Verbal expressions used by anaclitic and introjective patients with depressive symptomatology: Analysis of change and stuck episodes within therapeutic sessions

A person's speech makes it possible to identify significant indicators which reflect certain characteristics of his/her personality organization, but also can vary depending on the relevance of specific moments of the session and the symptoms type. The present study analyzed 10 completed and successful therapeutic processes using a mixed methodology. The therapies were video–and audio-taped, as well as observed through a one-way mirror by trained observers. All the sessions of each therapy were considered (N = 230) in order to identify, delimit, transcribe, and analyze Change Episodes (CEs = 24) and Stuck Episodes (SEs = 26). Each episode was made up by patients’ speech segments (N = 1,282), which were considered as the sampling unit. The Therapeutic Activity Coding System (TACS-1.0) was used to manually code each patient's verbalizations, nested within episodes and individuals, in order to analyze them using Hierarchical Linear Modelling (HLM). The findings suggest that anaclitic patients tend to use more verbalizations in order to ask for feedback or to be understood by their therapists (attune), whereas introjective patients tend to use more verbalizations in order to construct new meanings (resignify) during therapeutic conversation, but especially during SEs. Clinical implications to enrich the therapeutic practice are discussed.