Vol. 5 No. 2 (2025)
Constructing a Perspective: Epistemology of the Psi Sciences

Articles

Discussing the clinical efficacy of psychoanalysis: ideological stakes and current empirical studies

Published 2025-12-31

  • Pavel Odintsov
    • ,
  • Elizaveta Makhneva

Pavel Odintsov
Independent researcher

Elizaveta Makhneva
Independent researcher

Abstract

The article addresses the issue of the clinical efficacy of psychoanalysis, which occupies a central place in contemporary discussions of its scientific and therapeutic validity. The author critiques the ideology of contemporary Lacanian psychoanalysis, which interprets the “undemonstrability” of efficacy as a value and as proof of autonomy from the capitalist logic of productivity. Arguing against this position, the author substantiates the possibility of empirically studying the clinical efficacy of psychoanalysis without compromising its theoretical specificity and without being automatically reduced to capitalist practices. To this end, the author conducts a critical analysis of the argumentation within contemporary Lacanian discourse and of Lacan’s classical thesis on the analyst’s desire as a “desire not to heal”, followed by a review of current empirical data, including meta-analyses and randomized controlled trials (RCTs) devoted to psychoanalysis and long-term psychoanalytic psychotherapy (LTPP). The author demonstrates that the a priori rejection of the possibility of empirically testing the efficacy of psychoanalysis is based on logical fallacies, while recent RCTs and meta-analyses show statistically significant positive effects of LTPP in complex mental disorders, comparable to the results of cognitive-behavioral therapy and pharmacotherapy. The article thus shows that the empirical demonstrability of psychoanalysis in no way undermines its status and need not function as a way of its reduction; on the contrary, it may ultimately prove useful for a clearer articulation of its specificity. Clinical effectiveness, therefore, appears to be no less well substantiated for psychoanalysis than for most other psychotherapies, and the question of effectiveness is proposed as a potential site of emancipation — rather than, as standard Lacanian dogma suggests, a domain logically incompatible with psychoanalysis.

Keywords

psychoanalysis, long-term psychoanalytic psychotherapy, LTTP, clinical efficacy, randomized controlled trials, Lacanian psychoanalysis, Lacanian ideology

PDF (Russian)

Author Biography

Pavel Odintsov

Philosopher, independent researcher.

Elizaveta Makhneva

Independent researcher, Data Analysis Specialist.

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