Changes in Defensive Functioning in Completed Psychoanalyses: the Penn Psychoanalytic Treatment Collection

Abstract

Theory predicts that patients completing psychoanalysis should improve in their dynamic functioning. The aim of this naturalistic study is to examine whether a sample of 17 subjects from the Penn Psychoanalytic Treatment Collection with completed, tape-recorded psychoanalyses demonstrated improvement in one dynamic aspect: their defense mechanisms. The pre-post effect size for the change in overall defensive functioning (ODF) of the sample was large (.76) and statistically significant ( p = .01). The percentage of subjects who improved in their ODF (71%) was similar to that found by others who studied the same sample using general functioning measures. These findings provide the first empirical evidence to support a trait-like change in dynamic personality functioning in patients who have undergone psychoanalysis. Randomized controlled studies with homogeneous samples are needed to further confirm these findings.

Is there a relationship between therapist language use, patient defensive functioning and therapeutic alliance? A pilot study of in-session processes

“…Research has shown that a key indicator of successful psychodynamic psychotherapy is when patients use more adaptive defenses and less maladaptive defenses by the end of treatment [e.g., [7][8][9][10][11][12]. Research also indicates that improvement in patient defensive functioning is related to improved patient mental health years after treatment, reduced dropout rates, and successful outcomes [e.g., 10].…”

Ten Principles to Guide Psychodynamic Technique with Defense Mechanisms: An Examination of Theory, Research, and Clinical Implications

“…This research has led to several reviews that synthesize the theoretical, methodological, and empirical aspects of defenses [16][17][18]. There is evidence showing that patients who undergo successful psychodynamic treatment demonstrate more adaptive defense use [19][20][21][22][23][24][25][26][27]. Furthermore, the use of mature defenses has been shown to be associated with healthy psychological and physical functioning [18,28,29].…”

Do therapists practicing psychoanalysis, psychodynamic therapy and short-term dynamic therapy address patient defences differently?

“…For instance, the Wogan & Norcross [21] study did not examine defenses or the interpretation of defenses when surveying dynamic therapists. This is surprising as there is a growing body of research demonstrating the importance of adaptive patient defense use and its relationship to positive therapy process and outcome [9,22]. Additionally, there is a body of research that demonstrates positive relationship between the interpretation of defenses and outcome [23].…”