Clinical measurement in psychoanalysis: an approach.

Measurement of the complex phenomena in psychoanalysis is approached by defining interrelated elements in the analytic situation and specifying the range of their variation in scales which can be both generalized and made specific for an individual patient. Using this approach in transcripts of psychoanalytic sessions, we rate painful emotion, impairment of defensive maneuvers, and activation of threatening conflictual fantasies. This preliminary study involved rating of tape-recorded sessions by psychoanalytically oriented judges. Quantitative estimates appeared to relate in many ways to qualitative fluctuations in the patient's state. Such an approach may be helpful in developing more effective clinical theory about emotions, defensive processes, and transference fantasies.