The Lara case: A group analysis of initial psychoanalytic interviews using systematic clinical observation and empirical tools

With the objective of analysing the usefulness of empirical criteria for observing psychoanalytic cases, this article describes an experience of systematic clinical observation carried out by the Psychodynamic Clinical Research Team at the Psychoanalytic Association of Buenos Aires' University Institute of Mental Health (Instituto Universitario de Salud Mental, IUSAM). A group of four psychoanalytic therapists, including the treating therapist, systematically analysed the first four interviews in the psychoanalytic treatment of a 32-year-old female patient, which was discontinued six months after it started. We used the combined frameworks of the Multilevel Observation and Three-Level Model to systematise the information. We also used a computer-assisted text- analysis system-the Discourse Attribute Analysis Program (DAAP) to measure Referential Activity. The Shedler-Westen Assesment Procedure (SWAP) was included as a diagnostic tool. We describe the application of these resources to our analysis of the four interviews, including examples of the clinical material. We discuss both the hypotheses developed by our clinical observation group and the usefulness of group exchange for understanding the therapeutic process in general. Finally, we discuss the implications of this type of systematic case study for clinical practice, training, and research in psychoanalysis.