This study examined therapist technique and patient change in emotional experiencing and defense mechanisms in the successful and unsuccessful long-term psychoanalytic treatments of two male patients. Two consecutive sessions every 6 months were analyzed for each patient. Therapist interventions, patient defense mechanisms, and patient emotional experiencing were assessed using the Psychodynamic Intervention Rating Scale, Defense Mechanism Rating Scale and the Experiencing Scale, respectively. Between and within-session analyses were conducted to determine the impact of the patient’s defensive functioning and experiencing on therapist interventions, and the effect of therapist interventions on those same two patient variables. Pearson’s Coefficient was utilized for between-session analysis; within-session analysis tracking moment-to-moment changes in patient and therapist functioning was performed using lag sequential analysis. Across therapy, therapist use of Interpretive Interventions was associated with increased emotional engagement and decreased defense maturity; the use of Supportive Interventions had the opposite effect. Within-session analysis revealed that use of Supportive Interventions when emotional engagement is low, followed by interpretative interventions, occurred in the successful case. Persistent use of Supportive Interventions in the context of low emotional engagement was observed in the unsuccessful case. This study suggests that failure to stimulate emotional engagement through interpretation can negatively affect therapeutic outcome.

中文翻译：

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长期治疗的过程研究：比较成功与不成功的结果

这项研究检查了两名男性患者长期成功的和不成功的精神分析治疗方法中治疗师的技术以及患者情绪体验和防御机制的变化。每位患者每6个月进行两次连续检查。分别使用心理动力干预量表，防御机制量表和体验量表评估了治疗师的干预，患者的防御机制和患者的情绪体验。在会议之间和会议期间进行分析，以确定患者的防御功能和体验对治疗师干预的影响以及治疗师干预对这两个患者变量的影响。皮尔逊系数用于会话之间的分析；会话内分析使用滞后顺序分析进行跟踪患者和治疗师功能的瞬时变化。在整个治疗过程中，治疗师使用解释性干预措施会增加情感投入并降低防御成熟度。使用支持性干预的效果相反。会话内分析显示，在成功的案例中，当情绪参与度较低时使用支持性干预，然后进行解释性干预。在失败的案例中，观察到在情绪低落的情况下持续使用支持干预。这项研究表明，无法通过解释刺激情绪参与会负面影响治疗效果。