From Submission to Autonomy: Approaching Independent Decision Making. A Single–case Study in a Randomized, Controlled Study of Long–term Effects of Dynamic Psychotherapy

In the First Experimental Study of Transference Interpretations (FEST), showing the best treatment effects from dynamic psychotherapy with transference interpretations, one subgroup was female patients who had difficult relationships with others (low quality of object relations).

The aim of the present study was to explore further a highly successful therapy for this subgroup with a single case study in a randomized, controlled study of long-term effects of dynamic psychotherapy with a patient who was depressed and felt exploitable. Case formulation, transcription of sessions, and repeated applications of self-reports and observer-rated measures, both during and after therapy, are used. Detailed observer ratings of the therapistpatient interaction, using Structural Analysis of Social Behaviour (SASB) showed increasing patient autonomy and high positive complementarity throughout the therapy. The therapist’s countertransference feelings were almost positive. These findings coincide well with the patient’s sequential quick recovery from depression, increased insight, and FOLLOWED BY improved interpersonal functioning and less exploitability.