Lecturer, Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia, and Clinical Fellow, Department of Psychiatry, McGill University, Montreal, Canada.
Director of the Center for Teaching and Research of Short-Term Dynamic Psychotherapy, McGill University Health Centre, Montreal, Canada.
Psychodyn Psychiatry. 2020 Spring;48(1):55-69. doi: 10.1521/pdps.2020.48.1.55.
No previous research has investigated the emergence of stereotypic movements in patients during psychotherapeutic sessions, nor have such movements been mentioned in the numerous articles on Habib Davanloo's technique of intensive short-term dynamic psychotherapy. In this article, we present two clinical vignettes from early intensive short-term dynamic psychotherapy sessions, using Davanloo's technique, with a patient who was observed to have an emerging stereotypic movement. These vignettes, extracted from the videotaped sessions using audiovisual technology, concern a young woman who is known to have treatment-resistant obsessive-compulsive disorder. By presenting this case report, we aim to highlight the possibility of the occurrence of such a movement in response to specific interventions, and propose its clinical significance. We interpret this movement as being a tension-releasing mechanism that manifests in response to the therapist's exploration of the patient's emotions. We propose that the purpose of this stereotypic movement is to defend against the patient's actual experience of her repressed feelings. Clinical outcome of this case suggests that psychodynamic psychotherapy could be an effective intervention for patients with treatment-resistant obsessive-compulsive disorder.
目前尚无研究调查患者在心理治疗过程中出现刻板运动的情况,Habib Davanloo 的强化短期动力心理治疗技术的众多文章中也未提及此类运动。本文呈现了两位使用 Davanloo 技术的早期强化短期动力心理治疗过程中的临床案例,一位患者出现了正在浮现的刻板运动。这些取自使用视听技术录制的治疗过程的案例,涉及一位患有难治性强迫症的年轻女性。通过呈现这个病例报告,我们旨在强调在特定干预下可能会出现这种运动,并提出其临床意义。我们将这种运动解释为一种释放紧张的机制,是对治疗师对患者情绪的探索的反应。我们认为,这种刻板运动的目的是抵御患者对压抑情绪的实际体验。该病例的临床结果表明,动力心理治疗可能是治疗难治性强迫症患者的有效干预措施。