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Article |

Signs of Defensive Control Locate Conflicted Topics in Discourse

Mardi J. Horowitz, MD; Constance Milbrath, PhD; Charles H. Stinson, MD
Arch Gen Psychiatry. 1995;52(12):1040-1047. doi:10.1001/archpsyc.1995.03950240058011.
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Background:  Psychodynamic clinicians cite defensive actions observed in evaluation and treatment as a source of important information. Empirical support for such assertions has seldom been based on objective study of recorded psychotherapy. A quantitative study of the association of signs of defensive control with disclosure of conflicted beliefs was undertaken.

Methods:  Brief dynamic psychotherapies of two patients with pathological grief reactions were recorded and reviewed by independent judges. Periods of heightened defensive control of verbal and nonverbal communication were quantified using operational definitions. Reliably scored defensive episodes were algorithmically selected by computer programs. The people and topics discussed by patients were independently scored.

Results:  Highly defensive periods contained disproportionately more frequent instances of patient discourse about people involved in conflict and unresolved topics.

Conclusions:  The findings support the psychodynamic hypothesis that observation of defensive behaviors may locate times of communication about conflicted themes.


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