Psychoanalysis and Evidence: critical and historical perspectives

Abstract

In this paper, we discuss evidence-based practices in the field of mental health, tracing their origins, funding agents, and implementation policies, as well as the problematic effects that this policy has produced in the mental health practice. Although psychoanalysis and psychodybamic psychotherapy have evidence, as indicated by many clinical studies, been included in some Guidelines, like NICE Guideline, these are generally not publicized and, when they appear in the media or high-impact journals, criticism tends to point out flaws that, in most cases, are no different from the flaws found in research regarding practices with already accepted evidence of efficacy, effectiveness, and efficiency. Conclusion: in the f evidence-based practice in mental helth, there arestrong evidence of a policy that tries to implement at all costs, sometimes unethically, an extremely poor vision both epistemologically and in relation to practice, prioritizing certain treatments that, as we were able to verify, are not superior to other practices or, in some cases, not even to the placebo effect. Finally, we discuss the method of psychoanalysis and the reasons why it can work when other treatments often fail because they disregard the possibility of the unconscious, as discovered and supported by psychoanalytic theory and clinic.