Helen Sargent on Studying Intrapsychic Change

Abstract

Helen Sargent would have been immensely pleased to know that her remarkable methodological paper, published posthumously a year and a half after her premature death, was selected as a classic to be reviewed some 40 years after it appeared in print. Having worked closely with her during the fifties on the Prediction Study of the Menninger Psychotherapy Research Project, I was aware both of her thinking on the methodology of clinical research and of her signal contribution to the design of that research undertaking. In many ways, she was the chief methodologist of the project and certainly its scientific conscience. She was the architect of the Prediction Study, a complex and sophisticated method for converting clinical predictions into testable hypotheses (Sargent 1963) that served as a systematic approach to studying the validity of the psychoanalytic propositions that were used in forecasting the process and outcome of the 42 cases that were studied in the project. The Menninger study was composed of a large group of multidisciplinary clinicians, steeped in psychoanalytic thinking, taking their first steps into the complexities of psychotherapy research. In doing so, we were attempting to serve the dual masters of respect for the canons of scientific psychological research and the requirements of sound clinical thinking and practice. Helen Sargent stood at the interface of these two unseemly bedfellows and became the spokesperson for reconciling one with the other. She was a knowledgeable psychoanalytic clinician but was also quite well informed about the accepted research and scientific methods of that time. This paper was a clear and effective effort to challenge the prevailing narrow, behaviorist research philosophy while at the same time establishing clinical judgment as a legitimate scientific means of studying human behavior, particularly the intrapsychic aspects that are of such importance in clinical practice and research. She did not want the clinical methods of our researchers to be dismissed out of hand by the non-clinical scientific community as simply biased and subjective; simultaneously, she bolstered her fellow clinicians with needed arguments to justify the application of their clinical method to their research enterprise. In a beautifully organized and systematic approach to her topic, she touched on the most significant issues confronting the clinical researcher. First, she challenged the assumption that there is a standard scientific method applicable to all psychological problems and wittily observed that “science offers more leeway than graduate students are permitted to realize . . . .” (Sargent 1961, p. 107) It is well accepted these days that the methodological tail should not wag the problem-cenPsychiatry 67(1) Spring 2004 19