Fostering the capacity of the patients to oscillate between experiencing and reflecting: an empirical study on process and outcome of psychoanalyses

Aim: The aim of this study is to identify the technical and relation factors which contribute to the good outcome of psychoanalysis. Method: In order to accomplish this goal, we have assessed 600 sessions from 30 psychoanalytic treatments audio recorded an transcripted, 8 sessions from the first month, 4 from the middle of the therapy and 8 from the last month. The 8 sessions from the first month and the 8 sessions from the last month were assessed with the Shedler-Westen assessment Procedure-200 (SWAP-200; Shedler, Westen, 1999a, b), the Global Assessment of Functioning Scale (GAF, APA, 2000); the first 8 sessions were assessed also with the Helping Alliance Rating Scales (HAR; Luborsky, Crits-Cristoph, Alexander, Margolis, & Cohen, 1983) and all the sessions were assessed with the Analytic Process Scales (APS; Waldron et al., 2004) and the Dynamic Interaction Scales (DIS; Waldron et al., 2013). Results: The comparison between good and poor outcome treatments pointed out the relevance of both classical analytic interventions (clarification and interpretation of defenses, conflicts and emotional and behavioral patterns) and relational factors (straightforwardness, warmly and attuned responsiveness, empathy). Moreover, our data pointed out the correlation of the capacity of the patients to oscillate between experiencing and reflecting of the patients on their experience with the level of their Personality Health Index (PHI; Waldron et al., 2011).Finally, we explored what are the technical and relational elements of therapist communication that foster the patients capacity to oscillate between experiencing and reflecting. Discussion: The clinical and training implications of these data will be discussed.