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Studied processes and outcomes of psychoanalysis and psychoanalytic psychotherapy, both expressive and supportive. 42 Ss were followed via initial, termination, and follow-up studies over the entire natural course of treatment, with 100% follow-up 2-3 years posttermination. Some follow-ups extended over the 30-year life span of the study. Detailed case histories and life histories were obtained from all 42 Ss. Psychoanalyses achieved more limited outcomes than predicted; psychotherapies often achieved more than predicted. Supportive mechanisms infiltrated all therapies, psychoanalyses included, and accounted for more of the achieved outcomes (including structural changes) than anticipated. An expanded new categorization of supportive therapeutic mechanisms is proposed, along with an elaboration of expressive therapeutic mechanisms.

The kind of science that psychoanalysis is (can be), and the kind of research appropriate to it, qualitative and ⁄ or quantitative, have been divisive issues from the very inception of the discipline. I explore in detail the complexity of these issues, definitional and semantic, as well as methodological and substantive. A plea is made for the application of qualitative (idiographic)and quantitative (nomothetic) research methods, each to the extent that is appropriate, separately or in conjunction, across the entire spectrum of research domains in psychoanalysis, empirical, clinical, conceptual, historical, and interdisciplinary.

Psychotherapy research can be divided into 4 generations, marked by increasing conceptual sophistication and technological enhancement. The 1st generation ) comprised simple retrospective counts of improved outcomes by unspecified criteria. The 2nd generation consisted of 2 kinds: (a) prospective group-aggregated studies of psychoanalytic treatments, with specified definitions, operationalized criteria, and predictions to expected outcomes, and (b) individually studied outcomes in a sequence of patients. The 3rd generation combined both kinds of 2nd-generation studies with the added feature of separating outcomes at termination from the more enduring effects at subsequent follow-up. The 4th, current generation (1970s-) adds in microanalytic process studies made possible by recent technological advances-audiotapes, combined with computer searches.

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