The Virtual Case Report

Abstract

Reports of clinical happenings are coming under increasing suspicion because of their piecemeal nature and their problematic reliance on memory. Recent research on eyewitness testimony has raised the further concern that memory of an event can be easily and unwittingly influenced by something heard or seen after the fact. Once the psychoanalyst's memory has come under the influence of whatever theory is dominant, we can expect both an overselection of clinical happenings consistent with that theory, and an unwitting alteration of those that do not agree. Seemingly true case reports may be more virtual than veridical.

The patient's private construction of meaning and canons of science: Freud's case studiesnoch einmal

“…At the same time, growing attention is being paid to the insecure foundations of core theories and therapeutic principles (cf. Tuckett, 1998;Spence, 2002;Fonagy, 2002Fonagy, , 2003Fonagy and Target, 2003, pp. 283-301).…”

Sidney J. Blatt’s contributions to psychoanalytic psychology: Introduction to the special section.

“…It is therefore a particular problem for psychoanalysis that much of what passes for knowledge in the discipline is actually the result of a procedure that is of necessity conducted in private and the content of which is made public in highly processed case reports, without recourse to transcripts or recordings that can be discussed and critiqued by the community of scholars. It is too often a hermeneutics without access to actual texts (Siegel, Josephs, & Weinberger, 2002) but with analyst recollections that are almost of necessity biased, fragmented, misremembered, or highly inferential (Spence, 1986, 1998, 2002, 2007). This mode of transmission of knowledge, especially in combination with the overvaluation of one’s training analyst as the crucial marker of the legitimacy of one’s descent in the psychoanalytic world (Arlow, 1972; Kernberg, 1986; Kirsner, 2001), results in an overvaluation of received authority and is one of the main factors in the psychoanalytic world’s conservatism and rigidity, its imperviousness to scientific findings from other disciplines (Kernberg, 1986, 2000; Kirsner, 2009).…”