A Procedure for Evaluating the Results of Psychoanalysis: A Preliminary Report

Structural change as a predictor of long-term follow-up outcome

“…also Beutler & Hamblin, 1986) and that such changes to the inner reference system represent a particular aim of psychoanalytic treatment. We emphasize this point with reference to the reports of the patients at the follow-ups: Similar to other psychoanalytic follow-up studies (LeuzingerBohleber, 2002;Pfeffer, 1959), our patients repeatedly retrospectively reported that their views and evaluations had been fundamentally transformed during but also following their therapy and that they now saw themselves and other people ''in a different light'' so to speak. Problems that had caused much distress before therapy appeared less significant in hindsight and behaviours and arrangements that had previously seemed ''normal'' were perceived as problematic.…”

“…Follow-up studies (LeuzingerBohleber, 2002;Pfeffer, 1959;Schlesinger & Robbins, 1975) have repeatedly shown that patients remain susceptible with respect to their central conflicts for a long time after successful courses of therapy and that they transiently react in a neurotic manner when conflict-laden topics are touched upon. What is fundamentally changed is rather the patients' ability to deal with such situations in a regulatory fashion: Following therapy, patients are able to find healthy solutions instead of the neurotic solutions that were previously selected (Nedelmann, 1981;Pfeffer, 1959;Schlesinger & Robbins, 1975). These observations suggest that changes within psychoanalytic treatment should be conceptualized as changes in dealing with conflictual tendencies and vulnerabilities rather than their elimination.…”

After the Analysis: Analyst as Both Old and New Object

“…The case, previously reported in its entirety (Pfeffer, 1961), concerns a woman whose main symptoms had been attacks of severe anxiety and depersonalization. Her analysis by a senior analyst, terminated four years prior to followup study, had been regarded as highly satisfactory by analyst and patient.…”

“…Patients who had been analyzed by other analysts were seen in followup study years after analysis. Those patients who had been satisfactorily analyzed experienced and demonstrated brief, transient but vivid recurrences of the analytic transference neurosis, including the symptoms for which analysis was first sought (Pfeffer, 1963). The conclusions reached on the basis of such observations were that, after the analysis, the experience of the analysis, including both the transference neurosis and its resolution, continue to be mentally represented and remembered, and are repeated in the followup study as well as in life.…”

“…My interest in this question was stimulated in large part by observations I had occasion to make some years ago in carrying out followup studies (Pfeffer, 1959(Pfeffer, , 1961(Pfeffer, , 1963(Pfeffer, , 1980. Patients who had been analyzed by other analysts were seen in followup study years after analysis.…”