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10 Jan 2013

Dear Editor,

Re: ‘ Should Psychoanalysis be in the Science Museum?’ , New Scientist 2.10.2010, pp 22-23

We were very disappointed by Professor Bunge’ s intemperate and unscientific contribution to the debate on the scientific status of psychoanalysis. This is an important issue which sometimes receives far more sophisticated consideration. We would have welcomed a well-informed critique from a philosopher of science of the stature of Professor Bunge, and regret that he did not take this opportunity to address the issues seriously.

Far from being a discipline that has “ remained basically stagnant” , psychoanalysis has creatively developed, producing (as well as the most profound clinical theory) substantial research contributions of interest to other fields. Many basic psychoanalytic propositions have been widely accepted. Examples include the impact of early childhood relationships on adult personality (e.g. the explosive growth of scientific attachment research and theory), empirical demonstration in academic psychology of the impact of unconscious thoughts and feelings on behavior (e.g. the study of unconscious prejudice), among many others. Neurobiologist Nobel Prize-winner Eric Kandel MD sees the brightest future for psychiatry in a joining of psychoanalysis and neuroscience. Professor Bunge’ s claim of scientific irrelevance is untrue, and he goes on to make a series of statements which completely part company with the easily available evidence.

We are reluctant to accuse a distinguished colleague of poor scholarship, but cannot let pass the bizarre assertions that laboratory science has been absent from psychoanalysis throughout its existence, that we have not submitted papers to scientific journals, and that clinical trials have not attempted to examine the effectiveness of psychoanalytic psychotherapy, or that we are ‘ foreign to the scientific community’ . A cursory literature search would have provided citations and abstracts of hundreds of psychoanalytic research articles published in mainstream scientific journals. Masling’ s series on " Empirical Studies of Psychoanalytic Theories"  alone spans 10 volumes and includes 389 pages of references.

We readily accept that some specific developmental or psychopathological propositions put forward by Freud would not fare well in empirical testing, and that some details of his theories are probably incorrect or outdated. This is true of most bodies of knowledge evolving over 120 years, and would certainly be expected of any science. Contemporary psychoanalysis is not reducible to the study of the work of Freud, any more than contemporary physics stops with the study of Newton, or biology with Darwin. However, like other scientific frameworks built on fundamental insights into underlying reality, the basic psychoanalytic assumptions of a dynamic unconscious, actively shaping conscious experience, self-image and relations with others, have proved creative and convincing across many disciplines. There is welcome convergence, for example, with trends in current cognitive, social and affective neuroscience, being explored intensively by researchers in neuropsychoanalysis, which bridges these disciplines at a high level.

Psychoanalysts have been testing the outcomes of psychoanalytic therapies for decades, using randomized controlled trials and systematic follow-up studies, as Professor Bunge urges us to. Active academic researchers will form a minority of any clinical profession, but a committed international band of psychoanalysts have accepted the challenge to test the evidence for the effectiveness of psychoanalytically-based treatments. Recent literature reviews and meta-analyses of scientific studies of psychotherapy outcome (for example the series of papers by Leichsenring and colleagues) have found that effect sizes - a quantitative measure of treatment benefit - for psychoanalytic psychotherapy in randomized controlled trials are comparable to those for other therapies that are promoted as evidence based. The majority of trials have offered strong evidence of the effectiveness of psychoanalytic therapies, others have found stronger evidence for other therapies for specific conditions  the point is that psychoanalytic therapy has for a considerable period been tested in the same stringent way as have other approaches.

We are entirely bemused by Professor Bunge’ s assertion that the original studies in Shedler’ s meta-analysis did not have control groups, which a glance through the article (American Psychologist, vol 65, p 98) would have disproved. (We do not claim, however, that patients in psychoanalytic therapy have been studied in double-blind trials  it is difficult to imagine adult patients in a talking treatment being oblivious of what treatment they were receiving.)

The 74 signatories of this letter have raised many millions of pounds from competitive public research funding to undertake just the kind of research Professor Bunge advocates. We have adopted respected, mainstream methodologies despite the challenges of doing so in this area, and published systematic, empirical psychoanalytic research in first rank, peer-reviewed scientific journals (e.g. The Journal of the American Medical Association, Science, The Archives of General Psychiatry, The American Journal of Psychiatry, American Psychologist). We run twice-yearly, free research summer schools to offer consultation, training and ongoing mentoring to psychoanalysts and others wishing to engage in research of the kind Professor Bunge has been missing. Many early participants are now well-established psychoanalytic researchers. Although we would love to do more, this level of scientific contribution compares very well with that in other clinical professions.

We believe readers of this New Scientist debate will be reassured to know that psychoanalytic researchers are undertaking productive, cutting edge studies guided by psychoanalytic ideas, at world-leading universities, and helping younger colleagues to do so. We also believe that readers would expect contributors to their debates to be informed as to the facts. We fully agree that scientific progress requires a willingness to seek and learn from evidence, and in this spirit we respectfully offer a factual context in case the entertaining jibes of Professor Bunge might be mistaken for reality.

Yours etc

Professors Mary Target PhD, Peter Fonagy PhD, Anthony Bateman MD, Peter Hobson MD, University College London
Professor Falk Leichsenring DSc, University of Giessen
Professors Sidney Blatt MD and Linda Mayes MD, Yale University
Professors Otto Kernberg MD, Robert Michels MD, Barbara Milrod MD, Joseph Schachter MD, Stephen Roose MD, David Olds, MD, Frank Yeomans MD PhD, Richard C Friedman MD, Monica Carsky PhD, Weill Medical College of Cornell University &  Columbia University Center for Psychoanalytic Training and Research
Professor Mark Solms PhD, University of Cape Town
Professor Jonathan Shedler, PhD, University of Colorado
Professor Marianne Leuzinger-Bohleber PhD, Sigmund Freud Institut &  University of Kassel
Distinguished Professor Mardi Horowitz MD  Professor George Silberschatz Ph.D, University of California
Professors Ayelet Barkai MD, Raymond Levy PsyD, Harvard University and Medical School
Professors Helmut Thomä  MD, Horst Kä chele MD PhD, University of Ulm
Distinguished Professor Paul L. Wachtel PhD  Professors Diana Diamond PhD, Eric A. Fertuck Ph.D., Elliot Jurist, PhD, City University of New York
Professors Christopher Perry MD, Daniel Frank PhD, Martin Drapeau PhD, McGill University
Professor Kenneth N. Levy PhD, Pennsylvania State University
Professors Stephan Hau PhD, Andrzej Werbart Ph.D., Stockholm University
Professor Anna Buchheim PhD, University of Innsbruck
Professor Jeremy Safran Ph.D., New School for Social Research, New York
Professor Stijn Vanheule PhD, Reitske Meganck PhD, Mattias Desmet PhD, Ghent University
Professors Geoff Goodman Ph.D., Marvin Hurvich PhD, Philip S. Wong PhD, Long Island University
Professors Eve Caligor MD, Lewis Aron Ph.D., Richard Lasky PhD, New York University School of Medicine
Professors Morris Eagle PhD, Joel Weinberger PhD, Adelphi University
Professor Nancy McWilliams PhD, Rutgers University
Professor Michael Stuart Garfinkle, PhD, Mount Sinai School of Medicine
Professor Allan Abbass, MD, Dalhousie University
Professor Joseph Masling PhD, State University of New York at Buffalo
Professor Golan Shahar PhD, Ben-Gurion University
Professor Adela Leibovich de Duarte, Ph.D., Buenos Aires University
Professor John Auerbach PhD, East Tennessee State University
Professor Henning Schauenburg MD, University of Heidelberg
Professor Dorothea Huber MD PhD, University of Munich
Professor Stephen Soldz PhD, Boston Graduate School of Psychoanalysis
Professor Phebe Cramer PhD, Bronfman Science Center
Professor Bethany Brand Ph.D., Towson University
Professors Louis Diguer PhD, Karin Ensink PhD, Sté phane Sabourin Ph.D., Universite Laval, Quebec
Professor Clara Lopez-Moreno, Universidad del Salvador
Dr Alessandra Lemma PhD, Visiting Professor, Essex University
Dr Saskia de Maat PhD, Mentrum Institute for Mental Health, Amsterdam
Dr Patrick Luyten PhD, University of Leuven
Dr Margaret R. Zellner PhD, The Rockefeller University, President and Chair, The Neuropsychoanalysis Foundation
Dr Mary Beth Cresci Ph.D., President, Division of Psychoanalysis, American Psychological Association
William H. Gottdiener Ph.D., Director, Addiction Studies Program, John Jay College of Criminal Justice
Dr David Taylor, Clinical Director of the Tavistock''s Randomised Controlled Trial of psychoanalytic psychotherapy in the treatment of chronic and refractory depression
Dr Sherwood Waldron MD, Chair, Psychoanalytic Research Consortium
Dr Paolo Migone MD, Editor, Psicoterapia e Scienze Umane
Dr Henriette Lö ffler-Stastka MD, Medical University of Vienna
Answer 700 views

01 Jan 0001

A self-serving plea mainly from people who make a good living by selling psychoanalysis and research on it in one way or another. Which means neither that they are right or wrong. This readsrather like the NRA, the American National Rifle Association commenting on the school shootings, when they declared that the problem was that there are not ENOUGH guns in schools, and more armed guards should be added !
ANd as they admit, those who signed the letter have benefitted from millions of dollars in funding for research, and would agreee that there is a need for much more such research.
I notice that while they refer to studies of effectiveness ( and they're right that a double-blind trial would not be possible ), they don't seem to refer to COST-effectiveness, which is profoundly relevant.
Anyhow, I haven't read the original article by Bunge which they're defending against ( my budget doesn't run to these journals ) I see some former colleagues amongst the signatories, so I'd like to read the original and this reply with more care, if I had the time and access.
Simply to have assembled so many senior sinatories within a short time was an impressive achievement !
The debate seems more than academic within SA, where its not always practical to find Panado on the shelf of a government hospital, doesn't it ?
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