The phenomenology of the third ear: An empirical investigation of the psychoanalytic inference process.

The clinical inference process is one of the most crucial, yet least studied elements in the psychoanalytic situation. Through it clinicians formulate numerous partial and tentative conjectures about a patient's intrapsychic and interpersonal functioning. The present study explored characteristics of this process by asking a sample of expert psychoanalytically oriented clinicians (N = 72: 36 analysts; 36 therapists) to formulate and report inferences in response to two very different clinical vignettes taken from two patients in psychoanalysis. The clinicians then responded to a series of questions designed to explore their unique inference processes. The study also measured intimate parts of the inner worlds of the clinicians, including variables associated with fantasies and daydreaming (measured by the Short Imaginal Processes Inventory), potential for constructive ego regression (measured by the Experience Inquiry), and normal personality traits according to four bipolar indices of perception and judgment preferences (measured by the Myers-Briggs Type Indicator). The study yielded both quantitative and qualitative findings. The former were characterized by satisfactorily reliable ratings, but by few significant differences between subject groups. While only a few between-group hypotheses were supported, there were statistically significant differences between the two vignettes, indicating that subjects' inferences were tailored to the individual patient. Two of the most important qualitative findings, however, while based only on anecdotal evidence, were that these experienced clinicians achieved strong consensus about complex clinical phenomena, and their inferences were multi-dimensional. Subjects expressed expectable inferences for each of the vignettes, yet went further and expressed others characteristic of schools of analytic thought outside their clinical orientations. Such widespread agreement partially explains the paucity of statistical differences between clinician groups. The data suggest that experienced psychoanalytic clinicians view patients holistically and infer accordingly without resorting to stereotypic, or formulaic interpretations. The findings suggest we may continue to be optimistic about the evolution of psychoanalytic research and practice, that we have come far from "the consensus problem in psychoanalytic research.".PhDSocial Work and PsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/103515/1/9319659.pdfDescription of 9319659.pdf : Restricted to UM users only