies the experimental potential of psychoanalysis by focusing a number of structured research methods on a single case study. Drs. Kächele, Schachter, and Thomä, in tandem with the Ulm Psychoanalytic Process Research Study Group, bring their formidable tools and knowledge to bear on Amalia X, a former patient of Dr. Thomä’s, whose case history is well-documented, preserved and available for formal empirical study. After providing an intensive review of the problematic aspects of clinical psychoanalytic research and an exegesis on the use of the case study itself, the specific case history of Amalia X, which dominates and centers the remainder of the book, is thoroughly examined. The following two chapters – utilizing clinical and linguistic models, respectively – deconstruct Amalia’s psychopathology along a variety of methodological axes in an effort not only to uncover the roots of her presenting symptoms, but also to reify and validate the strange bedfellows of psychoanalysis and empiricism in general. The book would be incomplete, however, without its final chapter, which provides suggestions and insights into the clinical applications and implications of their combined research.

Table of Contents

Wallerstein, Foreword. Psychoanalytical Therapy Process Research. Problems of Metascience and Methodology in Clinical Psychoanalytic Research. The Significance of the Case History in Clinical Psychoanalytic Research. Amalia X: The German Psychoanalytic Specimen Case. Guided Clinical Judgments. Linguistic Studies. A Summary and Implications of Research for Clinical Practice.

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Horst Kächele, M.D., Ph.D., is Professor of Psychotherapy and Chair of the Department of Psychosomatic Medicine and Psychotherapy, Ulm University, and Training and Supervising Analyst of the German Psychoanalytic Association (DPV/IPA). He has conducted research on process and outcome in psychotherapy and psychoanalysis, psychosocial aspects of bone-marrow transplantation, eating disorders, and attachment. Besides many publications in German and English, he is co-author with Helmut Thomä of the Ulm textbook on Psychoanalytic Practice, which was translated into more than ten languages. Together with Dr. Thomä, He was awarded the Sigmund Freud Prize of the City of Vienna in 2002 and the Mary S. Sigourney Award in 2004.

Joseph Schachter, M.D., Ph.D., conducted neurophysiological and developmental research with newborn offspring of schizophrenic mothers when he was Director of Child Psychiatric Research at the University of Pittsburgh School of Medicine. He was a Training and Supervising Analyst at the Pittsburgh Psychoanalytic Institute, and is the author and co-author of many papers. He is the author of Transference: Shibboleth or Albatross? and the editor of Transforming Lives, which uniquely included patients’ commentaries about their psychoanalytic treatment. Recent interests include the status of the psychoanalytic profession and the nature of unresolved epistemological problems of psychoanalysis. Currently retired, he is a member of the faculty of the Columbia University Psychoanalytic Clinic for Training and Research, and the William Alanson White Society.

Helmut Thomä, M.D., Ph.D., was Chair of the Department for Psychotherapy, Ulm University (1967 – 1989) and Past President of the German Psychoanalytic Association (1968-1972). He is a member and training analyst of the International Psychoanalytic Association and was the first Privatdozent for Psychoanalysis at a German university working at Mitscherlich's Psychosomatic Clinic in Heidelberg. His monograph on Anorexia Nervosa (1961) was the first German psychoanalytic monograph translated into English (1968). Together with Horst Kächele, he was awarded the Sigmund Freud Prize of the City of Vienna in 2002 and the Mary S. Siguorney Award in 2004. In 2006, he was awarded a doctor honoris causa by the University of Leipzig.


"In order to deepen our knowledge about psychoanalytic theory of treatment, it is of vital importance to have an increasing number of empirically-based studies on psychoanalytic process and outcome. Relevant scientific psychoanalytic research should also include the clinician and his clinical skills as a source of inspiration for renewing ideas, and for the integration of research results in clinical practice. As professor Wallerstein writes in his foreword, this book is ‘a capstone volume bringing together the thinking and findings of a long, closely shared professional lifetime devoted to research and clinical work’ and is ‘a major path in the development of theory-building and a science of treatment.’ The studies of Amalia X are probably the most intensive empirical studies of one patient ever conducted, and give a multidimensional picture of empirical ways to study psychoanalytic work and process."

- Imre Szecsödy, M.D., Ph.D., Associate Professor, Karolinska Institute

"An outstanding integration of over a quarter-century of trailblazing research that used a wide-range of methods to evaluate single case reports in the investigation of the impact of unconscious processes on conscious behavior and experience. In an extensive presentation of their specimen case, Amalia X., the Ulm Psychoanalytic Process Research Study Group demonstrates how systematic analysis of detailed observations of a single case in psychoanalysis can provide invaluable understanding of the subtleties of psychological processes and of the dynamics of the treatment process. This volume will have major impact on research as well as on clinical theory and practice because it provides a variety of models for integrating the complexities of psychoanalytic observations so they can enrich and extend mainstream nomothetic psychotherapy research."

- Sidney J. Blatt, Ph.D., author, Polarities of Experience: Relatedness and Self-definition in Personality Development, Psychopathology and the Therapeutic Process (APA, 2008)

"This book aims to bridge the gap between psychoanalytic practice and systematic research. It easily achieves this but it does far more. The careful scrutiny of the psychoanalytic process through concurrent use of multiple methodologies has created a comprehensive reference text that clinicians can use to improve their understanding of the mechanisms of change, to learn about what is likely to make treatments more effective and to understand how relatively simple experimental strategies can clarify without oversimplifying even the most nuanced of clinical situations. This is a landmark volume, an integrative summary of the substantive achievements of psychoanalytic process research of the past decades."

- Peter Fonagy, Ph.D., FBA, Freud Memorial Professor, University College, London

"This important work by Kaechele, Schachter and Thomae - informed by monumental scholarship, enriched by their expertise in clinical psychoanalysis and research and anchored in a specimen case - provides a convincing solution to a central problem of psychoanalysis: how can data from the clinical psychoanalysis of individuals be used to construct a scientifically reliable psychoanalytic theory? Their work illuminates the fundamental relation between enquiry and therapy in clinical psychoanalysis."

- Charles Hanly, Ph.D., Emeritus Professor, University of Toronto

"In an era when cognitive behavioral therapy is king and empirically supported research is the currency on which its kingdom rests, this book is a valiant effort to develop methods to explore scientifically the depths of psychological process that psychoanalysts believe are compelling. All in all, this book reflects a lifetime of scholarly work, highly productive collaborations by some of the world's most brilliant psychoanalytic thinkers and researchers, and courageous self-revelation. The hard and disciplined work of the authors has produced a valuable text which can be used as a reference book or as a book one can read through for edification." 

- Michael Bond, MD, FRCPC, FAPA, SMBD-Jewish General Hospital, McGill University in The Journal of Nervous and Mental Disease, 197(3), 2009

"It is not only a tremendous academic achievement in the service of psychoanalysis itself. It is also vitally necessary in respect of the stressed position of our profession within the current societal situation. We need the approval of the environment in which we live and practice. This kind of scientific presentation…can help us to receive a better appreciation."

 – Axel Triebel, International Forum of Psychoanalysis

"This milestone work demonstrates the potential of psychoanalytic treatment research for improving our understanding of unconscious processes and mechanisms of change…The use of multiple methodologies in single case research is a powerful exposition of how the richness of the clinical observations can be distilled into refined and empirically provable theoretical models…I hope this epoch-making book is already being included in the curriculum of psychoanalytic education at many institutes." – Andrzej Webart, International Journal of Psychoanalysis