The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other

Abnormal default system functioning in depression: Implications for emotion regulation

open5noDepression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parietal executive areas, instead of responding automatically to emotional stimuli. According to such models, the weaker executive area activation observed in depressed patients is attributable to a lack of cognitive control over negative emotions. Going beyond the concept of cognitive control, psychodynamic models describe the development of individuals’ capacity to regulate their emotional states in mother-infant interactions during childhood, through the construction of the representation of the self, others, and relationships. In this mini-review, we link these psychodynamic models with recent findings regarding the abnormal functioning of the default system in depression. Consistently with psychodynamic models, psychological functions associated with the default system include self-related processing, semantic processes, and implicit forms of emotion regulation. The abnormal activation of the default system observed in depression may explain the dysfunctional aspects of emotion regulation typical of the condition, such as an exaggerated negative self-focus and rumination on self-esteem issues. We also discuss the clinical implications of these findings with reference to the therapeutic relationship as a key tool for revisiting impaired or distorted representations of the self and relational objects.openMessina, Irene; Francesca, Bianco; Cusinato, Maria; Calvo, Vincenzo; Sambin, MarcoMessina, Irene; Bianco, Francesca; Cusinato, Maria; Calvo, Vincenzo; Sambin, Marc

Filoni di ricerca in psicoterapia nella Facoltdi Psicologia dellUniversitdi Padova

Il moltiplicarsi di proposte di intervento psicologico e la crescente richiesta da parte degli utenti e delle istituzioni di cura di misurare efficacy ed effectiveness delle psicoterapie, rende necessaria una valutazione empirica dei modelli di intervento applicati, attraverso lo studio di ciò che avviene in psicoterapia e dei relativi meccanismi di cambiamento e azione. Scopo del presente lavoro è introdurre il lettore ai diversi disegni di ricerca per la valutazione empirica della psicoterapia nel complesso contesto di alcuni servizi Universitari dell’Ateneo Patavino. L'interesse sarà posto sui diversi progetti e strumenti per la valutazione dell’esito, dei macro e dei micro processi di cambiamento di terapie ad indirizzo psicodinamico, caso singolo e di gruppo, anche in relazione alle neuroscienze

L'applicazione degli strumenti di ricerca

Nel presente capitolo viene descritta l'applicazione di strumenti per la valutazione dell'esito e del processo di una psicoterapia dinamica breve di gruppo. In particolare il Core Conflictual Relationship Theme per l'analisi del cambiamento dei temi relazionali centrali e della loro pervasivit\ue0 nel corso della terapia; l'Indice di Valutazione dell'Alleanza Terapeutica per la valutazione dell'alleanza terapeutica; l'operazionalizzazione del Triangolo Drammatico per individuare come cambiano nel corso della terapia determinate modalit\ue0 relazionali disfunzionali; Global Assessment of Functioning Scale per la valutazione del funzionamento globale del paziente come effetto della terapia

Presentazione

Presentazione al volume M. Novellino, Psicoanalisi Transazionale, Franco Angeli, Milano, p 20