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.
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References
1.
Ablon, J.S., &Jones, E.E. (2005). On analytic process. Journal of the American Psychoanalytic Association5:541-568.
2.
Bailey, E., Bucci, W., Mergenthaler, E., & Greer, J. (in press). What do process notes contain? An empirical test of data equivalence between transcribed tape recordings and psychoanalytic process notes using computerized text analysis procedures. Psychotherapy Research.
3.
Bartlett, FC (1932). Remembering: A Study in Social Psychology. Cambridge: Cambridge University Press.
4.
Bernardi, R. (2003). What kind of evidence makes the analyst change his or her theoretical and technical ideas? In Pluralism and Unity; Methods of Research in Psychoanalysis, ed. M. Leuzinger-Bohleber, A.U. Dreher , & J. Canestri, London: International Psychoanalytical Association , pp. 125-136.
5.
Blatt, S.J., & Zuroff, D.C. (2005). Empirical evaluation of the assumptions in identifying evidence based treatments in mental health. Clinical Psychology Review25:459-486.
6.
Bowlby, J. (1969). Attachment and Loss: Vol. 1. Attachment. New York: Basic Books.
7.
Brenner, C. (1980). Metapsychology and psychoanalytic theory. Psychoanalytic Quarterly49:189-214.
8.
Bucci, W. (1984). Linking words and things: Basic processes and individual variation. Cognition17:137-153.
9.
— (1997). Psychoanalysis and Cognitive Science: A Multiple Code Theory. New York: Guilford Press.
10.
— ( 2002). Multiple code theory and the referential process: Applications to process research. In An Open Door Review of Outcome Studies in Psychoanalysis, ed P. Fonagy.2nd ed. London: International Psychoanalytical Association, pp. 192-195.
11.
— (2003). Varieties of dissociative experiences: A multiple code account and a discussion of Bromberg's case of William. Psychoanalytic Psychology20:542-557.
12.
— ( 2005). Basic concepts and methods of psychoanalytic process research. In Textbook of Psychoanalysis, ed. E. Person, A. Cooper, & G. Gabbard.Washington, DC: American Psychiatric Press, pp. 339-355.
13.
— (2006). Comparison of computerized discourse measures in five psychoanalytic treatments: Summary data and close process analysis . Presented at North American Society for Psychotherapy Research, Burr Oak, Ohio.
14.
— (2007a). Building the interface of research and practice: Achievements and unresolved questions. In The Integration of Clinical and Research Perspectives in Psychoanalysis: A Tribute to the Work of Robert Wallerstein, ed. W. Bucci & N. Freedman.London: International Psychoanalytical Association, pp. 175-204.
15.
— (2007b). Dissociation from the perspective of multiple code theory: Part I. Psychological roots and implications for psychoanalytic treatment. Contemporary Psychoanalysis43:165-184.
16.
— (in press). Four domains of experience in the therapeutic discourse . Psychoanalytic Inquiry.
17.
— Kabasakauan, R., & The Ra Research Group (1992 ). Instructions for Scoring Referential Activity (RA) in Transcripts of Spoken Narrative Texts. Ulm, Germany: Ulmer Textbank.
18.
— Kabasakauan-Nckay, R., & The Ra Research Group (2004 ). Scoring Referential Activity: Instructions for Use with Transcripts of Spoken Text, ed. E.A. Graham.www.referentialprocess.org
19.
— & Maskit, B. (2005). A weighted dictionary for Referential Activity . In Computing Attitude and Affect in Text, ed. J.G. Shanahan, Y. Qu , & J. Wiebe.Dordrecht, The Netherlands: Springer, pp. 49-60.
20.
Cooper, A.M. (1993). On empirical research. Journal of the American Psychoanalytic Association41 (Suppl.):381-391.
21.
Dahl, H. (1988). Frames of mind. In Psychoanalytic Process Research Strategies, ed. H. Dahl , H. Kächele, & H. Thomä.New York: Springer Verlag, pp. 51-66.
22.
Damasio, A.R. (1999). The Feeling of What Happens. New York: Harcourt Brace.
23.
Dubé, E., & Bucci, W. (2007). The referential function: Psychometric properties and psychological correlates. Unpublished manuscript.
24.
Edelman, G.M. (1989). The Remembered Present: A Biological Theory of Consciousness. New York: Basic Books .
25.
Efron, B., & Tibshirani, R.J. (1993). An Introduction to the Bootstrap. New York: Chapman & Hall.
26.
Fonagy, P., Roth, A., & Higgitt, A. (2005). The outcome of psychodynamic psychotherapy for psychological disorders. Clinical Neuroscience Research4:367-377.
27.
Freedman, N., Lasky, R., & Hurvich, M. (2003).Two pathways towards knowing psychoanalytic process . In Pluralism and Unity; Methods of Research in Psychoanalysis , ed. M. Leuzinger-Bohleber, A.U. Dreher & J. Canestri.London: International Psychoanalytical Association, pp. 207-221.
28.
—— & Webster J. (2007). The ordinary and the extraordinary countertransference . Unpublished manuscript.
29.
Freud, S. (1940). An outline of psycho-analysis. Standard Edition23:144-207.
30.
Gedo, J.E. (200 1). The enduring scientific contributions of Sigmund Freud. Annual of Psychoanalysis29:105-115.
31.
Gill, M.M., Simon, J., Fink, G., Endicott, N.A., & Paul, I.H. (1968). Studies in audio-recorded psychoanalysis: I. General considerations. Journal of the American Psychoanalytic Association16:230-244.
32.
—— Noble, A., Endicott, N.A., & Irving, P. (1970). Studies in audio-recorded psychoanalysis: II. The effect of recording upon the analyst. Journal of the American Psychoanalytic Association18:86-101.
33.
Green, A. (2003). The pluralism of sciences and psychoanalytic thinking . In Pluralism and Unity: Methods of Research in Psychoanalysis , ed. M. Leuzinger-Bohleber, A.U. Dreher, & J. Canestri.London: International Psychoanalytical Association, pp. 26-44.
34.
Grünbaum, A. (1984). The Foundations of Psychoanalysis. Berkeley: University of California Press.
35.
Hadamard, J. (1949). An Essay on the Psychology of Invention in the MathematicalField. Princeton: Princeton University Press.
36.
Hilsenroth, M.J., Ackerman, S.J., Blagys, M.D., Baity, M.R., & Mooney, M.A. (2003). Short-term psychodynamic psychotherapy for depression: An examination of statistical, clinically significant, and technique-specific change. Journal of Nervous & Mental Disease191:349-357.
37.
Hoglend, P., Amlo, S., Marble, A., Bogwald, K.P., Sorbye, O., Sjaastad, M.C., & Heyerdahl, O. (2006). Analysis of the patient-therapist relationship in dynamic psychotherapy: An experimental study of transference interpretations . American Journal of Psychiatry163:1739-1746.
38.
Jones, E.E. (2000). Therapeutic Action: A Guide to Psychoanalytic Therapy. Northvale, NJ: Aronson .
39.
Kernberg, O.F. (2006). The pressing need to increase research in and on psychoanalysis. International Journal of Psychoanalysis87:919-926.
40.
LeDoux, J. (1999). Psychoanalytic theory: Clues from the brain. Neuro-psychoanalysis1:44-49.
41.
Luborsky, L., & Crits-Cristoph, P. (1988). The assessment of transference by the CCRT method. In Psychoanalytic Process Research Strategies , ed. H. Dahl, H. Kächele, & H. Thomä.New York: Springer Verlag , pp. 99-108.
42.
Mackinnon, D.W., & Dukes, W.F. (1964). Repression. In Psychology in the Making, ed. L. Postman. New York: Knopf, pp. 662-744.
43.
Maskit, B., & Bucci, W. (2006). Smoothing discourse variables to capture the flow of verbal interaction. www.referentialprocess.org/papers
44.
— Kingsley, G., & Welsh, E. (2006). Clinical implications of mathematical segmentation of therapeutic discourse. Panel presented at the Society for Psychotherapy Research, Edinburgh.
45.
Mcclelland, J.L., Rumelhart, D.E., & Hinton, G.E. (1989). The appeal of Parallel Distributed Processing . In Parallel Distributed Processing: Explorations in the Microstructure of Cognition: Vol. 1. Foundations, ed. D.E. Rumelhart, J.L. McClelland, & the PDP Research Group.Cambridge: MIT Press, pp. 3-44.
46.
Mergenthaler, E., & Bucci, W. (1999). Linking verbal and nonverbal representations: Computer analysis of Referential Activity. British Journal of Medical Psychology72:339-354.
47.
Moskovitch, M., Yaschyshyn, T., Ziegler, M., & Nadel, L. (2000). Remote episodic memory and retrograde amnesia: Was Endel Tulving right all along? In Memory, Consciousness, and the Brain: The Tallinn conference, ed. E. Tulving.Philadelphia: Psychology Press, pp. 331-345.
48.
Panksepp, J. (1999). Emotions as viewed by psychoanalysis and neuroscience: An exercise in consilience. Neuro-psychoanalysis1:15-38.
49.
Perron, R. (2002). Response to Peter Fonagy. In An Open Door Review of Outcome Studies in Psychoanalysis, ed. P. Fonagy.2nd ed. London: International Psychoanalytical Association , pp. 30-33.
50.
— (2006). How to do research: Reply to Otto Kernberg. International Journal of Psychoanalysis87:927-932.
51.
Rubin, D.C. (2005). A basic-systems approach to autobiographical memory . Current Directions in Psychological Science14:79-83.
52.
Sandell, R., Bloomberg, J., Lazar, A., Carlsson, J., Broberg, J., & Schubert, J. (2000). Varieties of long-term outcome among patients in psychoanalysis and long-term psychotherapy: A review of findings in the Stockholm Outcome of Psychoanalysis and Psychotherapy Project (STOPP). International Journal of Psychoanalysis81:921-942.
53.
Sandler, J. (1983). Reflections on some relations between psychoanalytic concepts and psychoanalytic practice. International Journal of Psychoanalysis64:35-45.
54.
— Kennedy, H., & Tyson, R.L. (1980). The Techniques of Child Psychoanalysis: Discussions with Anna Freud. Cambridge: Harvard University Press.
55.
Stern, D.N. (1985). The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology. New York : Basic Books.
56.
Szecsody, I. (2000). Commentary on Michels's "The case history."Journal of the American Psychoanalytic Association48:397-403.
57.
Thomä, H., & Kachele, H. (1975). Problems of metascience and methodology in clinical psychoanalytic research. Annual ofPsychoanalysis3:49-119.
58.
Tuckett, D. (2000). Commentary on Michels's "The case history." Journal of the American Psychoanalytic Association48:403-411.
59.
Wallerstein, R.S. (1988). Assessment of structural change in psychoanalytic therapy and research. Journal of the American Psychoanalytic Association36(Suppl.):241-261.
60.
—( 200)). The generations of psychotherapy research: An overview . Psychoanalytic Psychology18:243-267.
61.
— (2006). The relevance of Freud's psychoanalysis in the 21st century: Its science and its research. Psychoanalytic Psychology23:302-326.
62.
— & Sampson, H. (1971). Issues in research in the psychoanalytic process . International Journal of Psychoanalysis52:11-50.
63.
Weiss, J., Sampson, H., & The Mount Zion Psychotherapy Research Group (1986). The Psychoanalytic Process: Theory, Clinical Observation, and Empirical Research. New York : Guilford Press.
