Preconditions and consequences of transference interpretations. A clinical-quantitative investigation

Our aim was to study the preconditions and consequences of transference interpretations by both quantitative and clinical methods. We selected the three specimen psychoanalytic treatments which had been studied most by clinical-quantitative research. For each patient the main data consisted of 16 interpretation contexts. The context of each interpretation included 250 patient words before and 250 patient words after the interpretation. Three judges independently rated these before and after segments for each of the 16 samples from each of the three patients. Judges tended to agree highly in rating these segments on nine variables. The before vs. after ratings showed that each patient had a different but individually typical response to the 16 interpretations, ranging from patient A who usually showed a negative response, to patient B who showed some positive response, to patient C who showed a very positive response. For each of these three patients there was a clear parallel between the positivity of the immediate response to interpretations and the outcome of treatment. Even though we have so far studied only three patients, the consistency of the results suggests that it would be worth testing in a larger group whether a sample of immediate responses to interpretations might predict the eventual outcome of the treatment. Patient factors seem central in explaining the bases for the different response of each of the three patients to transference interpretations. The Health-Sickness Rating Scale ratings showed that patient A and patient B were less healthy initially than patient C--healthier patients may be able to respond better to transference interpretations. Also, the analyses of the segments before the interpretation revealed that even before the interpretation there were differences in the three patients. These were consistent with their differing responses to interpretation; for example, patient A was rated as having less understanding than the other patients even before the interpretations. Another patient factor, the patient's readiness to experience a helping relationship, probably was significant also in explaining the differing response of the three patients to interpretations; they already differed in this experience by the third to fifth sessions, and these differences paralleled their response to interpretation.