Changes in Defensive Functioning in Completed Psychoanalyses: the Penn Psychoanalytic Treatment Collection

McGill University Faculty of Medicine at the Institute of Community and Family Psychiatry, S.M.B.D. Jewish General Hospital.
Journal of the American Psychoanalytic Association (Impact Factor: 0.79). 05/2009; 57(2):399-415. DOI: 10.1177/0003065109333357
Source: PubMed


Theory predicts that patients completing psychoanalysis should improve in their dynamic functioning. The aim of this naturalistic study is to examine whether a sample of 17 subjects from the Penn Psychoanalytic Treatment Collection with completed, tape-recorded psychoanalyses demonstrated improvement in one dynamic aspect: their defense mechanisms. The pre-post effect size for the change in overall defensive functioning (ODF) of the sample was large (.76) and statistically significant (p = .01). The percentage of subjects who improved in their ODF (71%) was similar to that found by others who studied the same sample using general functioning measures. These findings provide the first empirical evidence to support a trait-like change in dynamic personality functioning in patients who have undergone psychoanalysis. Randomized controlled studies with homogeneous samples are needed to further confirm these findings.

Download full-text


Available from: John Christopher Perry, Oct 16, 2014
1 Follower
43 Reads
  • Source
    • "Studying these relationships, however, has been greatly limited by the lack of recorded cases available to researchers. A number of psychoanalytic thinkers have addressed this problem through the years by collecting recordings, most notably Dahl, Kächele, and Thomä (1988); Luborsky and colleagues (e.g., Luborsky et al., 2001; Roy et al., 2009); Gill and colleagues (Gill, 1982; Gill and Hoffman, 1982); and Waldron and colleagues (Waldron et al., 2011; Waldron et al., 2013; Waldron, Scharf, Crouse, et al., 2004; Waldron Scharf, Hurst, et al., 2004). Several others have tried but been less successful in making collections available for study. "
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a need for careful study of the relationships between the psychoanalytic/psychodynamic processes and their outcomes, yet the raw data to accomplish this study (i.e., psychoanalyses and psychoanalytic psychotherapies fully recorded and transcribed, and empirical instruments for assessing from an analytic perspective both the processes and results of these treatments) have been limited. Two related strategies to solve this deficit have been developed over the past 30 years by the Psychoanalytic Research Consortium (PRC): (1) the collection of an increasing database currently holding 31 fully recorded psychoanalyses and a number of long-term psychoanalytic psychotherapies safeguarded, confidentialized, and made available to the field; and (2) the development of new measures for assessing processes and outcomes of treatments from an analytic point of view, such as the Analytic Process Scales (APS), the Dynamic Interaction Scales (DIS), and the Personality Health Index (PHI) with RADIO categories. This article summarizes the history of the PRC and some of the findings of the research conducted with the APS, DIS, and PHI on the PRC cases.
    Psychoanalytic Inquiry 01/2015; 35(1):169-184. DOI:10.1080/07351690.2015.987602 · 0.47 Impact Factor
  • Source
    • "The recognition and effective work with defense are an important and distinctive feature of the psychoanalytic technique (Blagys and Hilsenroth, 2000; Olson et al., 2011). Defense interpretation (DI) is a commonly used technique, and dynamic psychotherapists use DIs more frequently than transference interpretations (TIs; Olson et al., 2011; Roy et al., 2009). DI is related to patient defensive behavior (Junod et al., 2005; Winston et al., 1994) and has been associated with improved outcome (Bond et al., 1998; Perry et al., 2012) and working alliance (Foreman and Marmar, 1985; Junod et al., 2005). "
    [Show abstract] [Hide abstract]
    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.
    The Journal of nervous and mental disease 04/2014; 202(5). DOI:10.1097/NMD.0000000000000112 · 1.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: As we enter a new era of scientific evaluation and acceptance of Freud's ideas, psychodynamic practitioners need to be aware of the most valid and clinically useful findings relevant to their everyday work with patients. This handbook meets that need by integrating the best contributions of the clinical psychoanalytic literature with the latest generation of clinical-quantitative research, and translating these findings into pragmatic clinical wisdom about what works and what doesn't. In twenty-six chapters, forty-nine leading authorities and clinical-researchers discuss what is known about selecting patients, defining treatments, and measuring key processes and outcomes. This comprehensive volume not only offers the clinician the latest in psychodynamic research and thinking but can guide those who wish to shape their clinical hypothesis into a study. By reviewing the central clinical concepts and techniques of psychodynamic psychotherapy and by providing the necessary empirical documentation to support their validity and clinical relevance, "Psychodynamic Treatment Research" makes an important contribution to mapping out the future of therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Show more