Year

2003

Degree Name

Doctor of Psycology(Clinical)

Department

Department of Psychology

Abstract

This work examined the process and outcome of psychoanalysis by quantifying changes in patient mastery of relationship conflict using the Mastery Scale (Grenyer, 1994) a content-coding measure of changes in interpersonal relationship conflict. Examination of 170 verbatim transcripts from the Penn Psychoanalytic Treatment Collection (Luborsky, Stuart, Friedman, Diguer, Seligman, Bucci, Pulver, Krause, Ermold, Davison, Woody, & Mergenthaler, 2001) showed the path of change for 17 participants (11 women and 6 men) over an average of 4 years (2.5-5.5yrs) of psychoanalysis. Participants in the study were suffering from chronic relationship problems associated with pervasive patterns of psychological ill health for which they sought psychiatric help at outpatient treatment services. Results showed a moderate increase in mastery of relationship conflict in psychoanalysis. There was a large variation in participant improvement which mediated results for this patient group. Findings suggest more successful participants showed higher gains in emotional selfcontrol which appeared influential in working through repetitive relationship conflict. Mastery of interpersonal conflict was also shown to lead to and be related to significant changes in global mental health in the end phase of treatment. Investigation of participant paths of change showed 35% approximated continuous improvement, 24% showed higher gains in the initial phase of treatment, with continuing gains at a slower rate and 41% showed curved paths of change. Least successful participants showed deterioration in mastery components of selfunderstanding and control, which appeared detrimental to relationship life, including the transference relationship. Improvement was more marked for participants with less severe features of personality disorder. New research showed no relationship between the amount of verbal material presented in therapy and treatment gains.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.