Alliance rupture and repair processes in psychoanalytic psychotherapy: multimodal in-session shifts from momentary failure to repair

IF 1.6 Q3 PSYCHOLOGY, APPLIED Counselling Psychology Quarterly Pub Date : 2022-01-04 DOI:10.1080/09515070.2021.2013162
Anna Mylona, Evrinomy Avdi, Evangelos Paraskevopoulos
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引用次数: 2

Abstract

ABSTRACT This exploratory single session-study presents a multimodal, mixed-method description of a session of psychoanalytic psychotherapy and illustrates an in-session “failure”, defined in terms of rupture in the therapeutic alliance and the process of its repair. It aims to enhance our understanding of the mechanisms implicated in therapeutic change. The research materialcomprises session’s video-recording, transcript, and measurements of participants’physiological arousal, as reflected in their heart rate in the session. The analysis consisted of an iterative, multi-layered process that combines observations from verbal and nonverbal modalities of interaction for the identification of significant in-session moments. We applied quantitative descriptive analysis on participants’ physiological arousal and synchronization, qualitative analysis of the clinical dialogue, and coded the in-session fluctuations in the therapeutic alliance,using the Rupture Resolution Rating System. The detailed analysis of specific interactive events in the session illustrates the shift from a “failure” in therapeutic collaboration to gradual repair; this shift entailed increased relatedness and physiological synchronization, and on a semantic level, co-created, reflective meanings in the here-and-now of the therapeutic interaction. The findings highlight ruptures as important in-session events and suggest that the therapist’s empathic oscillation between interpretative and metacommunication strategies can be mutative during moments of relational rupture. Practical Implications Negotiation and resolution of in-session therapeutic ruptures may provide opportunities for therapeutic growth in terms of increased relatedness and reflectiveness. The therapist’s flexible shifts between using interpretative interventions and immediate collaborative explorations in the here-and-now, in the form of metacommunication, seem to facilitate the repair of alliance rupture. Multimodal methodologies and multi-layered analyses, integrating verbal and nonverbal, physiological data in the study of therapeutic interaction can shed light on significant in-session events and mechanisms of the change process.
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精神分析心理治疗中的联盟破裂和修复过程:从短暂失败到修复的多模态会话转变
摘要:本探索性单疗程研究提出了一个多模式、混合方法的精神分析心理治疗疗程的描述,并说明了一个疗程中的“失败”,定义为治疗联盟的破裂及其修复过程。它的目的是提高我们对治疗改变的机制的理解。研究材料包括会议的视频记录,文字记录和参与者的生理唤醒测量,反映在他们的心率在会议。分析包括一个反复的、多层次的过程,该过程结合了对口头和非口头互动模式的观察,以识别重要的会话时刻。我们对参与者的生理唤醒和同步进行了定量描述性分析,对临床对话进行了定性分析,并使用破裂解决评级系统对治疗联盟的会话波动进行了编码。会议中具体互动事件的详细分析说明了从治疗合作的“失败”到逐渐修复的转变;这种转变需要增加相关性和生理同步,并且在语义层面上,在此时此地的治疗相互作用中共同创造和反思意义。研究结果强调了破裂是重要的会话事件,并表明治疗师在解释策略和元沟通策略之间的共情振荡可能在关系破裂的时刻发生突变。实际意义:会话中治疗破裂的协商和解决可能为治疗增长提供机会,增加相关性和反思性。治疗师在使用解释性干预和即时合作探索之间的灵活转换,以元沟通的形式,似乎促进了联盟破裂的修复。多模态方法和多层次分析,结合语言和非语言的生理数据,在治疗相互作用的研究中可以揭示重要的会话事件和变化过程的机制。
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来源期刊
Counselling Psychology Quarterly
Counselling Psychology Quarterly PSYCHOLOGY, APPLIED-
CiteScore
6.20
自引率
6.70%
发文量
30
期刊介绍: Counselling Psychology Quarterly is an international interdisciplinary journal, reporting on practice, research and theory. The journal is particularly keen to encourage and publish papers which will be of immediate practical relevance to counselling, clinical, occupational, health and medical psychologists throughout the world. Original, independently refereed contributions will be included on practice, research and theory - and especially articles which integrate these three areas - from whatever methodological or theoretical standpoint. The journal will also include international peer review commentaries on major issues.
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