Verbal and nonverbal expressions of mutual regulation in relevant episodes of psychotherapy / Manifestaciones verbales y no verbales de la regulación mutua en episodios relevantes de psicoterapia

Abstract

The purpose of this paper is to describe verbal and nonverbal expressions of mutual regulation between patients and therapists through the analysis of relevant episodes of five psychotherapy processes. Microanalyses of discourse, vocal quality and facial expression of emotions were conducted on both patients and therapists in 67 Episodes of Change and 86 Episodes of Rupture of the Therapeutic Alliance. The analyses were carried out using hierarchical regression, showing that both Episodes of Change and Episodes of Rupture correspond to interactional scenarios where patients and therapists use different forms of speech, vocal qualities and facial expressions that account for specific regulation processes which are coherent with such scenarios.

Identification of Dynamic Patterns of Personal Positions in a Patient Diagnosed With Borderline Personality Disorder and the Therapist During Change Episodes of the Psychotherapy

“…These results are consistent with those found in previous studies ( Tomicic et al, 2015b ; Morán et al, 2016 ) regarding the patient’s achievement of a subjective positioning of greater openness to dialogue in change episodes, and the non-predominance of either of the two positions, professor and proposer, of the therapist, which were considered as organized speech from their therapeutic role independent of interactional contexts in which they found themselves. However, in this study, a difference was observed in the more elaborate episodes of change (level 3), in which the “proposer” position takes prominence, possibly suggesting specialization of its therapeutic role in a propositional aspect, possibly coherent with the much more reflective subjective manifestations of the patient.…”

“…A study that analyzed change episodes and rupture alliance episodes from five psychotherapies of different orientations identified a higher probability of patients interacting from the reflective subjective position in the former, and that this probability increases as the episode progresses, while the probability of interacting from the independent subjective position decreases. In therapists, no differences were observed in the interaction between the proposer and professor subjective positions in the two types of episodes ( Morán et al, 2016 ).…”

Embodied Coordination and Psychotherapeutic Outcome: Beyond Direct Mappings

“…We believe that in giving a compelling account of how alliance is constructed, in addition to synchrony, we should also study phenomena at different timescales along therapeutic processes, laborious though such a study may be. Regardless of the clinical approach used, therapeutic processes encompass a diversity of therapeutic phases in which different relational patterns predominate (Searles, 1961 ; Westerman et al, 1995 ; Morán et al, 2016 ; Orsucci et al, 2016 ; Rodríguez et al, 2018 ). There might be, for instance, an alliance building phase, an emotional support phase, a narrative phase, and so forth.…”

The Patient’s Change: Understanding the Complexity of the Dynamics of Change and its Precursors in Psychotherapy

“…This relational dimension consists of a continuous negotiation process between the patient's and therapist's needs and passes through rupture and repairs moments implemented by both participants that influence change (Safran et al, 2011;Locati et al, 2019). Precisely, ruptures manifest themselves through phases of lack of coordination characterized by non-cooperative behaviors between participants, while repairs through coordination phases identified by cooperative behaviors; both of them are expressed through verbal and non-verbal communication (Colli and Lingiardi, 2009;Morán et al, 2016;Colli et al, 2017). The therapist's capacity to acknowledge and manage these moments could lead the therapy to positive changes or negative results (Eubanks et al, 2018).…”

“…Even though the literature acknowledges that the TA manifests itself through verbal and non-verbal expressions (Morán et al, 2016), studies mainly focused on verbal interactions (e.g., Krause et al, 2016), giving little emphasis to research on non-verbal components (e.g., and their interactions with the former (e.g., Martinez Guzman et al, 2014) in the TA construction. Therefore, deepening the relationship between communication and TA by considering the verbal and non-verbal dimensions as an integrated and interacting system may overcome the limits of the previous research and provide professionals with useful information to increase knowledge about building such a collaborative relationship and the therapy effectiveness.…”