Physiologic Monitoring in Psychodynamic Psychotherapy Research

Abstract

There is a rich history of measuring physiologic responses between patient and clinician that has infused psychodynamic psychotherapy research for over half a century. The findings complement research outside of psychotherapy that increasingly supports a significant relationship between physiological, emotional, and psychological states [1]. Indeed, investigations into how physiologic parameters change during psychotherapy offer a unique opportunity to inform clinical practice, improve training of clinicians, and illuminate change processes unique to human dyadic relationships [2]. The goal of this chapter is to review the history of physiologic monitoring during psychodynamic psychotherapy and present recent findings that complement neuroimaging results and support recent advances in interpersonal neurobiology and social neuroscience. A clinical case from a research protocol is described that demonstrates the power of insights derived from physiologic measurement and illustrates the challenges of breaking through unconscious defenses in the process of psychodynamic psychotherapy. Through a variety of methodological approaches, the early literature on psychophysiology and psychotherapy begins to address two critical questions. First, is there a measurable, biologically based influence that emerges from the physiological responses of patient and therapist during psychotherapy? Second, what are the observable correlates of these physiologic responses and what are the implications for psychotherapy practice, training, and research? These two questions are at the core of this chapter. Prior studies on psychophysiology and psychotherapy almost exclusively use heart rate (HR) and skin conductivity (SC) as a measure of physiologic reactivity, thus the present chapter briefly reviews the origins and mechanisms of these two measures. A critical review of the rich historical literature employing psychophysiology in psychodynamic psychotherapy is presented with an update on more recent studies. Following the description of a clinical case, the review is placed in the context of modern neurobiology and neuroscience with a discussion of future directions. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (chapter)