Beyond Scientific Method

The article headed “Programs Try to Restore Luster to Psychodynamic Psychotherapy” in the June 18 issue reported that all graduating psychiatry residents are now required to demonstrate competence in five core psychotherapy treatment options, including psychodynamic psychotherapy.

One course being offered presents “some of the scientific evidence underpinning psychodynamic psychotherapy.” Scientific evidence may help restore the prominence, popularity, and respect for psychodynamic psychotherapy, but the scientific method has its limitations. It is based on comparing groups. If individuals fit into groups that have been studied, there is a statistical probability that the outcomes of the group studies apply to an individual. Scientific method cannot study or evaluate a single unit, a single individual.

In contrast, psychoanalysis or psychodynamic psychotherapy of a single patient is a method of studying and evaluating a single individual. The analytic process has an internal, logical, and rational approach throughout. Even in one session, a patient's statements at the beginning of a session are compared with statements during and at the end of the session.

This same rational process applies throughout an analysis. Statements and reports about mental pictures, feelings, and behaviors are continually cross-checked and compared. Inductive reasoning proposes hypotheses that are repeatedly confirmed or contradicted. In the latter case new hypotheses are formed. Thus, the study of an individual is continually being developed. The probabilities (to borrow a scientific term) of valid conclusions about an individual are gradually increased.

While we are in debt to scientific methods for much knowledge and information, and science-based treatment will always be important to treatment of individuals, it is time for professionals to stop worshiping the scientific method as if it were the only source of knowledge and information and accept that it cannot study or evaluate a single individual and produces only probabilities for an individual patient.

It is time to start appreciating the rational and logical approach of psychodynamic psychotherapy for producing probable knowledge and information about an individual patient.