Academic journal article Psychologische Beiträge

The Psychoanalytic Case Study as a Source of Epistemic Knowledge

Academic journal article Psychologische Beiträge

The Psychoanalytic Case Study as a Source of Epistemic Knowledge

Article excerpt

Introduction

It will be the task of this chapter to examine in detail the short story-like, narrative character of the declining genre of the case study, with specific respect to its adequacy and scientific quality. It is not the intent of the chapter to provide an overview of the multitude of psychotherapeutic and psychoanalytic case reports that have appeared since Freud's studies on hysteria (Freud, 1895). Nor are we interested in attempting an adequate and/or sufficient account of the many modern quantitatively based single-case analyses. Rather, we shall concentrate on the justification and acceptability of narrative case reports, primarily with regard to methodological aspects, in order to work out a methodology. We shall begin by locating the value of the case study within recent psychotherapy research. In a second step, we shall look at the roots and historical development of the case study. In particular, we shall consider Freud's famous case reports, trying to pinpoint their implicit methodology and to relate it to modern approaches of biographical psychology and qualitative research. We shall then proceed to try to conceptualize Freud's implicit methodology and to relate it to the methodology of qualitative research. Finally, we shall present a preliminary description of our concept of the case study which will not only delineate it from other methods but also determine it structurally. Essential characteristics in this context will be the concepts of typification, ideal type, and trajectory. Within this framework, we shall end by discussing the linear, dialectical, and dramatic aspects of the psychotherapeutic trajectory.

Discontent in Psychotherapy Research and the Need for a Holistic Understanding

Since the mid-80s, there has been a growing discontent with psychotherapy research findings hitherto attained. Originally, this discontent had been about a series of over 4000 studies centering on the question of effectiveness, wherein preference was given to research designs based on group comparison - similar to what is done in pharmacological research settings. The dispute arose from Eysenck's (1952) provocative claim that spontaneous remission rates among patients with psychoneuroses were higher than improvement rates from psychotherapeutic treatments. This claim has proved to be untenable even on the basis of Eysenck's own data pool (McNeilly & Howard, 1991). More strongly, it has been refuted by further findings from the relevant literature (Lambert & Bergin, 1994). Currently, a somewhat polemical discussion is going on regarding the question of superiority of different individual therapy approaches (Grawe, Donati & Bernauer, 1994; Mertens, 1994; Meyer, 1994; Tschuschke, Michele & Holzer, 1994). The different parties agree, however, that, although psychotherapy can be reasonably assumed to be helpful, it is yet unclear how this is achieved. According to Klaus Grawe, the problem is caused by "... an all too euphemistic, statistically generated concept of effectivity of different individual therapy approaches under study."1 (Grawe, 1988, p. 2).

Grawe has further argued, "... group statistical screenings and analyses isolate each piece of data from the context within which it operates as meaningful for an individual or for a specific therapy, integrating it with other likewise decontextualized scraps of data. The results and evaluations thus extracted no longer relate to an individual or to a therapy, but represent abstract features, such as, for instance, membership of a certain patient or therapy group..."2 (Grawe, 1.c.). As a consequence, the data collection of a project grows into an enormous data pool, by means of which the various different statistical procedures, aiming at isolating significant relationships, can then be "tested". Yet, high and unambiguous correlations are rare. In a programmatic essay of 1988 Grawe demanded, Zuruck zur psychotherapeutischen Einzelfallforschung (Back to psychotherapeutic single-case research). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.