title: How does addressing patient's defenses help to repair alliance ruptures in psychodynamic psychotherapy?: An exploratory study.
abstract: Interpreting or addressing defenses is an important aspect of psychoanalytic technique. Previous research has shown that therapist addressing defenses (TADs) can produce a positive effect on alliance. The potential value of TADs during the process of alliance rupture and resolution has not yet been documented. We selected patients (n = 17) undertaking a short-term dynamic psychotherapy in which the therapeutic alliance, measured with the Helping Alliance Questionnaire and monitored after each session, showed a pattern of rupture and resolution. Two control sessions (5 and 15) were also selected. Presence of TADs was examined in each therapist interpretation. Compared with control sessions, rupture sessions were characterized by fewer TADs and especially fewer TADs addressing specifically intermediate-essentially neurotic-defenses. Resolution sessions were characterized by more TADs addressing specifically intermediate defenses. This confirms the link between therapist technique and alliance process in psychodynamic psychotherapy.
authors.affiliation: Institute for Psychotherapy, Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
authors.forename: Antonios
authors.initials: A
authors.lastname: Gerostathos
authors.forename: Yves
authors.initials: Y
authors.lastname: de Roten
authors.forename: Sylvie
authors.initials: S
authors.lastname: Berney
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Despland
authors.forename: Gilles
authors.initials: G
authors.lastname: Ambresin
mesh_terms: D000328:Adult; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D055815:Young Adult