Traditional objections to research in dynamic psychotherapy on the grounds that patients experience research procedures as significantly intrusive and disruptive appear to be unfounded.

No need exists, it is argued, for a new psychoanalytic theory of homosexuality. Certainly psychoanalysis should not be expected to generate such a theory using its own methodology alone. The preoccupation with producing such a theory avoids more important questions about psychoanalytic theory building raised by an examination of the long relationship between psychoanalysis and homosexuality. These questions concern the problems related to using psychoanalytic methodology (1) to construct categories (including the categories normal and abnormal), (2) to construct causal theory (the problems include the limitations of psychoanalytic developmental theory and a long-standing confusion between psychoanalytic developmental theory, psychoanalytic genetic reconstruction, and psychodynamics), and (3) to identify "bedrock." Finally, the question is addressed of what might be needed that is new in the psychoanalytic approach to homosexuality.

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Despite the widespread use of long-term psychodynamic treatments, methodologically rigorous outcome studies have not been conducted. The authors describe the results of a feasibility study designed to (1) investigate whether patients in psychodynamic treatment, including psychoanalysis, could be recruited and retained as research subjects, (2) determine patient and therapist compliance with self-report measures, rater-administered structured interviews and session audiotaping and (3) obtain pilot data on changes in these measures after one year of treatment. Nine patients entering psychoanalysis and fifteen entering psychodynamic psychotherapy were studied at baseline, six months and one year. Major findings were as follows: (1) recruitment rates were 27% (psychoanalysis) and 83% (psychotherapy), (2) all patients who remained in treatment remained in the research protocol, (3) drop-out rates among research participants and non-participants were equivalent, (4) current Axis I (usually affective or anxiety) disorders were found in over 60% of patients, (5) Axis II disorders in the absence of current Axis I disorders were rare, (6) despite a small number (N) of participants, significant positive change was demonstrated on a variety of measures after one year. Results suggest that it is possible to demonstrate a therapeutic effect of psychodynamic treatments, including psychoanalysis, but changing negative clinical perceptions of research is necessary if methodologically rigorous outcome studies are to be possible in the future.