On the micodynamics of psychoanalytic counseling: resentment as a factor complicating the therapeutic action of interventions

Context and Relevance. Since J. Strachey's landmark paper in 1934, the question of the mechanisms of therapeutic action in the psychoanalytic approach has remained a subject of debate. Of particular interest is how different types of therapeutic interventions create the conditions for structural personality change. Purpose. To develop and apply a parameter for assessing the effectiveness of different types of therapeutic interventions within the psychoanalytic approach. Hypothesis. The hypothesis about the differential influence of different types of verbal interventions on the dynamics of defensive personality organization during psychoanalytic counseling was tested. Methods and Materials. A mixed-methods design was used, incorporating qualitative (diagnostic-therapeutic interview, configurational analysis) and quantitative (Kruskal-Wallis H-test, descriptive statistics) methods. Audio recordings of 30 diagnostic-therapeutic interviews with 10 clients were analyzed. Results. A parameter for assessing intervention effectiveness based on the analysis of changes in defensive personality organization (integrating concepts by B. Joseph and J. Steiner) is proposed. Statistical analysis did not reveal a deterministic role of the intervention type but showed variability in individual client susceptibility to them and differing frequencies of their use with different clients. The description of a selected clinical case demonstrated the influence of resentment (Feldman, 2012) on the therapeutic action of interventions. The study proposes: an integrated classification of interventions (based on the typology of D. Tuckett) and a schematic concept the therapeutic action within the psychoanalytic approach. Conclusions. Therapeutic action is not determined solely by the type of intervention but is mediated by a number of factors, particularly the characteristics of the individual's defensive personality organization. The criterion for assessing intervention effectiveness opens up prospects for further research on the psychotherapeutic process.

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