As psychoanalysis approaches its second century, it seems no closer to being a science than when Freud first invented the discipline. All the clinical experience of the past hundred years, Donald Spence tells us in this trenchant book, has not overcome a tendency to decouple theory from evidence. Deprived of its observational base, theory operates more like shared fantasy. In support of this provocative claim, Spence mounts a powerful critique of the way psychoanalysis functions—as a clinical method and as a scholarly discipline or “science.” In the process, he prescribes an antidote for the uncontrolled rhetoric that currently governs psychoanalytic practice.

The reliance on rhetoric is the problem Spence identifies, and he attributes the troubling lack of progress in psychoanalysis to its outmoded method of data collection and its preference for fanciful argument over hard fact. Writing to Jung in 1911, Freud admitted that he “was not at all cut out to be an inductive researcher—I was entirely meant for intuition.” His intuitive approach led him to retreat form traditional Baconian principles of inductive investigation and to move toward a more Aristotelian approach that emphasized choice specimens and favorite examples, played down replication, and depended on arguments based on authority. Detailing this development, with particular attention to the role of self-analysis in the Freudian myth and the evidential drawbacks of the case study genre, Spence shows how psychoanalysis was set on its present course and how rhetorical maneuvers have taken the place of evidence.

With this diagnosis, Spence offers a remedy—an example of the sort of empirical research that can transform clinical wisdom into useful knowledge. His book holds out the hope that, by challenging the traditions and diminishing the power rhetoric, psychoanalysis can remain a creative enterprise, but one based on a solid scientific foundation.