Patient defense/therapist interventions.

Abstract

LISA WALLNER SAMSTAGBeth Israel Medical CenterCity University of New YorkPatient defensive behavior and therapistaddressing defense (TAD) was studiedover the course of two brief dynamicpsychotherapies in twenty-eight patientswith personality disorders, primarily ofthe Axis II Cluster C variety. Three levelsof patient defense were coded: immature,intermediate, and mature. Resultsindicate a significant decrease in thefrequency of intermediate defensivebehavior across psychotherapy which isnot related to patient outcome. However,there is a positive relationship betweenthe frequency of immature defenses in thefirst quartile of treatment and outcome attermination. Further, there is a significantcorrelation between patient defensivebehavior and the therapist addressingthis behavior, as well as a decrease inimmature and intermediate defenseswhich correlates with the frequency ofthe therapist addressing these behaviorsearlier in treatment. Finally, thefrequency of TAD is significantlycorrelated with patient outcome.