Objectivity in psychoanalytic judgements

Background There is widespread scepticism concerning the reliability and validity of 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. In his attack on psychoanalysis as a pseudoscience, Eysenck (1985) insisted that: "a science cannot be based on subjective interpretations", We have responded to this criticism by testing whether it is possible for independent raters to agree in their psychoanalytic judgements about videotaped patient-therapist transactions. A further aim was to examine the coherence and clinical validity of Klein's characterisation of paranoid-schizoid and depressive position modes of mental functioning.