Patients’ verbal emotional expressions and their connection with the psychotherapeutic change: a multi-level analysis of the psychotherapeutic activity

Emotional expressions contribute to the activation and regulation of personal emotional experiences, and communicate something about internal states and intentions. These emotional expressions can be observed in the words we use in our speech. The growing interest in knowing what happens during the psychotherapeutic process has made researchers focus on the study of verbal patient-therapist interaction, considering a notion of performative language, in which language is not only understood as a simple reflection of reality, but as constitutive of it. The present Doctoral Thesis aims at studying the link between verbal emotional expressions and psychotherapeutic change, through the use of five levels of analysis of the psychotherapy: therapy, session, episode, speaking turn and word. The specific objectives that oriented this research were: (a) to determine the differential characteristics of the verbal emotional expression of patients and therapists during Change Episodes; (b) to determine the behavior of these verbal emotional expressions in Change and Stuck Episodes; (c) to determine the behavior of these verbal emotional expressions in each phase of the therapy and throughout the psychotherapeutic process; and (d) to determine which cognitive mechanisms are present in verbal emotional expressions during Change Episodes and throughout the psychotherapeutic process. A mixed methodology was used to analyze 38 Change Episodes (1016 speaking turns) and 19 Stuck Episodes (581 speaking turns) which were identified within two psychodynamic psychotherapeutic processes. Verbal expressions were analyzed using the Therapeutic Activity Coding System (TACS-1.0) which was built to respond to the need to conceptualize and study the verbal activity of patients and therapists. The present Doctoral Thesis is a dossier made up by seven articles that detail the results of each of the aforementioned studies, in order to: (a) identify the main characteristics of the therapeutic conversation during Change Episodes; (b) establish the existence of communicative patterns to work on emotional contents during Change Episodes; (c) determine temporal sequences of interaction between these patterns; (d) analyze the main communicative patterns in order to determine their behavior within Change Episodes, and throughout the different phases of the psychotherapeutic process; and (e) analyze the words verbalized during the use of the main communicative patterns in order to determine the cognitive mechanisms involved in the work of emotional contents during Change Episodes