Where's the text? The problem of validation in psychoanalysis.

Abstract

Whatever their differences, the various schools of psychoanalysis all subscribe to the case study, based on clinical vignette and anecdote, as the "text" of psychoanalysis. Because the typical case study presents not the actual analytic dialogue but a reconstruction based on the analyst's selective memory, the use of such a text renders problematic the validation of an analyst's case formulation, and has traditionally diminished the epistemological status of psychoanalysis. Pristine clinical data, as would be provided by verbatim transcripts of audio-recorded analytic sessions, are rarely created and even more rarely made public. Study of the psychoanalytic process is thereby made impossible, whether by clinical exegesis, qualitative analysis, or quantitative statistical analysis. Yet the analytic community, highly resistant to this public documentation, continues to marshal five common arguments against it. These arguments are reviewed and responded to in the belief that such documentation would enhance the field's intellectual status by allowing the problem of clinical validation to be addressed in ways that move beyond appeals to the authority of private clinical experience.