Beneath the surface of the therapeutic interaction: the psychoanalytic method in modern dress

This study represents a new generation of psychotherapy process research, using multiple perspectives on the data of the analytic situation, including impressions of the treating analyst, ratings of complete sessions by clinical judges, and objective linguistic measures. Computerized measures of language style developed in the framework of multiple code theory were applied to verbatim session recordings from a psychoanalytic case; the measures are illustrated in microanalyses of the process in two sessions. The results show agreement between the linguistic measures and clinical ratings based on a psychoanalytic perspective. The linguistic measures look beneath the surface of the therapeutic interaction by relying largely on lexical items of which clinicians are not likely to be explicitly aware, and enable a new perspective on the therapeutic discourse as seen in the graphic images of the microprocess. While the results of this study were limited to a single case, the automatized measures can be readily applied to large samples and in repeated single case designs. Two goals of process research, using measures such as those developed in this study, are discussed: to develop measures of mediating variables that can be used to identify specific treatment effects in comparative outcome studies; and, beyond this pragmatic aim, to assess development of capacities for self-exploration and self-regulation as psychoanalytic treatment goals.     

The Sleeping Analyst,The Waking Dreams: Commentary on Papers by Richard A. Chefetz and David G. Mark

The discussion applies the basic psychological concepts of emotion schemas and the referential process to the case material presented by Drs. Richard Chefetz and David Mark. Emotion schemas are types of memory schemas that develop in an interpersonal field. They include subsymbolic processes, symbolic imagery, and linguistic codes, integrated to varying degrees. In treatment both participants come in with their emotion schemas, developed in the course of their lives, activated in the events of the day; communication between analyst and patient occurs on all levels in subsymbolic somato-sensory and symbolic verbal forms. The discussion of Dr. Chefetz's presentation emphasizes the relationships among multiple schemas of self and others, within the patient and between patient and analyst. The discussion of Dr. Mark's three cases focuses on connections and disconnections within the schemas as well as between them and emphasizes the pivotal role of imagery in connecting subsymbolic experience and words, and in the reconstruction of dissociated schemas in the context of the therapeutic relationship.     

Automated measure of conditioned orienting behavior in rats

The behavioral and neural mechanisms of orienting behavior have interested experimental psychologists for the last several decades. For example, in the framework of associative learning, examining the brain substrates of orienting behavior has yielded significant insight into the neural basis of attentional function and learning. The present study describes a procedure by which the orienting response to a visual stimulus (rearing on the hind legs) can be monitored automatically, and it validates the procedure by comparing data generated by the automated procedure with data generated by the typical observational procedure. The automated procedure provides an inexpensive means of obtaining immediate, online assessment of rearing behavior during a conditioning session, reduces the possibility of experimenter bias, and significantly reduces the time required to evaluate observational data.     

Clinical Mutual Attunement and the Development of Therapeutic Process: A Preliminary Study

Despite the identification of many factors that play a central role in the development of the psychotherapy process, there is still a lack of evidence about the basic relational mechanisms that pave the way to its working. In this pilot study, we focus on nonverbal microprocessual attunement as the basic mechanism grounding the displacing of discrete factors in shaping the clinical process. Two single sessions of two short-term psychodynamic treatments, selected respectively from a good- and a poor-outcome treatment, have been coded in terms of patient and therapist speech rate, coordination in ruptures, resolution of the therapeutic alliance, and patient's displayed thinking processes. Two dynamic structural equation models focusing on clinical attunement as a factor able to activate the interplay of the assessed clinical dimensions have been theoretically designed and tested in both cases. The driven theoretical structural equation models fit the data, suggesting a different role of nonverbal attunement as a moderating factor. The obtained results are consistent with the hypothesis claiming that a good-outcome psychotherapy session is characterized by a mechanism of clinical attunement that enforces the therapist–patient relationship and promotes the integration of formal thinking processes that affect emotional and cognitive domains.     

The Penn Psychoanalytic Treatment Collection: a set of complete and recorded psychoanalyses as a research resource

From a set of seventeen complete and tape-recorded psychoanalyses, a sample of findings is presented: (a) the level of agreement of two clinical judges on the psychological health of these patients is adequate for the late sessions, but not for the early sessions; (b) the amount of change during psychoanalysis appears to be similar to that in the Menninger Foundation Psychotherapy Research Project; (c) psychiatric severity measures from the early sessions can yield a significant level of prediction of the later benefits from psychoanalysis. Finally, further research uses of this collection of psychoanalyses are suggested.     

The Primary Process as a Transitional Concept: New Perspectives from Cognitive Psychology and Affective Neuroscience

ABSTRACT

The initial defining framework of the primary process based on flow of psychic energy has been largely rejected by contemporary psychoanalytic theorists, but the concept remains in use clinically, particularly in application to the flow of associations and the interpretation of dreams. Some researchers have attempted to characterize primary process thought in terms of contents and formal properties of thought without reference to the energy framework, but this approach fails to account for the role of emotional intensity in mental life. The integration of affective arousal with particular properties of thought that is central to the primary process concept can be understood today in the context of current research in cognitive psychology, emotion theory, and neuroscience. The version of multiple code theory outlined here provides a framework for the involvement of affect in productive and complex mental operations in areas from sports and the arts to scientific discovery, as well as therapy, and also provides a basis for empirical research.     

Systematic Review of Self-Report Measures of General Mental Health and Wellbeing in Adolescent Mental Health

Clinical Child and Family Psychology Review - The assessment of general mental health and wellbeing is important within child and adolescent mental health services (CAMHS) for both clinicians and...