Validating Self-Other Differentiation in a Psychodynamic Psychotherapy Context: Virtues, Emotion Regulation, and Well-Being.

Abstract

Objective: We advanced the virtues of intellectual humility, gratitude, forgiveness, and emotion regulation as relevant to monitoring treatment progress. We did so by exploring the construct validity evidence for differentiation as an indicator of emotion regulation in a psychotherapy context.

Method: The sample consisted of clients (N = 117; M_age = 37.96; 60.7% female; 69.2% White; 70.1% heterosexual; 70.9% religious identifying) receiving outpatient psychotherapy at a psychodynamic training clinic. First, we conducted exploratory factor analysis to examine the validity evidence for differentiation, as measured by widely used items. Second, we used the factor analytic results to measure differentiation as an indicator of emotion regulation. We modeled the virtues and differentiation as linear and curvilinear combinations predicting depression symptoms and well-being, using a series of polynomial regressions and response surface analyses.

Results: The intra- and interpersonal aspects of differentiation, reactivity and emotional cutoff, respectively, showed evidence supporting their use as indicators of emotion regulation. Results also showed that the virtues and differentiation were curvilinear predictors of depression symptoms and well-being, with each of the virtues and reactivity combining to predict initial well-being, and intellectual humility and emotional cutoff combining to predict later treatment symptom levels.

Conclusion: Our design limits inference about the directionality of associations, and we used a recently developed self-report measure of virtues. Nevertheless, our findings point to the use of intellectual humility, gratitude, forgiveness, and differentiation to monitor treatment effectiveness, and potentially guide psychotherapy processes to lower negative emotion (intra-personal differentiation) and increase positive emotion (gratitude, forgiveness) early in treatment, and enhance prosocial interpersonal responding (intellectual humility, interpersonal differentiation) later in treatment. We highlight that virtues can be indirectly addressed within alliance processes, and addressed via direct interventions.