Followup in psychoanalysis: what happens to treatment gains?

A recent panel (1989) discussed the feasibility and the desirability of systematic post-treatment followup study of psychoanalytic patients. In this paper, I compare the data bearing on these issues from the Menninger Foundation Psychotherapy Research Project, headed by me, and the Boston Institute Project, headed by Kantrowitz, and I indicate why their data are neither comparable nor adequate enough to warrant the conclusion that their apparent discrepant findings--that in the Menninger project outcome at termination tended to be predictive of the subsequent followup course, while in the Boston project this was not so--are more than chance events. I then present detailed case descriptions of two patients from the Menninger project who were quite similar in character and in illness structure, had seemingly comparable analytic courses, and similar good therapeutic results, but had quite different followup courses, one with further consolidation, and the other with regression. I present some of the determinants of this difference.