Instability and discontinuous change in the experience of therapeutic interaction: an extended single-case study of psychodynamic therapy processes.
The authors developed a concept that applies self-organization theory to psychodynamic principles. According to this concept, episodes of temporary destabilization represent a precondition for abrupt changes within the therapeutic process. The authors examined six courses of therapy (patients diagnosed with depression and personality disorder). After each therapy session, patients rated their experience of the therapeutic interaction. A measure of instability was used to identify episodes of destabilization with respect to patients' interaction experience throughout the process. Episodes of pronounced destabilization occurred in the four courses of therapy that showed better therapy outcomes. These episodes were characterized by temporary strong deteriorations in interaction experience (negative peaks). Three of the four courses showed subsequent discontinuous improvements to a higher level of interaction. Results indicate that the systematic inclusion of a measure of instability is worthwhile in investigations of discontinuous changes. This method allows the theoretical assumptions of the psychodynamic approach to be tested.
Gumz
Antje
A
Department of Psychotherapy and Psychosomatic Medicine, University of Leipzig, Leipzig.
Kästner
Denise
D
Geyer
Michael
M
Wutzler
Uwe
U
Villmann
Thomas
T
Brähler
Elmar
E
D000328:Adult; D003379:Countertransference; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008960:Models, Psychological; D010554:Personality Disorders / Q000523:psychology / Q000628:therapy; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy; D013811:Psychotherapeutic Processes; D011613:Psychotherapy; D011795:Surveys and Questionnaires; D014167:Transference, Psychology; D016896:Treatment Outcome