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If the pharmaceutical industry develops a new drug which claims to reduce blood pressure, the logic of testing whether it works is seemingly easy. You gather two samples. Both have… Continue Reading…

Testing Therapy

If the pharmaceutical industry develops a new drug which claims to reduce blood pressure, the logic of testing whether it works is seemingly easy. You gather two samples. Both have their blood pressure measured. I know about such testing because I once took part in a study which meant I wore an automatic blood pressure machine, which took my blood pressure every 15 minutes over 24 hours.

In my imagined experiment for testing, Group A takes the new drug as prescribed, while Group B takes a placebo. To know if the drug works, you measure blood pressure over a period of time. There is only one crucial question: does the group that takes the drug then have lower pressure?

It is not so easy though when it comes to testing whether psychological therapies work. Freud, whose first papers were scientific studies of eels, disdained the idea of proving analysis worked. It was hard to tell if Ego was now where ID and Super Ego had once dominated. In her Tribute to Freud the American poet Hilda Doolittle said Sigmund told her apparently he wished someone would explain to him how analysis worked. We only have her word for it, though.

Jung’s early research studied how long it took for people to give associations to key words. He suggested that the reaction time was linked to how the ideas and feelings expressed in those words were defended. Sounds like a sensible method, but it was not a direct study of whether therapy worked. Jung’s later work was rather harder to prove or disprove.

Until the late 1940s, psychoanalysts thought it impossible or unnecessary to test if the treatment worked or not. Even after Hans Eysenck wrote his 1952 paper which claimed that any improvement was due to spontaneous remission, psychoanalysts resisted the idea of scientific testing. Eysenck sniped that that showed they did not want to face the truth. The reality is complex as the question of whether psychological therapies work is not as simple as measuring blood pressure levels. Consider what a study minimally needs to assess:
Does the client feel better in herself or himself after therapy?

Does the client seem better to friends and family?

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