Lingustic realization of resistance in psychodynamic psychotherapy

这个跨学科项目旨在更好地理解心理动力学心理治疗的一个核心概念，“抵抗”。它研究耐药性在心理治疗过程中如何变化，取决于治疗反应和患者变量。在混合方法的方法，结合语言，对话分析和心理学，心理治疗方法，录像和门诊心理治疗会议的文字记录将进行分析。在对180例抑郁症患者（单极情感障碍、有焦虑和抑郁症状的患者以及有抑郁人格障碍的患者）进行完整心理动力学治疗的基础上，确定了抵抗的语言实现。之前的治疗相互作用序列和治疗师对抵抗的反应也将包括在分析中。分析将产生一个分类矩阵，允许捕获两种类型的耐药性实现和对耐药性的治疗反应类型。目标是发展一种基于语言和相互作用的抵抗实现类型和抵抗的治疗反应形式，这可以作为在心理治疗过程中探索抵抗变化动态的基础。分类矩阵将被转换成一个编码系统，用于识别治疗过程中不同类型耐药性的频率和强度的变化。关于抵抗如何作为治疗干预的效果而改变的问题将被纵向地研究，定性地使用会话分析和互动语言学的方法，定量地使用编码、问卷调查数据和统计分析。第5、15和30阶段将在总共110种疗法中进行分析。它将测试如何实现的阻力及其变化取决于不同的病人，治疗师和过程变量一方面和治疗反应的另一方面。从理论上讲，该项目的首要目标是发展一种基于语言和互动的概念，以实现心理动力心理治疗中的抵抗及其管理。因此，该项目将有助于更好地理解语言和互动对心理治疗变化的影响。研究结果与心理动力心理治疗实践和培训的相关性将被讨论。

This interdisciplinary project aims for a better understanding of a core concept of psychodynamic psychotherapy, ‚resistance‘. It studies how resistance changes over the course of psychotherapeutic treatment, depending on therapeutic reactions and patient variables. In a mixed methods approach, which combines linguistic, conversation-analytic and psychological, psychotherapeutic methods, video-recordings and transcripts of outpatient psychotherapeutic sessions will be analyzed. On the basis of 180 complete psychodynamic therapies with depressive patients (unipolar affective disorder, patients suffering from anxiety and depressive symptoms and patients with a depressive personality disorder), linguistic realizations of resistance are identified. The immediately preceding sequences of therapeutic interaction and the therapist’s responses to resistance will also be included in the analysis. The analyses will result in a categorical matrix that allows to capture both types of realizations of resistance and types of therapeutic responses to resistance. The goal is to develop a linguistically and interactionally based typology of realizations of resistance and of forms of therapeutic responses to resistance, which can serve as a basis for inquiring into the dynamics of change of resistance over the course of psychotherapeutic treatment processes. The categorical matrix will be transformed into a coding-system, which will be used to identify changes in frequency and intensity of different types of resistance over the course of the therapeutic sessions. The issue of how resistance changes as an effect of therapeutic interventions will be studied longitudinally both qualitatively, using the approach of conversation analysis and interactional linguistics, and quantitatively, using coding, questionnaire data and statistical analysis. Sessions 5, 15 and 30 will be subjected to analysis in a total of 110 therapies. It will be tested how realization of resistance and its change depends on various patient, therapist and process variables on the one hand and on therapeutic responses on the other hand. Theoretically, the project sets as ist goal to develop a linguistically and interactionally based concept of the realization of resistance and its management in psychodynamic psychotherapy. The project thus will contribute to a better understanding of how language and interaction matter for psychotherapeutic change. The relevance of the results for practice and training in psychodynamic psychotherapy will be discussed.