TY - JOUR

T1 - The in-session discourse of unresolved/disorganized psychotherapy patients

T2 - An exploratory study of an attachment classification

AU - Talia, Alessandro

AU - Taubner, Svenja

AU - Miller-Bottome, Madeleine

AU - Muurholm, Signe Dall

AU - Winther, Anne-Marie Lund

AU - Frandsen, Frederik Weischer

AU - Harpøth, Tine S.D.

AU - Onofri, Antonio

AU - Kongerslev, Mickey

AU - Simonsen, Sebastian

AU - Poulsen, Stig Bernt

AU - Duschinsky, Robbie

PY - 2022

Y1 - 2022

N2 - The Unresolved/disorganized (U/d) attachment classification has generatedconsiderable interest among clinicians. This is in part based on its empiricalassociations with adult mental health, parenting practices, and treatmentoutcomes. Despite decades of theorizing, however, we have little empiricalinformation regarding how patients with a U/d classification assigned byaccredited coders actually behave or speak in psychotherapy sessions. Here,we take a step towards bridging this gap by reporting our observations of thepsychotherapy session transcripts of 40 outpatients who were independentlyclassified as U/d on the Adult Attachment Interview (AAI), the gold standardmeasure of adult attachment research. These patients were extracted froma larger sample of 181 and compared to others without a U/d classification.In this paper, we discuss two different discourse styles associated with aU/d classification. Some U/d patients did not seem to sufficiently elicit thetherapist’s endorsement of what they said. For example, they did not justify theirclaims with examples or explanations, or did not consider others’ intentions orexperiences. Other U/d patients were credible, but left the listener uncertainas to the underlying point of their discourse, for example, by glaringly omittingthe consequences of their experiences, or interrupting their narratives mid-way. In the discussion, we place these observations in the context of recentthinking on attachment and epistemic trust, and discuss how this study mayform the basis for future quantitative studies of psychotherapy.

AB - The Unresolved/disorganized (U/d) attachment classification has generatedconsiderable interest among clinicians. This is in part based on its empiricalassociations with adult mental health, parenting practices, and treatmentoutcomes. Despite decades of theorizing, however, we have little empiricalinformation regarding how patients with a U/d classification assigned byaccredited coders actually behave or speak in psychotherapy sessions. Here,we take a step towards bridging this gap by reporting our observations of thepsychotherapy session transcripts of 40 outpatients who were independentlyclassified as U/d on the Adult Attachment Interview (AAI), the gold standardmeasure of adult attachment research. These patients were extracted froma larger sample of 181 and compared to others without a U/d classification.In this paper, we discuss two different discourse styles associated with aU/d classification. Some U/d patients did not seem to sufficiently elicit thetherapist’s endorsement of what they said. For example, they did not justify theirclaims with examples or explanations, or did not consider others’ intentions orexperiences. Other U/d patients were credible, but left the listener uncertainas to the underlying point of their discourse, for example, by glaringly omittingthe consequences of their experiences, or interrupting their narratives mid-way. In the discussion, we place these observations in the context of recentthinking on attachment and epistemic trust, and discuss how this study mayform the basis for future quantitative studies of psychotherapy.

U2 - 10.3389/fpsyg.2022.985685

DO - 10.3389/fpsyg.2022.985685

M3 - Journal article

C2 - 36275246

VL - 13

JO - Frontiers in Psychology

JF - Frontiers in Psychology

SN - 1664-1078

M1 - 985685

ER -