Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

Abstract

The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

“…Moreover, journals currently provide more clear guidelines as to what comprises an eligible case study. High quality cases, for example Gazillo et al (2014) , Mauck and Moore (2014) and Cornelis et al (2017) , set the tone for a future where case aggregation based on scientifically sound cases that include triangulated data and analysis methods while not disregarding clinical context becomes increasingly possible. This attention for the clinical context is of crucial importance in the field of psychotherapy ( Spence, 2001 ).…”

Validity Beyond Measurement: Why Psychometric Validity Is Insufficient for Valid Psychotherapy Research

“…To clarify the relationship between test validity and epistemic validity in the practical context of psychotherapy research, we discuss the findings from an empirical case study by Cornelis et al (2017) , 7 that was conducted in the context of a broader psychotherapy study that was conducted at Ghent University, Belgium (“SCS”, cf. Desmet, 2018 ).…”

“…The data used in this paper were gathered in a mixed method psychotherapy study conducted at Ghent University from 2009 onward ( Cornelis et al, 2017 ). In this study, patients in a private psychotherapy practice were followed on a session-by-session basis with a variety of means.…”

“… Individual outcome measure battery throughout treatment for patient James (retrieved from Cornelis et al, 2017 ; reprinted with permission). …”

“…However, the validity of a measure does not cover the validity of its use as operationalization of another target concept within a research procedure, nor the validity of its function toward an epistemic goal. In this paper, we discuss the importance of considering validity of the epistemic process beyond the validity of measures per se , based on an empirical case example from our psychotherapy study (“SCS”, Cornelis et al, 2017 ). We discuss why the psychometric understanding of validity is insufficient in covering epistemic validity, and we evaluate to what extent the available terminology regarding validity of research is sufficient for working researchers to accurately consider the validity of their overall epistemic process.…”