Objectivity in psychoanalytic judgements

Abstract

Background: There is widespread scepticism concerning the reliability and validity psychoanalytic judgements of patient-therapist transactions. We predicted that (a) in reviewing the initial part of 14 videotaped assessment interviews with borderline and dysthymic subjects, dynamic psychotherapists would agree in their ratings of psychoanalytically relevant characteristics of subjects' interpersonal relations; (b) inter-correlations among the ratings would conform with those expected from psychoanalytic descriptions of paranoid-schizoid' and 'depressive position' states of mind; and (c) these ratings would differentiate between borderline and dysthymic groups.

Method: Six trained psychotherapists who were blind to the design of the study, independently rated qualities of interpersonal relatedness during the first 30 minutes of each interview, on a 30-item 'personal relatedness profile'.

Results: There was satisfactory interrater reliability in judgements among the raters, and evidence that the items were interrelated. There was also a significant difference between the two subject groups.

Conclusions: It is possible to make reliable psychoanalytic judgements about qualities of interpersonal relatedness. Moreover, there is evidence that paranoid-schizoid and depressive positive aspects of psychological functioning do constitute a meaningful constellation of clinically grounded phenomena.