Interventions That Move: Characterizing the Language of Therapist Responses to High Patient Arousal

<p>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.</p>

Name thesis:degree_name

Doctor of Philosophy (Ph.D.)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Psychology

Year dc:date.available

2023

Author dc:creator

• Tocatly, Karen

Contributors dc:contributor

• Steve Tuber
• Wilma Bucci
• Lissa Weinstein

• Therapist interventions
• referential process
• language research
• psychodynamic psychotherapy
• arousal
• symbolizing
• reflecting/reorganizing
• Clinical Psychology

Repository record dc:identifier

https://academicworks.cuny.edu/cc_etds_theses/1187

OAI identifier oai:identifier

oai:academicworks.cuny.edu:cc_etds_theses-2181