Steinmair D, Wong G, Frantal S, Rohm C, Löffler-Stastka H. Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison. World J Psychiatr 2021; 11(12): 1328-1345 [PMID: 35070781 DOI: 10.5498/wjp.v11.i12.1328]
Corresponding Author of This Article
Dagmar Steinmair, MD, Research Fellow, Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, Wien 1090, Austria. dagmar.steinmair@meduniwien.ac.at
Research Domain of This Article
Psychology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Dec 19, 2021; 11(12): 1328-1345 Published online Dec 19, 2021. doi: 10.5498/wjp.v11.i12.1328
Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison
Dagmar Steinmair, Guoruey Wong, Sophie Frantal, Christine Rohm, Henriette Löffler-Stastka
Dagmar Steinmair, Sophie Frantal, Christine Rohm, Henriette Löffler-Stastka, Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Wien 1090, Austria
Dagmar Steinmair, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, Krems 3500, Austria,
Dagmar Steinmair, Department of Ophtalmology, University Hospital St. Pölten, St. Pölten 3100, Austria
Guoruey Wong, Faculté de Médecine, Université de Montréal, Montréal H3C 3J7, Québec, Canada
Author contributions: Steinmair D engaged in writing and review of the original draft, editing and contributed to visualization and investigation; Wong G reviewed the final version of the manuscript (English language); Löffler-Stastka H engaged in the conceptualization and methodology, validation, provided resources, data curation, writing-original draft preparation, supervision, project administration; Frantal S was responsible for the software and performed the formal analysis; Rohm C contributed to the validation, KH, NF, MS, AHL, SM and GS investigation; all authors have read and agreed to the published version of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Medical University Vienna.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dagmar Steinmair, MD, Research Fellow, Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, Wien 1090, Austria. dagmar.steinmair@meduniwien.ac.at
Received: February 23, 2021 Peer-review started: February 23, 2021 First decision: July 15, 2021 Revised: July 19, 2021 Accepted: November 20, 2021 Article in press: November 20, 2021 Published online: December 19, 2021 Processing time: 294 Days and 17.8 Hours
ARTICLE HIGHLIGHTS
Research background
Emotional reactivity in patients with borderline personality disorder (BPD) due to dysfunctional processes is still a concept being developed. Specifically designed psychotherapies for BPD have significant, modest benefits over TAU. The effects of psychotherapy on BPD are still insufficiently understood. Substantial heterogeneity of processes and populations studied contributes to varying research results when investigating the effects of different treatment methods, and whether they differ from each other.
Research motivation
The question was whether similarities and differences between psychoanalysis (PSA) and psychodynamic psychotherapy (PDT) in BPD would be detectable, especially in terms of emotional reactivity in the patient-therapist interaction.
Research objectives
We aimed to study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.
Research methods
Within a retrospective study framework, we compared matched PSA (n = 10) and PDT (n = 10) BPD patients’ treatment sessions. Five consecutive sessions were recorded and analyzed, with evaluation of effects compared to baseline over three years. Patient characteristics (including affect regulation and personality traits), quality of object relations, as well as related therapeutic actions, were analyzed (micro-process analysis).
Research results
Differences between PSA and PDT were significant when analyzing the “mean change” in the Shedler-Westen Assessment Procedure Borderline variable after one year of therapy (P = 0.024). Variance of observed change was higher in PSA than in PDT (SDPSA ± 9.29 vs SDPDT ± 7.94). Transference interpretations are followed closely by affective changes in the patient, and were useful modes of interaction.
Research conclusions
PSA and PDT were both effective in BPD. Interactional aspects differed between the two treatments.
Research perspectives
As BPD patients are a very heterogeneous population, further research should focus on investigating optimal matching of BPD patients to specific modes of affect regulation, as well as which specific level of personality functioning would benefit from a given therapy modality.
