Establishing a Method of Systematic and Reliable Analysis of Psychodynamic Process Notes.

Process notes contain unique information concerning core elements of a psychodynamic treatment. These elements may be both conscious and unconscious for the author. One element for study is the tendency to which a therapist writes about providing either supportive or expressive interventions.

Addressing At-the-Moment Defenses against Painful Affects: A Core Mechanism of Change in Psychodynamic Treatment.

There is an ongoing tension in the psychodynamic field between interpreting the meaning of a patient's verbal productions or actions and addressing the defenses utilized by the patient. Some authors maintain that implicit interactions between analyst and patient may be more important than the verbal interventions by the analyst. This article stresses the importance of observing and appropriately addressing how patients manage painful affects in the sessions.

First Validation of the Referential Process Post-Session Scale - Therapist Version (RPPS-T).

Objective: Bucci's multiple code theory maintains that for a significant change the patient-therapist relationship should foster a referential process shaping in three alternating phases: arousal of emotion schemas, symbolizing/narrating emotional experiences, and reflecting/reorganizing the emotional meanings. Until now to monitor these phases clinicians and researchers have used several referential process computerized linguistic measures, which however need the sessions verbatim transcription. In order to have a less time-consuming method we developed and tested a therapist self-report questionnaire measuring the referential process phases.

The development of a self-report scale to assess therapists' acceptance of telepsychotherapy.

Objective: We aimed to develop a self-report measure of therapist acceptance of telepsychotherapy based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework.

Methods: Using a cross-sectional survey design, 1265 therapists completed the UTAUT-T, as well as additional questions.

Results: Confirmatory analysis indicated that the original UTAUT model did not fit the therapist context well.

What Do Therapist Defense Mechanisms Have to Do With Their Experience of Professional Self-Doubt and Vicarious Trauma During the COVID-19 Pandemic?

This is the first study to examine psychotherapists' levels of defense mechanisms, their concurrent relationship with professional work-related stress (professional self-doubt and vicarious trauma), and how their levels of defense mechanisms predict the changes in these professional stresses over the course of 3 months since the start of the COVID-19 pandemic. Data from two online studies (Study 1; = 105 and Study 2; = 336), using two self-report measures of therapists' defense mechanisms (Defense Style Questionnaire-40 in Study 1 and Defense Mechanism Rating Scales Self-Report-30 in Study 2), are presented. Therapists reported higher levels of mature defense mechanisms, and lower levels of immature defense mechanisms, compared to published community and clinical populations assessed before and during the pandemic.

Locating Nodal Moments Within Psychotherapy Sessions: A Mixed-Methods Study Using a Computerized Measure and Therapist Comments.

A computerized linguistic measure, the Weighted Referential Activity Dictionary (WRAD), was applied to locate nodal turns of speech in psychotherapy, defined here as significant moments of patient emotional communication that are likely to reveal important themes. Two published demonstration sessions conducted by a senior clinician, who made extensive comments on this material, were utilized to illustrate the method. The WRAD, defined in the context of referential process theory, was developed and has been validated as assessing the vividness and immediacy of language.

Analytic Process and Linguistic Style: Exploring Analysts' Treatment Notes in the Light of Linguistic Measures of the Referential Process.

This paper presents a comparison between a clinical evaluation and a computerized linguistic analysis of the treatment notes of the first two years of an analysis conducted four sessions a week with the patient lying on a couch. Clinical notes had been written as part of the analyst's standard practice after every session, some years prior to the planning of this study. The notes describe the analytic interchange and the analyst's internal thoughts.

Putting it into Words: A Clinical and Linguistic Analysis of Trauma Narratives in Two Short-Term Exposure Therapies for Co-Morbid PTSD and SUD.

Nearly half of the individuals who experience Posttraumatic Stress Disorder (PTSD) will also have a Substance Use Disorder (SUD) in their lifetimes. Prolonged Exposure Therapy (PE), considered the "gold standard" in treating PTSD, has been increasingly used and studied as an intervention for PTSD, yet little is known about the mechanisms of change in this type of treatment. In PE for PTSD, participants tell and re-tell the story of their primary trauma many times over.

Development of WRRL: A New Computerized Measure of the Reflecting/Reorganizing Function.

Reflecting/Reorganizing (R/R) is one of the three functions described by Bucci (Overview of the referential process: the operation of language within and between people, 2021a) as part of the referential process. The Weighted Referential Activity Dictionary (WRAD) was previously developed to model the Symbolizing function of the referential process. This paper presents the development of the Weighted Reflecting Reorganizing List (WRRL) as a model of the R/R function.

Stretching the Analytic Frame: Analytic Therapists' Experiences with Remote Therapy During COVID-19.

Remote therapy has been used by analytic therapists for quite some time, though many have been reluctant to use it regularly, out of concern that it might distort analytic frame and relational dynamics. Now the Covid-19 pandemic has forced therapists to make a sudden, across-the-board transition to remote therapy. This study reports on survey responses from 190 analytic therapists on their transition to online therapy via videoconferencing during the pandemic and their previous experience with remote therapy (the majority had such experience).

Why Is It Easier to Get Mad Than It Is to Feel Sad? Pilot Study of Regulation-Focused Psychotherapy for Children.

Objective:: This article reports results of a pilot study of three participants receiving regulation-focused psychotherapy for children (RFP-C), a manualized, short-term, psychodynamic treatment for children with oppositional defiant disorder and other externalizing problems. RFP-C targets implicit emotion regulation while using an intensive, psychodynamic, play therapy approach to decrease the child's need for disruptive behaviors.

Methods:: Three children with oppositional defiant disorder participated in a trial of RFP-C.

Trauma-Focused Psychodynamic Psychotherapy of a Patient With PTSD in a Veterans Affairs Setting.

Objective:: This article aims to articulate the use of trauma-focused psychodynamic psychotherapy (TFPP) for a 33-year-old U.S. Army veteran with posttraumatic stress disorder (PTSD) in a Veterans Affairs (VA) setting.

A Proposal to Address the Workforce Shortage in Child and Adolescent Psychiatry.

Drs. Findling and Stepanova end their Commentary on the workforce shortage in child and adolescent psychiatry with the following statement: "We should use our field's rich traditions and unique insights to establish new ways of doing more for the youths we are honored to serve" (p. 301).

The relationship between defense mechanisms and religious coping using a new two-factor solution for the Defense Style Questionnaire-40.

This study examined the factor structure of the Defense Style Questionnaire (DSQ-40) and explored the relationships between defense mechanisms and religious coping in a diverse sample of 380 college students. In contrast with the three-factor model of defenses proposed by the developers of the DSQ-40, principal axis factoring yielded two internally consistent components: adaptive and maladaptive defense styles. Endorsement of adaptive defenses was positively correlated with the use of positive religious coping strategies and negatively correlated with negative religious coping.

Treatment notes: objective measures of language style point to clinical insights.

Application of a computerized text analysis procedure is proposed that has the potential for use by psychoanalytic and psychodynamic clinicians: the systematic examination of linguistic style as reflected by clinicians in their ongoing process and case notes, which are ubiquitous in the mental health field. The studies reported here are, as far as is known, the first attempts to study treatment notes systematically using such procedures. Linguistic measures are used to track the trajectory of the clinical process throughout the treatment in two contrasting cases, one rated successful, the other not.

Insights, epiphanies, and working through: on healing, self-healing, and creativity in the writer and the analyst.

The author discusses similarities and differences between the way that writers and psychoanalysts go about their respective tasks. He raises questions about the role of creativity and its sources in both these vocations. He illustrates his points by relating a brief clinical vignette from his work with a patient who was a writer, and by sharing the description of a creative story he wrote many years before becoming an analyst.

Ernst Kris: the objects of memory.

In 1956, the year before his death, Ernst Kris published a trilogy of papers on memory--"The Personal Myth," "On Some Vicissitudes of Insight in Psychoanalysis," and "The Recovery of Childhood Memories"--and was planning to publish a monograph on the subject. In his papers on memory, by juxtaposing his clinical work with adult patients and his research on very young children, Kris sketched a trajectory of the dynamic relationship between preoedipal ego development and object relations, against the backdrop of psychosexual stages and the defenses that mediate memory. Kris was firmly committed to the premise that "the development of ego functions and object relations .

One hundred years after Sigmund Freud's lectures in America: towards an integration of psychoanalytic theories and techniques within psychiatry.

The impact of Sigmund Freud's lectures in America in 1909 is discussed. Some of the roots of psychoanalysis and their contemporary relevance are addressed: neurological ideas, the discussions of the sexologists, and the degeneration theories at the turn of the twentieth century. Factors which led to the dominance of psychoanalysis in psychiatry included, in particular, its arguments against the hopelessness of degeneracy theories;yet,by isolating itself from mainstream academic psychiatry and psychology,organized psychoanalysis itself contributed to its own subsequent marginalization.