Edited by Wilma Bucci and Norbert Freedman
Psychoanalytic ideas and applications: 2
International Psychoanalytical Association, London
Reviewed by Ron Spielman
This book represents the proceedings of a conference to mark the lifetime’s work of Dr. Robert Wallerstein, almost certainly the person most responsible for the current recognition of, and support for, research into psychoanalytic outcomes and process, by the IPA. As a consequence, the book itself is a multi-authored collection of chapters.
All the contributors pay tribute to the inspiration provided by Wallerstein in their own research careers and acknowledge his own pioneering efforts in the field of research, together with the administrative and organisational – as well as funding - foundations he provided in the course of his Presidency of the American Psychoanalytical Association and, later, of the International Psychoanalytical Association.
The first quarter of the book is comprised of personal tributes and reminiscences, as well as a very interesting chapter by Wallerstein himself, outlining his own history involving both personal and professional aspects.
The second quarter addresses the development and use of the “SPC” – the Scales of Psychological Capacities – a comprehensive set of rating procedures intended to serve the interests of quantifying outcomes of psychoanalytically oriented treatments. The development of the “SPC” owes much to Bob Wallerstein’s initiatives as well as his ability to recruit co-workers and harness their research efforts. The detailed account of the need for validation and reliability testing when new such “scales” are developed reveals how daunting such research projects are in the current scientific research climate.
The remainder of the book offers considerable historical and current information about the major research projects which have been mounted – are currently being pursued.
A constant “background theme” throughout the book is the tension between research objectives and clinical practice considerations: whether intrusions into the confidentiality of the treatment setting and the risks of doing violence to the analytic process itself justify the benefits (if any!) of the research. Many psychoanalyst clinicians have a strong antipathy to anything intruding into the analytic setting and probably often feel something like “So what? We already knew that!” in response to some of the more “mundane” research “findings”. Nevertheless, our field’s credibility within the human sciences depends on developing appropriate research projects which support and demonstrate beneficial outcomes and address relevant process aspects.
Validation of theoretical concepts – while important in themselves – are not part of this book’s purview.
For those who do not hold much store in research into outcomes and process, this book has little to offer – other than interesting personal and professional “information” about a man who has undoubtedly played a key role, at a critical period of time, in the development of the International Psychoanalytical Association. Apart from Wallerstein’s own contribution of two chapters, three other Presidents of the IPA are contributors: Claudio Eizirick (current President) provides the introduction, while Otto Kernberg and Daniel Widlocher contribute two chapters detailing aspects of Wallerstein’s important influence on the IPA itself, and on the field of research more widely.
Three other “names” in psychoanalytic research are contributors: Lester Luborsky and Hartvig Dahl (recently deceased), together with Peter Fonagy write of their indebtedness to Wallerstein in the development of their own research careers. Luborsky is an important initiator of relevant rating scales (including the Global Assessment of Functioning, the “G.A.F.”, many may be surprised to learn!) and more recently the C.C.R.T. (Core Conflictual Relationship Theme). Hartvig Dahl was a pioneer of “micro-analytic research” procedures which involve analysing the texts of transcripts of sessions themselves.
Peter Fonagy will be well known to all as the inspiration and “driver” of much productive research involving attachment studies and the development of the useful concept of “mentalisation” as a hallmark of psychic developmental achievement. Fonagy’s (and co-workers’) demonstration of a relationship between impaired capacity for mentalisation in mothers and the subsequent development of borderline psychopathologies in their offspring is, I consider, a major contribution to contemporary psychoanalysis.
Now, for those who are interested in the broad field of psychoanalytic research, this book is a treasure trove of references to past significant published research papers (from earliest times) and to current research projects being developed in increasingly imaginative ways.
Wallerstein himself initially wrote of the history and development of three “generations” (of sophistication) of research projects. This concept has been taken on and developed further by Wilma Bucci in this volume to include current and projected directions in relevant research.
Her contribution addresses comprehensively many of the relevant issues and acknowledges the need to firmly base the projected research designs in psychoanalytic treatment realities: the concepts relating to transference and countertransference relationship; allowing for the analyst’s own subjectivity; importance of validation by psychoanalytically sophisticated observers, supervisors and raters; and sensitive and appropriate external validation procedures.
Lastly, a number of contributors referred to the so-called “Wallerstein Summary”. This refers to Bob Wallerstein’s renowned ability to succinctly and comprehensively summarise the proceedings of conferences at concluding plenary sessions. The present reviewer has also had the opportunity to be awed by this ability of Wallerstein’s!
The final chapter of the book is one such tour de force by Wallerstein himself, encapsulating the entire book’s main points.
Whether the time, effort and money devoted to these newly designed research projects justify the findings which may or may not result, remains to be seen. But as ancient Jewish wisdom asserts: “the work is not yours to finish – but neither are you free not to partake in it”. The task is daunting, but some of our colleagues are courageously putting their shoulders to the wheel. This volume documents many of their efforts.