Hi Mike, First, I enjoy healthy skepticism and have a good dose of it myself. Second, you are right, this video is designed to show the scientific efficacy of the psychoanalysis in comparison to other treatments, technically not 'proving' the theory of psychoanalysis. It shows that when people engage in psychoanalysis they seem to show improvements in the ways demonstrated in the studies. Now, to get technical, this method is basically how all the current treatments (everything from ECT, to psycho-pharmacology, to CBT, to TMS) 'prove' themselves - they show that the people who engage in the treatment do statistically better than people who don't have the treatment. However, psychoanalysis is in a bit of a renaissance, buoyed by a lot of basic research in areas of neuroscience. Now, like any theory, there are not conclusive studies - for example there will never be a study that can conclusively prove evolution, there are simply increasing supports of evidence. Well, there is more and more acknowledgement by the scientific community of the validity of many psychoanalytic theories. Here's a recent article from the Atlantic where a brain researcher is recognizing the large association areas of the brain, and how studying how brains make associations lets you understand things such as creativity. She specifically cites how psychoanalysis uses free association to study the mind, and how she is trying to duplicate the process using other methods and imaging studies of the various association areas in the brain. www.theatlantic.com/features/archive/2014/06/secrets-of-the-creative-brain/372299/ Another area that comes to mind is the re-emergence of research citing the importance of the unconcious mind and dreams. Dreams were once dismissed as 'random' - no longer! Robert Stickgold, a Harvard sleep researcher gave a TED talk where he discusses some of the material : th-cam.com/video/WmRGNunPj3c/w-d-xo.html. In it I think he lends a lot of supporting evidence that there is an unconscious mind that works in dynamic and important ways - including the importance of dreams - that can be scientifically tested. Great idea for me to make a followup video - I'll put it on the list! Thanks for your question, John Cornelius
Just want to add my own "Thank you!" You very clearly make a case for psychoanalysis...something I find challenging to do. I spent the full 45 minutes watching your video because it was worth my while, and I hope I will revisit it to strengthen my own capacity to articulate the very case you describe. Well done and quite seemingly unbiased.
Hey this is very true! I am a trainee psychologist. My university instructor always says psychoanalytic treatment has no proof, I cannot be bothered to argue with her but she has the opinion without backing it up!
Thank you for sharing this - as a psychoanalyst specializing in eating disorders, I'm often asked why I think psychoanalysis is more effective than "evidenced-based" therapies such as CBT. This is very helpful :)
This is great, thank you - encouraging and clear. Providing evidence for the way in which the psychoanalytic process endures and continues beyond the end of treatment is especially welcome. One of the downsides you point out in your summary is that it is "hard to treat in large numbers". I'm a group-analytic psychotherapist. Group analysis can help with that!
Thank you for sharing this with us. I teach residents and child fellow psychodynamic psychotherapy. This is very good and very effective teaching tool. As an adult psychoanalyst, i appreciate what you had offered all of us. Mali Mann
Outstanding presentation Dr!!! I’m a PGY-2 psych resident with a particular interest in psychoanalysis and was brought here from Dr. Don Carveth’s website who actually has this video in his list of recommended resources. This is a very needed contribution to what I believe is a resurgent interest in psychoanalytic theory and practice given the limitations found with CBT and standard of care psychiatry. I would like to know if there have been any potential updates to this video within the past 7 years since posted? Has there been any new evidence solidifying the effectiveness of psychoanalytically oriented therapies? What recommendations would you give in terms of study design for residents like me who are interested in contributing to the evidence base of psychoanalytic therapy? Thanks!
Thanks you! I enjoy the presentation. We (in the hispanic world) don't have a serious material to understand this questions about psychoanalysis and his clinical effectivity research. Again, thanks :v .
John, if you revisit this material at some point, can you include confidence intervals for some of your estimates and also define the scale on which they are being measured? I was unclear what the effect size was estimating in these analyses. It sounds like they're estimating a difference between one treatment type versus another in some studies. Whereas in others, they're estimating rates (as in relapse rates). Thanks for posting this! I didn't know about the relapse rates associated with CBT for some of these disorders. That was definitely new information to learn about.
This is a potent, compelling argument in defense of psychoanalytic/psychodynamic approaches. It truly serves to augment the apology for psychodynamic psychotherapy offered by Jonathan Shedler in the American Psychologist: www.apsa.org/portals/1/docs/news/JonathanShedlerStudy20100202.pdf These are critical voices at a time when psychoanalytic/psychodynamic treatments have become marginalized within academic settings and, by extension, have been largely dismissed by political activists. Thank you for contributing to this important conversation, John. I very much look forward to sharing this video with my colleagues and students. -Mike
I am a undergraduate deciding on whether I should pursue CBT, psychodynamic or both. According to this video, it would be unwise yo pursue cbt given the unpromising long term efficacy. would you agree with this? any advice?
I think it depends on what you want to do and how you want to do it. Both fields offer many possibilities, but approach the mind very differently. Nancy McWilliams does a nice job of pointing out how CBT is quickly evolving into longer and more in depth treatments that increasingly recognize unconscious motivations- some may call that simply 'becoming psychoanalysis', but I am not sure - I think a motivated person would find room in either theory. I personally find psychoanalysis much more theoretically deep right now in a way where each person is a unique and complex person who must be dealt with individually- I prefer that so psychoanalysis makes sense for me. But that is not for everyone.
Hi Mike,
First, I enjoy healthy skepticism and have a good dose of it myself. Second, you are right, this video is designed to show the scientific efficacy of the psychoanalysis in comparison to other treatments, technically not 'proving' the theory of psychoanalysis. It shows that when people engage in psychoanalysis they seem to show improvements in the ways demonstrated in the studies.
Now, to get technical, this method is basically how all the current treatments (everything from ECT, to psycho-pharmacology, to CBT, to TMS) 'prove' themselves - they show that the people who engage in the treatment do statistically better than people who don't have the treatment.
However, psychoanalysis is in a bit of a renaissance, buoyed by a lot of basic research in areas of neuroscience. Now, like any theory, there are not conclusive studies - for example there will never be a study that can conclusively prove evolution, there are simply increasing supports of evidence. Well, there is more and more acknowledgement by the scientific community of the validity of many psychoanalytic theories.
Here's a recent article from the Atlantic where a brain researcher is recognizing the large association areas of the brain, and how studying how brains make associations lets you understand things such as creativity. She specifically cites how psychoanalysis uses free association to study the mind, and how she is trying to duplicate the process using other methods and imaging studies of the various association areas in the brain. www.theatlantic.com/features/archive/2014/06/secrets-of-the-creative-brain/372299/
Another area that comes to mind is the re-emergence of research citing the importance of the unconcious mind and dreams. Dreams were once dismissed as 'random' - no longer! Robert Stickgold, a Harvard sleep researcher gave a TED talk where he discusses some of the material : th-cam.com/video/WmRGNunPj3c/w-d-xo.html. In it I think he lends a lot of supporting evidence that there is an unconscious mind that works in dynamic and important ways - including the importance of dreams - that can be scientifically tested.
Great idea for me to make a followup video - I'll put it on the list!
Thanks for your question,
John Cornelius
Just want to add my own "Thank you!" You very clearly make a case for psychoanalysis...something I find challenging to do. I spent the full 45 minutes watching your video because it was worth my while, and I hope I will revisit it to strengthen my own capacity to articulate the very case you describe. Well done and quite seemingly unbiased.
Hey this is very true! I am a trainee psychologist. My university instructor always says psychoanalytic treatment has no proof, I cannot be bothered to argue with her but she has the opinion without backing it up!
Thank you for sharing this - as a psychoanalyst specializing in eating disorders, I'm often asked why I think psychoanalysis is more effective than "evidenced-based" therapies such as CBT. This is very helpful :)
This is great, thank you - encouraging and clear. Providing evidence for the way in which the psychoanalytic process endures and continues beyond the end of treatment is especially welcome. One of the downsides you point out in your summary is that it is "hard to treat in large numbers". I'm a group-analytic psychotherapist. Group analysis can help with that!
I am a researcher and I consider this a very well done and balanced presentation.
Good lecture. Thanks for posting.
Thank you for sharing this with us. I teach residents and child fellow psychodynamic psychotherapy. This is very good and very effective teaching tool.
As an adult psychoanalyst, i appreciate what you had offered all of us.
Mali Mann
thank you for this wonderful lecture. as a psycho dynamic therapist it is very relevant and very helpful for me!
Thank you John for making this video. It's easy to follow and understand and the information is priceless.
Outstanding presentation Dr!!! I’m a PGY-2 psych resident with a particular interest in psychoanalysis and was brought here from Dr. Don Carveth’s website who actually has this video in his list of recommended resources. This is a very needed contribution to what I believe is a resurgent interest in psychoanalytic theory and practice given the limitations found with CBT and standard of care psychiatry. I would like to know if there have been any potential updates to this video within the past 7 years since posted? Has there been any new evidence solidifying the effectiveness of psychoanalytically oriented therapies? What recommendations would you give in terms of study design for residents like me who are interested in contributing to the evidence base of psychoanalytic therapy? Thanks!
Thanks you! I enjoy the presentation. We (in the hispanic world) don't have a serious material to understand this questions about psychoanalysis and his clinical effectivity research. Again, thanks :v .
John, if you revisit this material at some point, can you include confidence intervals for some of your estimates and also define the scale on which they are being measured? I was unclear what the effect size was estimating in these analyses. It sounds like they're estimating a difference between one treatment type versus another in some studies. Whereas in others, they're estimating rates (as in relapse rates). Thanks for posting this! I didn't know about the relapse rates associated with CBT for some of these disorders. That was definitely new information to learn about.
very good presentation! are the slides available on internet?
It would be really nice if you could link the references in the description box
This is a potent, compelling argument in defense of psychoanalytic/psychodynamic approaches. It truly serves to augment the apology for psychodynamic psychotherapy offered by Jonathan Shedler in the American Psychologist: www.apsa.org/portals/1/docs/news/JonathanShedlerStudy20100202.pdf These are critical voices at a time when psychoanalytic/psychodynamic treatments have become marginalized within academic settings and, by extension, have been largely dismissed by political activists. Thank you for contributing to this important conversation, John. I very much look forward to sharing this video with my colleagues and students.
-Mike
I am a undergraduate deciding on whether I should pursue CBT, psychodynamic or both. According to this video, it would be unwise yo pursue cbt given the unpromising long term efficacy. would you agree with this? any advice?
I think it depends on what you want to do and how you want to do it. Both fields offer many possibilities, but approach the mind very differently. Nancy McWilliams does a nice job of pointing out how CBT is quickly evolving into longer and more in depth treatments that increasingly recognize unconscious motivations- some may call that simply 'becoming psychoanalysis', but I am not sure - I think a motivated person would find room in either theory. I personally find psychoanalysis much more theoretically deep right now in a way where each person is a unique and complex person who must be dealt with individually- I prefer that so psychoanalysis makes sense for me. But that is not for everyone.