On the setting of analytic fees.
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Biomedical subjects
Publications and source records attributed to J B Erle.
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Some specific approaches to the study of analyzability have been identified in this study as productive and feasible. First, it was possible to enlist a group of experienced analysts as a source of clinical material--the data and their own evaluations. Second, the assessment of analyzability can only be made at the end of the treatment. Third, the classification of analysands as either "analyzable" or "unanalyzable" warrants further differentiation. Cases of patients who develop an analytic process may have variable outcomes: some conclude successfully with no modification in technique; some conclude with significant limitations in the analytic resolution; others require an appropriate modification in technique at some point. Cases of unanalyzable patients also have a variable outcome: some develop no useful treatment situation; in others the patient's unsuitability for analysis is manifest very early and a change to the appropriate psychotherapy is made. The study of how analysts make their evaluations and the subsequent course of those treatments seems useful in providing information on our work as psychoanalysts pertinent to practice, teaching, and research. Our experience suggests that a prospective study would be advantageous: data reported at the time of assessment could be more complete and less subject to retrospective distortion; definitions and criteria could be established in advance; important questions could be more clearly defined and explored as the material develops (by co-investigators as well as the analyst). This might include significant differences between analysts, the identification and impact of modifications, and the study of cases started in psychotherapy and subsequently seen in analysis.
As additional studies of assessment of analyzability have been reported, research has proven very difficult and provided little clarification. This paper reviews the literature, particularly of the last twenty-five years, from the viewpoint of identifying the nature of the problems in developing useful methods of study. Some approaches to these problems, which might provide increased understanding as well as a clearer definition of some inherent limitations, are discussed.
The cases of 40 consecutive patients, accepted for supervised psychoanalysis at the Treatment Center of The New York Psychoanalytic Institute, are reviewed. The process of the initial evaluation is examined as well as the nature of the patient group, the characteristics of the treatment, outcome, and follow-up data. A survey of a group of 42 patients from the private practice of a group of graduate analysts during the same period of time is also reported. Both studies are discussed in relation to methodological issues, and an approach is suggested for the study of assessment of analyzability and analyses through a systematic prospective study of analytic treatments conducted by experienced analysts.