"The body doesn’t lie". Diagnosis, therapeutic alliance and neurovegetative activation in the therapists

Journal title QUADERNI DI PSICOTERAPIA COGNITIVA
Author/s Gaetano Mangiola, Chiara Labate, Luca Cento, Adele Chisari, Daniela Emo, Annalisa Giordano, Paola Pazzano, Matteo Aloi
Publishing Year 2016 Issue 2016/38
Language Italian Pages 11 P. 31-41 File size 118 KB
DOI 10.3280/QPC2016-038003
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Different authors agree in recognizing that one of the most influential indicators of a patient’s mental state is the therapist’s experience of her patient. The most influential indicator to measure in this sense is the physical component characterizing the mental state, which is also a powerful means of non-verbal communication. For this reason, the body can be used to read and modulate cognitive and affective components (Semerari, 1999). The aim of this explorative study is to investigate if there is a correlation between the diagnosis, the therapist’s physical activation during the session and the quality of the therapeutic alliance. Five expert therapists (members of the Clinical Center of Cognitive Therapy "Ecopoiesis" in Reggio Calabria) monitored their physical index (pulse, pressure, breathing and muscle tension) for four consecutive weeks, before and after each session of therapy with 67 patients having different diagnoses. The quality of the therapeutic alliance was measured with the Scale To Assess Therapeutic Relationships (STAR) in the patient and clinician version. The hypothesis is that, just as it happens for the emotional reaction (Betan et al., 2005; Colli et al., 2014), patients with similar diagnoses trigger a similar neurovegetative reaction in therapists with a relapse on alliance assessment. Contrary to all expectations, the data collected suggests that there is a relation between the quality of the alliance and the activation of the therapist, but it is not correlated with the diagnosis.

Keywords: Therapeutic alliance, neurovegetative activation, diagnosis

  1. Bateman A.W., Fonagy P. (2006). Mechanism of change in mentalization based treatment of borderline personality disorder. Journal of Clinical Psychology, 62(4): 411-430.
  2. Bein E., Anderson T., Strupp H.H., Henry W.P., Schaht T.E., Binder J.L., Butler S.F. (2000).
  3. The effects of training in time limited dynamic psychotherapy: changes in therapeutic outcome. Psychotherapy Research, 10: 119-131. DOI: 10.1080/71366366
  4. Berkowitz L. (1999). Anger. In: Dalgleish T., Power M.J., editors, Handbook of Cognition and Emotion, XXI, 843: 411-428.
  5. Betan E., Heim A.K., Conklin C.Z., Westen D. (2005). Countertransference phenomena and personality pathology in clinical practice: An empirical investigation. American Journal of Psychiatry, 162: 890-898. DOI: 10.1348/14760830232115190
  6. Bourke M.E., Grenyer B.F.S. (2010). Psychotherapists’ response to Borderline Personality Disorder: A Core Conflictual Relationship Theme analysis. Psychotherapy Research, 20(6): 680-691. DOI: 10.1080/10503307.2010.50424
  7. Bradley M.M., Codispoti M., Cuthbert B.N., Lang P.J. (2001). Emotion and motivation I: Defensive and appetitive reactions in picture processing. Emotion, 1(3): 276-298. DOI: 10.1037/1528-3542.1.3.27
  8. Clarkin J.F., Levy K.N. (2006). Psychotherapy for patients with borderline personality disorder: Focusing on the mechanisms of change. Journal of Clinical Psychology, 62: 405-410.
  9. Colli A., Tanzilli A., Dimaggio G., Lingiardi V. (2014). Patient personality and therapist response: An empirical investigation. American Journal of Psychiatry, 171: 102-108.
  10. Davidson R.J., Irwin W. (2002). The functional neuroanatomy of emotion and affective style. In: Cacioppo J.T., Bernston J.J. et al., Foundation in social neuroscience. Cambridge, MA: The MIT Press, pp. 473-489.
  11. Gunderson J.G. (2009). Borderline personality disorder: Ontogeny of a diagnosis. American Journal of Psychiatry, 166: 530-539.
  12. Henry J.P. (1993). Biological basis of the stress response. Physiology, 8, 2: 69-73.
  13. Kvilighan D.M., Patton M.J., Foote D. (1998). Moderating effects of client attachment on the counselor Experience-working alliance relationship. Journal of Counseling Psychology, 45: 274-78.
  14. Lang P.J., Bradley M.M., Cuthberg B.N. (1997). International Affective Picture System [Pictures]. Gainesville: NIMH Center for the Study of Emotion and Attention.
  15. Lingiardi V., Croce D., Fossati A.,Vanzulli L., Maffei C. (1999). La valutazione dell’alleanza terapeutica nella psicoterapia dei pazienti con disturbi di personalità. Ricerca in Psicoterapia, 1-2-3.
  16. Lingiardi V., De Bei F. (2005). Rotture nell’alleanza: Una lettura sistemico-diadica. Infanzia e Adolescenza, 4(2): 81-100.
  17. Liotti G. (1994). La dimensione interpersonale della coscienza. Roma: La Nuova Italia Scientifica.
  18. McGuire-Snieckus R., McCabe R., Catty J., Hansson L., Priebe S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychol. Med., 37(1): 85-95. Epub 2006 Nov 9. DOI: 10.1017/S003329170600929
  19. Monticelli F. (2014). Relazione terapeutica e alleanza terapeutica. In: Liotti G., Monticelli F., a cura di, Teoria e clinica dell’alleanza terapeutica. Milano: Raffaello Cortina.
  20. Murphy F.C., Nimmo-Smith I., Lawrence A.D. (2003). Functional neuroanatomy of emotions: a meta-analysis. Cogn. Affect. Behav. Neurosci., 3: 207-233. DOI: 10.3758/CABN.3.3.20
  21. Ogden T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, LXXV, 3: 3-19.
  22. Palomba D., Angrilli A., Mini A. (1997). Visual evoked potentials, heart rate responses and memory to emotional pictorial stimuli. Int. J. Psychophysiol., 27: 55-67. DOI: 10.1016/S0167-8760(97)00751-
  23. Rohrmann S., Hopp H. (2008). Cardiovascular indicators of disgust. International Journal of Psychophysiology, 68(3): 201-208.
  24. Safran J.D., Segal Z.V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books, Softcover edition, 1996, Jason Aronson, Inc.
  25. Sarlo M., Buodo G., Munafò M., Stegagno L., Palomba D. (2008). Cardiovascular dynamics in blood phobia: evidence for a key role of sympathetic activity in vulnerability to syncope. Psychophysiology, 45: 1038-1045.
  26. Semerari A. (1991). I processi cognitivi della relazione teraputica. Roma: La Nuova Italia Scientifica.
  27. Semerari A. (1999). La relazione terapeutica e la tecnica del colloquio. In: Semerari A., a cura di, Psicoterapia cognitiva del paziente grave. Milano: Raffaello Cortina.
  28. Siegel D.J. (2006). Prefazione (a cura di). In: (trad. it.) Ogden P., Minton K., Pain C., Il trauma e il corpo. Sassari: Istituto di Scienze Cognitive Editore.
  29. Steptoe A., Wardle J. (1988). Emotional fainting and the psychophysiologic response to blood and injury: autonomic mechanisms and coping strategies. Psychosom. Med., 50: 402-417.
  30. Sullivan H.S. (1954). Il colloquio psichiatrico. Milano: Feltrinelli.
  31. Thayer J.F., Lane R.D. (2009). Claude Bernard and the heart-brain connection: further elaboration of a model of neurovisceral integration. Neurosci. Biobehav. Rev., 33: 81-88.

Gaetano Mangiola, Chiara Labate, Luca Cento, Adele Chisari, Daniela Emo, Annalisa Giordano, Paola Pazzano, Matteo Aloi, "Il corpo non mente". Diagnosi, alleanza terapeutica e attivazione neurovegetativa nei terapeuti in "QUADERNI DI PSICOTERAPIA COGNITIVA" 38/2016, pp 31-41, DOI: 10.3280/QPC2016-038003