Given the complexity of analytic therapies and individual change, it seems desirable to introduce more objective and quantitative measures into the clinical situation in assessment of change. A traditional case study describes one patient's change pattern in symptomatic distress, interpersonal relations and self-esteem during 44 months of group analysis. We hypothesized that change described by repeated applications of self-report measures (SCL-90-R, HP, and SASB) would converge with the clinical narrative. This was confirmed for symptoms and interpersonal problems. However; in early and middle phase of therapy during periods of deterioration, negative aspects of her self-image at worst (self-attack, self-neglect) improved. During the same periods she suffered from a pronounced feeling of depersonalization. For the remaining part of the therapy; including a period after a miscarriage later in therapy, she was able to experience the negative aspects of her self-image at worst. The feeling of depersonalization was then much less pronounced. Her complex SASB-patterns may represent a split of internal self-representations, seen in certain personality disorders. More studies are needed.
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