The Significance of the Case History in Clinical Psychoanalytic Research
The discussion of psychoanalysis as a discipline has generated a host of quite controversial philosophical debate, as we have sketched out in the preceding chapter. The more it enters into general awareness that psychoanalysis as a psychological system has exerted and will continue to exert a tremendous influence on the psychosocial profession and on contemporary culture generally, the more remarkable it seems that decades after its inception, some of the most basic concepts of this theoretical and practical system remain controversial (cf. Meehl, 1973, p. 104). Yet surely it would not be an exaggeration to speak of Sigmund Freud’s (1895d) first attempt to explain neurotic symptoms in a fundamentally different way from his contemporaries as a scientific revolution. Before Freud’s attempts, hysterical symptoms were regarded by psychiatry as the result of a “degenerate constitution,” the consequence of a somatic predisposition. Freud’s critical contribution to the development of psychological research consisted in his formulation of two assumptions: that hysterical symptoms should be regarded primarily as psychic phenomena-though not necessarily conscious ones-and that as such they are to be viewed as comprehensible psychic structures. As Mayman (1973b) emphasizes, these postulates of psychologism and determinism remain the two most important postulates upon which psychoanalysis is based today.‡
The introduction of these two assumptions, which went hand in hand with the development of a corresponding method of observation, represents
a decisive turning point, a new methodological paradigm (Kuhn, 1962). It is one of the central paradoxes in the development of psychoanalytic theory and practice that while Freud has gone down in the history of scientific theory as a significant and incisive methodologist,* the yield of empirical psychoanalytic research has only recently begun to bear fruits.