ArticleFrontiers in psychology2024
The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics.
Article in Frontiers in psychology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Pattern formation, ruptures, and repairs in treatments of personality disorders: an idiographic case series study.Frontiers in human neuroscience · 2025Article
- Psychotherapy Process Dynamics and Their Relation to Treatment Success Do Not Differ Across Diagnoses.Clinical psychology & psychotherapyArticle
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8 authors.
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Abstract
Introduction: The aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process. Method: The multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics. Result: Results reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs. Discussion: Clinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy.
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