Psychoanalysis - With whom, for what, and how? Comparisons with psychotherapy

Sidney J. Blatt, Golan Shahar

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


If psychoanalytic treatment is to survive in the era of evidence-based medicine and managed care systems, empirical evidence is needed to demonstrate its unique nature and effectiveness. To address this need, comprehensive analyses were conducted of data from the Menninger Psychotherapy Research Project (Wallerstein 1986). These analyses addressed three questions: (1) What are the differences in outcome between psychoanalysis (PSA) and supportive-expressive psychotherapy (SEP)? (2) With what types of patient, and in what ways, are these two psychodynamic treatments differentially effective? (3) Are these differences in outcome the consequence of possibly different mechanisms of therapeutic action? PSA was found to contribute significantly to the development of adaptive interpersonal capacities and to the reduction of maladaptive interpersonal tendencies, especially with more ruminative, self-reflective, introjective patients, possibly by extending their associative capacities. SEP, by contrast, was effective only in reducing maladaptive interpersonal tendencies and only with dependent, unreflective, more affectively labile anaclitic patients, possibly by containing or limiting their associative capacities.

Original languageEnglish
Pages (from-to)393-447
Number of pages55
JournalJournal of the American Psychoanalytic Association
Issue number2
StatePublished - 1 Jan 2004
Externally publishedYes

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Psychology


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