The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics
IntroductionThe aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process.MethodThe multimethod i...
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Frontiers Media S.A.
2024-09-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1408183/full |
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| author | Stine S. Høgenhaug Stine S. Høgenhaug Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Franco Orsucci Franco Orsucci Giovanna Zimatore Giovanna Zimatore Guenter Schiepek Mickey T. Kongerslev Mickey T. Kongerslev Anthony Bateman Gry Kjaersdam Telléus Gry Kjaersdam Telléus |
| author_facet | Stine S. Høgenhaug Stine S. Høgenhaug Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Franco Orsucci Franco Orsucci Giovanna Zimatore Giovanna Zimatore Guenter Schiepek Mickey T. Kongerslev Mickey T. Kongerslev Anthony Bateman Gry Kjaersdam Telléus Gry Kjaersdam Telléus |
| author_sort | Stine S. Høgenhaug |
| collection | DOAJ |
| description | IntroductionThe aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process.MethodThe multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics.ResultResults reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs.DiscussionClinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy. |
| format | Article |
| id | doaj-art-38582f7bafe3468882e775ba2cf4f60f |
| institution | OA Journals |
| issn | 1664-1078 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj-art-38582f7bafe3468882e775ba2cf4f60f2025-08-20T01:55:12ZengFrontiers Media S.A.Frontiers in Psychology1664-10782024-09-011510.3389/fpsyg.2024.14081831408183The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamicsStine S. Høgenhaug0Stine S. Høgenhaug1Sune V. Steffensen2Sune V. Steffensen3Sune V. Steffensen4Sune V. Steffensen5Franco Orsucci6Franco Orsucci7Giovanna Zimatore8Giovanna Zimatore9Guenter Schiepek10Mickey T. Kongerslev11Mickey T. Kongerslev12Anthony Bateman13Gry Kjaersdam Telléus14Gry Kjaersdam Telléus15Clinic North, Psychiatric Hospital, Brønderslev, DenmarkDepartment of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, DenmarkDanish Institute for Advanced Study, Odense, DenmarkCenter for Ecolinguistics, South China Agricultural University, Guangzhou, ChinaCollege of International Studies, Southwest University, Chongqing, ChinaDepartment for Culture and Language, University of Southern Denmark, Odense, DenmarkNorfolk and Suffolk NHS Foundation Trust, Research & Development Hub, Norwich, United KingdomCEMHS – Centre for Excellence in Mental Health Sciences, University of Amsterdam, Amsterdam, NetherlandsDepartment of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy0CNR Institute for Microelectronics and Microsystems (IMM), Bologna, Italy1Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University Salzburg, Salzburg, Austria2Department of Psychology, University of Southern Denmark, Odense, Denmark3Mental Health Services West, Region Zealand, Slagelse, Denmark4Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom5Psychiatry, Aalborg University Hospital, Aalborg, Denmark6Psychology, Department of Communication and Psychology, Aalborg University, Aalborg, DenmarkIntroductionThe aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process.MethodThe multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics.ResultResults reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs.DiscussionClinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy.https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1408183/fullinterpersonal physiologyprocess researchrecurrence quantification analysisdeterminismcomplex dynamicsalliance |
| spellingShingle | Stine S. Høgenhaug Stine S. Høgenhaug Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Sune V. Steffensen Franco Orsucci Franco Orsucci Giovanna Zimatore Giovanna Zimatore Guenter Schiepek Mickey T. Kongerslev Mickey T. Kongerslev Anthony Bateman Gry Kjaersdam Telléus Gry Kjaersdam Telléus The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics Frontiers in Psychology interpersonal physiology process research recurrence quantification analysis determinism complex dynamics alliance |
| title | The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics |
| title_full | The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics |
| title_fullStr | The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics |
| title_full_unstemmed | The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics |
| title_short | The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics |
| title_sort | complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder a proof of concept multimethod single case study of verbal and non verbal interactional dynamics |
| topic | interpersonal physiology process research recurrence quantification analysis determinism complex dynamics alliance |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1408183/full |
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