1
|
Buchheim A, Kernberg OF, Netzer N, Buchheim P, Perchtold-Stefan C, Sperner-Unterweger B, Beckenbauer F, Labek K. Differential neural response to psychoanalytic intervention techniques during structural interviewing: A single-case analysis using EEG. Front Hum Neurosci 2023; 16:1054518. [PMID: 36684843 PMCID: PMC9846161 DOI: 10.3389/fnhum.2022.1054518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/02/2022] [Indexed: 01/05/2023] Open
Abstract
Background Previous studies detected changes in the electroencephalographic (EEG) signal as an effect of psychoanalytic interventions. However, no study has investigated neural correlates of specific psychoanalytic interventions in the EEG power spectrum yet. In the present case study, we contrasted three types of interventions (clarification, confrontation, and interpretation) and a neutral control condition during a structural psychoanalytic interview conducted while EEG was recorded. Methods A 27-year-old male patient diagnosed with major depressive disorder and borderline personality disorder with recurrent suicidal and self-injurious behavior underwent a structural interview while recording EEG. Two independent experts selected by consensus the characteristic episodes of the four conditions (clarification, confrontation, interpretation, and neutral control) within the interview, which were included in the EEG analyses. Fast Fourier transformation (FFT) was applied to subsegments of the intervention type to analyze the EEG power spectra. Alpha and beta power from central, frontal, and parietal sites were considered in linear mixed-effects models with segments as a random factor with maximum-likelihood estimates due to the lack of balance in the length of the interview segments. Results The interventions "interpretation" and "confrontation" showed a significantly lower alpha power compared with the control condition in the central electrodes. In the frontal and parietal sites of the alpha power and all beta power sites, the omnibus tests (full model/model without intervention) and comparisons relative to control conditions showed no significant overall result or failed significance after alpha error correction. Conclusion Incisive interventions, such as confrontation with discrepancies and interpretation of unconscious intrapsychic conflicts, may have provoked temporary emotional lability, leading to a change in psychic processing akin to interference from external stimuli. This conclusion is consistent with the finding that interpretations, which are potentially the most concise interventions, had the strongest effects on alpha power. Using EEG during therapeutic psychoanalytic intervention techniques might be a helpful tool to evaluate differential responses to the psychotherapeutic process on a neural level. However, this single-case result has to be replicated in a larger sample and does not allow generalizations.
Collapse
Affiliation(s)
- Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria,*Correspondence: Anna Buchheim,
| | - Otto F. Kernberg
- New York-Presbyterian Hospital–Westchester Division, New York, NY, United States
| | - Nikolaus Netzer
- Hermann Buhl Institute, University of Innsbruck, Eurac Research, Innsbruck, Austria,Eurac Research, Bolzano, Italy
| | - Peter Buchheim
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | | | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Karin Labek
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
2
|
Assessment of personality functioning in psychosomatic medicine. Wien Klin Wochenschr 2022; 134:602-610. [PMID: 35344100 PMCID: PMC9418278 DOI: 10.1007/s00508-021-01993-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/30/2021] [Indexed: 11/21/2022]
Abstract
Background Personality functioning, also referred to as structural integration, describes basic emotion-related perception and regulation capacities directed towards the self and others. Patients with impairments of personality functioning experience difficulties in self-regulation and interpersonal relations. Although personality functioning has become increasingly important in psychotherapeutic and psychiatric diagnoses and treatment planning, there is little systematic evidence on the role of personality functioning in patients with chronic and somatic diseases. This article reviews empirical studies using standardized assessments of personality functioning in patients with chronic and somatic diseases and discusses the role of personality structure in psychosomatic medicine. Results Currently, there are only a limited number of studies using standardized assessments of personality functioning in patients with chronic or somatic diseases. The available evidence points to correlations of personality functioning with pain perception and the development of chronic pain. In addition, patients with lower levels of personality functioning may have difficulties in managing chronic conditions that require enduring changes in health behavior, such as in diabetes or posttransplantation therapy. Conclusion The review suggests a systematic link between personality functioning and health behavior in patients with chronic diseases that relate to self-regulation and coping strategies. These findings underline the importance of assessing personality functioning for diagnostics and treatment planning in psychosomatic medicine. Finally, an assessment of personality functioning could be helpful in choosing specific psychotherapeutic treatment strategies; however, more empirical studies are needed to comprehensively prove these assumptions.
Collapse
|
3
|
Cantone D, Feruglio S, Crescentini C, Cinot S, Matiz A. A Multilevel Approach to Explore the Wandering Mind and Its Connections with Mindfulness and Personality. Behav Sci (Basel) 2021; 11:bs11090125. [PMID: 34562963 PMCID: PMC8469085 DOI: 10.3390/bs11090125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 01/07/2023] Open
Abstract
We propose an innovative approach to study Mind Wandering (MW), and we present an application of this methodology to study the effects of a Mindfulness-Oriented Meditation (MOM) training. We assessed individuals' MW through a free association task and an attentional task with thought-probes combined with a questionnaire for the phenomenological characteristic of each MW episode. We used the Temperament and Character Inventory to assess participants' personality traits and their associations with measures of MW. Our study was limited by the course of the Covid-19 pandemic and only nine healthy young individuals completed the testing sessions, which were carried out before and after the MOM training. After MOM, participants showed fewer repetitive and self-relevant thoughts and indices of better performance in the attentional task; the linguistic analysis of participants' free associations showed lower verbal productivity and a decrease in utterances that expressed anxiety/stress. Overall, we foresee that future studies could replicate our preliminary findings with larger samples and in a period without a global health emergency. This multilevel approach to the study of MW may allow researchers to gain a broader view of the phenomenon, considering its occurrence, qualitative characteristics, impact on cognitive tasks, malleability via mindfulness or other psychological interventions, and relations with personality traits.
Collapse
Affiliation(s)
- Damiano Cantone
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.F.); (C.C.); (A.M.)
- Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
- Correspondence:
| | - Susanna Feruglio
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.F.); (C.C.); (A.M.)
- Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
| | - Cristiano Crescentini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.F.); (C.C.); (A.M.)
| | - Sabrina Cinot
- Department of Medicine, University of Udine, 33100 Udine, Italy;
| | - Alessio Matiz
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.F.); (C.C.); (A.M.)
| |
Collapse
|
4
|
Roesler C. Theoretical foundations of analytical psychology: recent developments and controversies. THE JOURNAL OF ANALYTICAL PSYCHOLOGY 2019; 64:658-681. [DOI: 10.1111/1468-5922.12540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Kessler H, Axmacher N, Diers M, Herpertz S. On the Purported Dichotomy Between Fake and Real Symptoms: The Case of Conversion Disorders. Front Psychol 2019; 10:2114. [PMID: 31620053 PMCID: PMC6759484 DOI: 10.3389/fpsyg.2019.02114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
- *Correspondence: Henrik Kessler
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
6
|
Kehyayan A, Matura N, Klein K, Schmidt AC, Herpertz S, Axmacher N, Kessler H. Putative Markers of Repression in Patients Suffering From Mental Disorders. Front Psychol 2018; 9:2109. [PMID: 30459684 PMCID: PMC6232250 DOI: 10.3389/fpsyg.2018.02109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background: The concept of psychodynamic conflict is essential to psychodynamic theory and therapy. In classical psychodynamic therapy, unconscious conflict themes need to be identified by the therapist and brought to the patient's awareness, in order to work through and ultimately solve them. According to theory, touching upon conflict-related topics leads to arousal, followed by activation of defense mechanisms such as repression. Starting with C.G. Jung's association studies more than 100 years ago, various proposals have been made to investigate psychodynamic conflicts based on free association and psychophysiological measures. This study presents an attempt to identify and differentiate between psychodynamic conflict themes in patients, using an adopted version of Jung's paradigm that had in previous studies been applied to healthy subjects. Method: Seventeen patients suffering from depression and other mental disorders associated freely to different cue sentences. Prior to the experimental procedure, patients' individual psychodynamic conflict types were assessed through clinical interviews. Sentences were either neutral, negative (but not conflict-related), or related to specific types of psychodynamic conflicts. Memory for the first three associations was later tested in an unexpected recall task. Skin conductance response (SCR) was recorded and analyzed together with reaction times (RTs) and self-ratings of emotional valence, arousal, and agreement with cue sentences. Results: Patients showed reduced memory performance for associations to conflict-related sentences in general, compared with negative and neutral sentences. Agreement with conflict-related sentences was lower compared to neutral but not negative sentences. Memory was negatively correlated with RTs and SCR. RTs were longer for conflict types that had been rated as relevant in clinical interviews prior to the association task, compared to the other, non-relevant conflict types. Conclusion: Our study shows that some putative markers of repression of psychodynamic conflicts previously established in healthy participants also occur in patients. Moreover, it provides evidence that general conflict effects differ from specific effects of personally relevant conflicts.
Collapse
Affiliation(s)
- Aram Kehyayan
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany,*Correspondence: Aram Kehyayan,
| | - Nathalie Matura
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Kerstin Klein
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
| | - Anna-Christine Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
7
|
Marron TR, Lerner Y, Berant E, Kinreich S, Shapira-Lichter I, Hendler T, Faust M. Chain free association, creativity, and the default mode network. Neuropsychologia 2018; 118:40-58. [DOI: 10.1016/j.neuropsychologia.2018.03.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
|
8
|
Kessler H, Schmidt AC, Hildenbrand O, Scharf D, Kehyayan A, Axmacher N. Investigating Behavioral and Psychophysiological Reactions to Conflict-Related and Individualized Stimuli as Potential Correlates of Repression. Front Psychol 2017; 8:1511. [PMID: 28959219 PMCID: PMC5603662 DOI: 10.3389/fpsyg.2017.01511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Repression is considered as a central defense mechanism in psychodynamic theory. It refers to the process by which "unbearable" mental contents (e.g., those related to internal conflicts) are kept out of consciousness. The process of repression is probably closely related to concepts of emotion regulation derived from a different theoretical background. This relationship is particularly relevant because it relates repression to current research in the affective neurosciences as well as to experimental studies on emotion regulation. Due to its complex and highly individual nature, repression has been notoriously difficult to investigate. We investigated repression with an individualized experiment in healthy subjects in order to establish methods to study repression in clinical populations. To this end we operationalized repression using individualized experimental conditions, and then studied potential behavioral [memory and reaction time (RT)] and psychophysiological correlates [skin conductance response (SCR)]. Method: Twenty-nine healthy female subjects were asked to freely associate to individualized cue sentences. Sentences were generated from individual psychodynamic interviews based on operationlized psychodynamic diagnosis (OPD), and were comprised of three different types: positive, negative non-conflictual, and negative conflict-related sentences. Subjects were asked to name the first three associations coming into their mind. Afterward, the remaining time was used for free association. SCR during each association trial and RT of the first given association were recorded. The memory for the first three associations was subsequently tested in an unexpected recall. Results: Associations to conflict-related cue sentences were associated with longer RTs and increased SCRs. Moreover, the unexpected recall task showed memory for these associations to be reduced. Conclusion: We interpret these findings as possible correlates of repression, in line with a history of experimental research into repression using non-individualized cues. Consequently, we suggest that this experimental paradigm could serve to investigate repression in clinical populations.
Collapse
Affiliation(s)
- Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University BochumBochum, Germany
| | - Anna Christine Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University BochumBochum, Germany
| | | | - Daniela Scharf
- Department of Medical Psychology, University of BonnBonn, Germany
| | - Aram Kehyayan
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University BochumBochum, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University BochumBochum, Germany
| |
Collapse
|
9
|
Axmacher N. Causal explanations within weak and incomplete theories. Front Psychol 2015; 6:1689. [PMID: 26579060 PMCID: PMC4630309 DOI: 10.3389/fpsyg.2015.01689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 10/19/2015] [Indexed: 11/25/2022] Open
|
10
|
Axmacher N, Kessler H, Waldhauser GT. Editorial on psychoanalytical neuroscience: exploring psychoanalytic concepts with neuroscientific methods. Front Hum Neurosci 2014; 8:674. [PMID: 25221501 PMCID: PMC4147297 DOI: 10.3389/fnhum.2014.00674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/13/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nikolai Axmacher
- Department of Epileptology, University of BonnBonn, Germany
- *Correspondence:
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University BochumBochum, Germany
| | | |
Collapse
|
11
|
Kessler H, Stasch M, Cierpka M. Operationalized psychodynamic diagnosis as an instrument to transfer psychodynamic constructs into neuroscience. Front Hum Neurosci 2013; 7:718. [PMID: 24298247 PMCID: PMC3829565 DOI: 10.3389/fnhum.2013.00718] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/10/2013] [Indexed: 11/13/2022] Open
Abstract
This theoretical article makes a contribution to the field of "psychoanalytically informed neuroscience". First, central characteristics of psychoanalysis and neuroscience are briefly described leading into three epistemic dichotomies. Neuroscience versus psychoanalysis display almost opposing methodological approaches (reduction vs. expansion), test quality emphases (reliability vs. validity) and meaning of results (correlation vs. explanation). The critical point is to reach an intermediate level: in neuroscience an adequate position integrating both aspects-objective and subjective-of dual-aspect monism, and in psychoanalysis the appropriate level for the scientific investigation of its central concepts. As a suggestion to reach that level in both fields the system of Operationalized Psychodynamic Diagnosis (OPD; OPD Task Force, 2008) is presented. Combining aspects of both fields areas, expansion and reduction as well as reliability and validity, OPD could be a fruitful tool to transfer psychodynamic constructs into neuroscience. The article closes with a short description of recent applications of OPD in neuroscience.
Collapse
Affiliation(s)
- Henrik Kessler
- 1Department of Psychosomatic Medicine and Psychotherapy, LWL-University, Ruhr-University Bochum Germany
| | | | | |
Collapse
|