What Defense Mechanisms Do Therapists Interpret In-Session?

One of the key technical guidelines outlined by psychodynamic theorists and clinicians is for therapists to interpret a patient's most prominent defenses (Greenson, 1967; Langs, 1973). However, a debate exists about what constitutes a patient's most prominent defense and which defenses therapists actually choose to interpret in-session. This study aimed to shed light on this debate by examining 35 psychotherapy sessions (18 high alliance and 17 low alliance dyads) of individuals in therapy at a university counselling center. The analysis focused on comparing the patients' most prominent defenses and the range of defenses they utilized, and the therapists' most prominent interpretation level as well as the range of interpretation level. Paired sample t-tests showed no significant mean difference between sessions with low and high alliance scores in patient defense levels (e.g., frequency and range) and therapist interpretation levels (e.g., frequency and range). Significant differences were found between the range of patient defense levels and the range of therapist interpretation levels. Correlational analyses showed no significant relationship between patient defense levels and therapist interpretation levels on both the frequency and range levels. Clinical implications of these results, and directions for future research are discussed.