psychoanalyst author editor
Research and Comparative Debate
The hyper-rationalism of the public service demand for evidence, even in those ‘sciences’ concerned with human beings, prompted thoughts about the kind of research we need to be doing in psychoanalysis. I was provoked by the rather willing acceptance of RCTs (random control trials) as the arbiter of psychoanalytic thinking. And the germs of a new strand began. Outcome studies are important, but so long as we know what treatments they are the outcomes of. Less and less attention is paid to the conceptual research that explores the theoretical background leading to techniques whose outcomes need to be measured. Too many different theories now make up psychoanalysis, and give rise to all sorts of technical innovations that can all be lumped together as psychoanalysis for the purposes of outcome evidence. In fact, much more rigorous methods of conceptual research need to be developed, and adopted as standard, otherwise we do not know what kind of psychoanalysis we are measuring the outcome from. This line of thinking has led eventually to a book on the way the clinical work can be used as research, and clinical material can be used as research data.
2008 Repression and splitting: Towards a method of conceptual comparison.
International Journal of Psychoanalysis 89: 503-521
By the time I had spent 10 years at an academic institution (The University of Essex), dedicated to the study of psychoanalysis, I had puzzled over how psychoanalytic research could be conducted more effectively. The situation within psychoanalysis was dire, as its popularity was declining, spawning many desperate attempts to develop theories sympathetic to the public, and entice popularity whilst rivalling each other. I took two terms, splitting, and repression, as signifying two different schools of psychoanalytic thought, and tried to formulate ways in which a rigorous comparison of them could be made using clinical material as research data.
2010 Psychoanalytic research: Is clinical material any use?
Psychoanalytic Psychotherapy 24: 362–379
Following on from the last paper, this is another attempt to study the process of psychoanalytic studies itself. The paper attempts to rescue some reflection on single case studies, which have been more or less totally rejected by experimental psychology. A general argument is made to reconsider a case study as potentially decisive in psychoanalysis. That argument rests in part on the fact that natural science (as opposed to experimental psychology) relies on a single well-designed experiment. So the conditions for the design of a psychoanalytic case study needs to be equally determined and rigorously designed.
2013 Research on the Couch: Subjectivity, Single Case Studies and Psychoanalytic Knowledge
London: Routledge (published in the New Library of Psychoanalysis)
This book brings together the necessary thinking on psychoanalysis ‘as a science’, given it is not a standard science at all, neither a natural science nor a medical or psychological science. The issues involved in research design described in a preliminary way in the previous paper, are elaborated considerable, and especially in relation to some contemporary philosophy of science. The argument is that material from single cases can be adequate research data, provided the research question is precisely enough formulated; and provided that the use of the data conforms to the conditions of a precise research design. That claim is then followed by an even more difficult issue – the gathering of data which is subjective, not objective, and the fact that the instrument of observation is itself subjective (the psychoanalyst’s mind). Very precise forms of clinical observation for generating such data are argued for, and eventually a number of examples from the literature are re-examined using the tools elaborated in this book – a binary research question, a critical clinical situation that will be decisive, and a precise protocol of observation. The fact that the interpretation of meanings is the stock in trade of psychoanalytic work, the formulation of such a hermeneutic approach with a science-like mode of empirical work, brings together one of the rifts within contemporary psychoanalysis – that between the hermeneutic approach and the psychoanalysis-as-science approach.
2014 Winnicott and Bion: Claiming alternate legacies.
Chapter in Spellman, M. and Salo, F. (eds.) London: Routledge.
Donald Winnicott and Wilfred Bion were contemporaries, and both built on Klein’s discoveries, although in different ways. There is a growing critical debate about the comparisons between Winnicott and Klein and Bion, of which this Chapter is an early contribution.
2017 The Clinical Paradigms of Melanie Klein and Donald Winnicott: Comparisons and Dialogues (Authors: Abram, J and Hinshelwood, R.D.)
This work evolved out of workshops run by Jan Abram and Bob Hinshelwood, which led into extended dialogues by email. The aim is to present the key features of each the protagonist in relation to each other, with a subsequent exploration of the key differences by means of the authors persistent questioning each other on the key clinical concepts.
2018 Intuition from beginning to end? Bion’s clinical approaches
British Journal of Psychotherapy
Whilst Winnicott and Klein had a professional relationship about which a good deal is known, the conceptual differences (and similarities) and rivalries between Winnicott and Bion are less well explored. This paper originated in a workshop in Los Angeles, where we intended to begin this important exploration
Insufficient debate is conducted on what form of research is appropriate for therapy that is based on relational qualities as opposed to quantitative measurement of symptoms and personality attributes.
2002 Symptoms or relationships (Comment on Jeremy Holmes’, ‘All you need is CBT’).
British Medical Journal 324: 288-294.
This was an invited comment for a discussion on Jeremy Holmes’ position on CBT versus psychodynamic forms of therapy. This comment concerns the immeasurable qualities of relational issues which are not so amenable to the assessment of quantitative change. And yet quality of relations is more important as a living function for troubled people.
2011 Manual or matrix: How can we know our outcomes?
Therapeutic Communities 31: 328-337.
Therapeutic communities focusing on the evaluation of learning from the individual-community relationship slips between the need for measurable outcome ‘quantities’, and the development of a capacity to enter and exist within social matrix of others whatever that may happen to be. Protocols or manuals pervaded by ‘should’ distract from the capacity for individual initiative in social relationships