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Yıl:2022; Cilt: 37; Sayı: 90>> Özet
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Klinik Psikoloji Dergisi; 2022;37(90):18-39
Psikodinamik Psikoterapide Duygular ve Belirtisel Değişim:Boylamsal bir Çalışma
A Çavdar
İstanbul Bilgi Üniversitesi, İstanbul
Bu çalışmanın amacı, psikodinamik psikoterapide terapist ve danışanların belirli duyguları deneyimlenme düzeyleri, aralıkları ve eğilimlerini betimlemek ve duyguların belirtisel iyileşme ile olan ilişkisini incelemektir. Bu amaçla, 54 danışan ve 12 stajyer terapistin süreçlerinin başında ve sonunda belirti ölçümleri ve 899 seansında duygu ölçümleri alınmıştır. Süreçte en çok deneyimlenen duyguların üzüntü, mutluluk, rahatlama ve şaşırma; en az deneyimlenen duyguların küçük görme, tiksinme, korku ve haset olduğu görülmüştür. Lineer Karma Modeller analizlerine göre danışanın geniş bir aralıkta suçluluk deneyimlemesinin ve terapistin düşük düzeyde öfke deneyimlemesinin belirtisel iyileşmeyi yordadığı bulunmuştur. Danışanın üzüntü ve suçluluk duygularının yas ve sorumluluk alma kapasitelerine işaret edebileceği; terapistin öfkesinin kayıtsızlaşma ve kopmaya neden olmuş olabileceği tartışılmıştır. Duyguların eğilimleri Çok Düzeyli Modelleme ile incelenmiş ve danışanın şaşırma, terapistin ise mutluluk ve rahatlama duygularında doğrusal eğilimler bulunmuştur. Bu bulgu süreçlerin sonlandırma şekilleri ile ilişkili olarak yorumlanmıştır. Danışan ve terapistin süreçteki duygu eğilimlerinin birbiri ile ilişkisi için Çok Düzeyli Vektör Otoregresyon analizi yapılmış; terapist ve danışanın üzüntü ve mutluluk duygularının güçlü bir eşzamanlı ilişkisi olduğu görülmüştür. Danışan ve terapistin birlikte sevinip birlikte üzülmesi terapi ilişkisinde karşılıklı uyumlanma olarak değerlendirilmiştir. Sonuçlar, duygu alanyazınını ve psikodinamik alanyazını destekler ve terapist-danışan ikilisinin süreç deneyimlerinin boylamsal olarak çalışılması konusunun gelişime açık olduğunu gösterir niteliktedir.
Emotions and Symptom Change in PsychodynamicPsychotherapy: A Longitudinal Study
The aim of this study is to study the level, range, and trend of experiencing certain emotions in open-ended psychodynamic psychotherapy, and their association with symptomatic improvement. For this aim, pre- and post-therapy symptoms were assessed for 54 clients and 12 intern therapists and emotion ratings were collected for 899 sessions. Emotions with the highest averages were happiness, sadness, relief, and surprise; whereas emotions with the lowest averages were contempt, disgust, fear, and envy. Linear Mixed Modeling revealed that higher ranges of clients’ guilt and lower levels of therapists’ anger predicted symptom improvement. It was discussed that sadness and guilt of the client might point to a capacity to grieve and to take responsibility; and anger of the therapist might have instigated indifference and rupture. Emotion trends were studied using Multi-level Modeling, and linear trends were observed for clients’ surprise, and therapists’ happiness and relief. This finding was interpreted in relation to the type of termination. The associations between clients’ and therapists’ emotion trends were analyzed by Multi-Level Vector Autoregression; and a strong association between the contemporaneous happiness and sadness of the client and the therapist was found. This state of “laugh together cry together” was considered as mutual attunement. Results were supportive of emotion literature and psychodynamic literature as well as promising in terms of the longitudinal study of the process experience of the client and the therapist as a dyad.

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