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ERIC Number: ED563649
Record Type: Non-Journal
Publication Date: 2013
Pages: 201
Abstractor: As Provided
Reference Count: N/A
ISBN: 978-1-3035-3334-1
Therapeutic Communications and the Process of Change in a Psychoanalytic Treatment
Vegas, Monica
ProQuest LLC, Ph.D. Dissertation, City University of New York
This study looked at the interplay of the analyst verbal speech acts and the process of change in a psychoanalytic treatment. Using a single case design on the session transcripts of the well studied case of Mrs. C., following Halfon and Weinstein's (2013) methodology the study tracked linguistic patterns as represented by the interaction of fixed/exact repetitions and representational language, assessed through the patient's use of Referential Activity (Bucci, 1997). These linguistic structures organize the psychodynamic content and meaning of the exchange that is taking place between the analyst and his patient. The representation of the different speech patterns in conjunction with the analyst's interventions allowed the creation of a map of the process inside the sessions at different points of the treatment. Results indicate that these speech patterns do not happen in a random way, 38% of the units evidenced a baseline speech pattern, 23% a symbolizing mode, 11% an overexcited mode, 8% a disengaged pattern and 3% of the units the patient was in a conflict mode. One important finding was the addition of the baseline pattern as a distinct mode of psychic functioning. By analyzing the baseline segments a picture emerged that was characterized by the patient's usual defensive style. In these instances the patient is adhering to the fundamental rule, the alliance is in place, and the potential for symbolization and discovery is within reach. 52% of the time the analyst intervened this is the type of speech pattern that preceded his interventions, 48% of the time after the analyst spoke the patient would go towards a baseline mode of functioning; both of these frequencies are significantly higher than those observed for any of the other reported patterns. It was hypothesized that interventions with exploratory functions would evidence a greater disorganizing potential, which would be reflected by increased repetitions. Additionally interventions with linking qualities were predicted to have greater organizing potential to be evidenced in speech with greater symbolizing qualities and more integration. Quantitative analysis showed no significant findings for either of these hypotheses. Qualitative analysis, however, indicated that the way the analyst intervenes has an effect on the response that can be observed in the patient's speech, it was therefore suggested that the measures employed failed to capture this effect. In terms of the evolution of the treatment it was predicted that the analyst would increase his level of activity as the treatment progressed and that he would use more interpretive comments in the later phases of treatment, additionally faster fluctuations in terms of the speech patterns would be observed as the treatment progressed. The data trended in this direction but statistical evidence was not found to corroborate these hypotheses. Qualitative observations note that interpretations become more detailed and transference based and that explorations are geared towards unconscious fantasies in the later stages of treatment. Finally integrating qualitative and quantitative results the questions of analytic technique and process will be revisited using the concepts of Vigotsky's zone of proximal development (ZPD), thirdness and symbolization following Norbert Freedman's contributions. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page:]
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Publication Type: Dissertations/Theses - Doctoral Dissertations
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A