Dissertations and Theses
Date of Award
2023
Document Type
Dissertation
Department
Psychology
First Advisor
Steve Tuber
Second Advisor
Wilma Bucci
Third Advisor
Lissa Weinstein
Keywords
Therapist interventions, referential process, language research, psychodynamic psychotherapy, arousal, symbolizing, reflecting/reorganizing
Abstract
The Referential Process (RP) is defined as a set of functions (Arousal, Symbolizing, and Reflecting/Reorganizing) that describe the rendering of subsymbolic experience into verbal, symbolized form (Bucci, 2021). Movement through the RP — beginning with the subsymbolically-dominated Arousal function — has been tied to multiple theoretical and clinical understandings of therapeutic progress and personality change (Bucci, 2013; Mariani et al., 2013). The present exploratory study seeks to identify whether certain therapist language features are linked to the facilitation of patients’ movement from Arousal to Symbolizing. Using treatment transcripts from the RP Group Data Base, cases of high patient Arousal were divided into intervention trajectory categories based on the presence and/or positioning of the subsequent patient Symbolizing peak. The language of therapists’ interventions in response to high patient Arousal moments was then examined using the computerized measures of the RP, as well as additional measures of Disfluency, pronoun use, a supportive-exploratory intervention distinction, use of direct questions, number of words, and turn number (i.e., when the intervention takes place in the session). Results indicate that the interventions most immediately facilitative of patient movement from Arousal to Symbolizing displayed significantly higher Reflecting/Reorganizing scores and tended to take place significantly earlier in the session than interventions in which a patient symbolizing peak occurred later in the session and those in which no patient symbolizing peak occurred at any subsequent point. Additionally, interventions proceeded by patient Symbolizing peaks tended to include significantly more direct questions than interventions in which no patient subsequent symbolizing peaks occurred. As hypothesized, these findings suggest that there are indeed language features attributable to therapist interventions that are most facilitative of patient movement from high Arousal to high Symbolizing. Through an integration of these findings with historical threads of psychoanalytic literature, this preliminary study explores the utility of each of these shared language features in offering the patient an opportunity for scaffolded exploration. More broadly, the study demonstrates the potential for RP language research to capture some of the latent processes in clinical interventions, inviting iterative applications in the study of psychotherapy process.
Recommended Citation
Tocatly, Karen, "Interventions That Move: Characterizing the Language of Therapist Responses to High Patient Arousal" (2023). CUNY Academic Works.
https://academicworks.cuny.edu/cc_etds_theses/1187