Operational definition and measurement of dynamics shown in the stream of free associations

The study of sequences in the stream of consciousness during patient free association and self observation has long been held by psychoanalysts to be a major part of successful psychotherapy. Yet there have been essentially no methods for rigorously quantifying and studying the dynamic relations implied by the sequencing of patient verbalizations. The present paper proposes that Structural Analysis of Social Behavior (Benjamin 1974) offers a means operationally to define and study dynamics as they are shown in the stream of consciousness from a productive patient hour. The method is demonstrated on a woman who became suicidal following maternal phone calls even though the conversations were seemingly "nice." SASB codes were made by nonclinicians, and the dynamics emerged from the computer analyses of the codes. The SASB-based ability objectively to define dynamics in the stream of consciousness offers opportunities reliably to identify different dynamics in different cases and relate them to different possible therapeutic interventions and outcomes.