Department of Psychiatry, University of Oslo, Vinderen, N-0319 Oslo, Norway.
J Consult Clin Psychol. 2010 Jun;78(3):438-48. doi: 10.1037/a0019245.
According to psychoanalytic theory, interpretation of transference leads to increased insight that again leads to improved interpersonal functioning over time. In this study, we performed a full mediational analysis to test whether insight gained during treatment mediates the long-term effects of transference interpretation in dynamic psychotherapy.
This study is a randomized clinical trial with a dismantling design. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment with the same therapists but without the use of transference interpretation. Interpersonal functioning and insight were measured pretreatment, posttreatment, and 1 year and 3 years after treatment termination.
Contrary to common expectation, patients with a life-long pattern of low quality of object relations and personality disorder pathology profited more from therapy with transference interpretation than from therapy with no transference interpretation. This long-term effect was mediated by an increase in the level of insight during treatment.
Insight seems to be a key mechanism of change in dynamic psychotherapy. Our results bridge the gap between clinical theory and empirical research.
根据精神分析理论，对移情的解释会增加洞察力，从而随着时间的推移改善人际关系功能。在这项研究中，我们进行了全面的中介分析，以检验在动力心理治疗中，治疗过程中获得的洞察力是否可以解释移情解释的长期效果。
这是一项随机临床试验，采用拆分设计。100 名因抑郁、焦虑、人格障碍和人际关系问题而寻求心理治疗的门诊患者被随机分配到为期 1 年的每周一次的动力心理治疗，包括移情解释，或相同类型和持续时间的治疗，但不使用移情解释。人际关系功能和洞察力在治疗前、治疗后以及治疗结束后 1 年和 3 年进行测量。
与普遍预期相反，具有终生低客体关系质量和人格障碍病理模式的患者从带有移情解释的治疗中获益多于没有移情解释的治疗。这种长期效果是通过治疗过程中洞察力的提高来介导的。
洞察力似乎是动力心理治疗中改变的关键机制。我们的结果弥合了临床理论和实证研究之间的差距。
