Does it work?

Psychoanalysis as a form of therapy – i.e. a treatment aimed at making people get better, also called psychoanalytic or psychodynamic therapy – is notoriously difficult to research using quantitative methods, such as randomised controlled trials, that have become the standard for assessing effectiveness in the current political and scientific climate. Freud attempted to found psychoanalysis as a science, but its clinical practice is as much an art as a science. It is centered around subjectivity and, unlike much of academic psychology, it has so far stubbornly refused to abandon its aspiration to account for the human mind in all its complexity in favour of easy-to-measure simplified versions of it that are often further from reality than common sense allows.

This intrinsic problem is also its greatest asset. Because psychoanalysis is not satisfied with superficial models of the mind, because it does not claim to know (and instead is committed to finding out), and because it does not attempt to make patients comply with a pre-arranged course of therapeutic action, its effects can be more difficult to document. But they are also more fundamental and longer lasting.

There is a growing body of solid research that makes just this point. A recent article in the Guardian, “Therapy wars: the revenge of Freud”, gives an excellent overview with links to relevant empirical studies. Somewhat more detailed (and dry) is this video on the scientific evidence for psychoanalysis by a US-based psychiatrist and psychotherapist. A meta-analysis published by the Journal of the American Medical Association shows that long-term psychodynamic therapy is an effective treatment, especially for complex mental health problems.

There are also fascinating developments in the emerging field of neuropsychoanalysis, summarised here by Mark Solms, psychoanalyst and professor in neuropsychology, who argues:

What’s unique to psychoanalysis is that we study subjective experience. The psychoanalytical method, for all of its faults, is the best method we have for dealing with all the shifting sands and subtle complexities of subjectivity.

For more on the comeback of Freud’s ideas on the unconscious and the latest neuroscience research, have a look at this opinion piece in the Guardian.