The effects of long-term psychotherapy on patients' self-perception.

A review of the literature regarding the effects of long-term psychotherapy indicates that it has rarely been examined purely from the standpoint of the patient. This study attempts to determine how the patients perceive attitudinal change in themselves and their therapists during the treatment process. Twenty patients who received dynamically oriented psychotherapy in excess of one year in a typical outpatient clinic participated. These patients were randomly assigned a therapist who was either a Clinic staff member or senior resident in psychiatry. Slightly more than half the patients included in the study had a diagnosis of psychoneurosis, while the remainder were viewed as possessing characterological or psychotic disturbances. Evaluation of patient attitudes was achieved through the use of a modified version of Osgood's Semantic Differential Scale. It was determined that patients perceived themselves as becoming significantly more like their therapists after one year of psychotherapy. They saw themselves as more active, independent, dominant, outgoing, realistic and happy. This "psychic shift" is discussed in terms of identification, transference and counter-transference phenomena.