Dramatic storytelling and naming subjective experiences in psychodynamic treatments of depressed women-An exploratory study of assimilative functions of narrating.

Objective: The present study aims to demonstrate how assimilation processes indicated by formal aspects of in-session narratives change in the course of psychodynamic therapy and how this differs by therapy outcome. Method: Two sessions each from the initial, the middle, and the termination phase of six successful and six unsuccessful psychodynamic treatments were compared. All narratives were identified and coded for dramatic narrating and naming of emotions and mental verbs. Results: Good outcome cases peaked in the use of direct speech and naming negative emotions in the middle phase of treatment. Poorer treatment outcome was associated with a high amount of narrating and a tendency to more dramatic narrating in the termination phase and with a use of more narrative clauses throughout treatment. Conclusions: Emotional remembering and naming of emotional states in the middle phase could provide partial support for the role of assimilation processes in good outcome cases. Narrative characteristics of less successful treatments are discussed.

The development of narrative identity in the psychodynamic treatment of avoidant personality disorder: A case study.

Avoidant personality disorder (AvPD) is characterized by feelings of shyness, inadequacy, and restraint in intimate relationships and has been associated with a disturbance in narrative identity, which is the internalized and evolving story of past, present, and future experiences. Study findings have indicated that an improvement in overall mental health through psychotherapy may increase narrative identity. However, there is a lack of studies incorporating not only the examination of narrative identity development before and after psychotherapy but also within psychotherapy sessions. This case study examined the development of narrative identity in short-term psychodynamic psychotherapy treatment of a patient with AvPD, using therapy transcripts and life narrative interviews before, after, and 6 months following treatment termination. Narrative identity development was assessed in terms of agency, communion fulfillment, and coherence. Results showed that the patient's agency and coherence increased over the course of therapy, whereas communion fulfillment decreased. At the six-month follow-up, agency and communion fulfillment increased, whereas coherence remained stable. The results of this case study suggest that the patient's sense of narrative agency and ability to narrate coherently improved after undergoing short-term psychodynamic therapy. The decrease of communion fulfillment during psychotherapy and later increase after termination suggests that the patient became more aware of conflictual patterns in their relationships, therefore realizing that their wishes and desires were not being fulfilled in their current relationships. This case study displays the possible impact short-term psychodynamic therapy may have by helping patients with AvPD develop a narrative identity.