اثربخشی خنثی‌سازی دفاع‌های تاکتیکی در روان‌درمانی پویشی فشرده و کوتاه مدت بر سبک‌های دفاعی، اضطراب و ترس از صمیمیت در نمونه غیربالینی

نویسندگان
دانشگاه بوعلی سینا همدان
چکیده
پژوهش حاضر با هدف تعیین اثربخشی خنثی‌سازی دفاع‌های تاکتیکی در روان درمانی پویشی فشرده و کوتاه مدت بر سبک‌های دفاعی، اضطراب و ترس از صمیمیت انجام شد. در واقع هدفی که این تحقیق را از مطالعات اندک در حیطه‌ی روان‌پویشی متمایز می‌‌کند، بررسی ساختار مثلث تعارض(احساس، اضطراب، دفاع) با تاکید بر دفاع‌های بین فردی است. این پژوهش از نوع شبه آزمایشی ( طرح پیش‌آزمون و پس‌آزمون با گروه گواه) است. جامعه آماری کلیه دانشجویان سال ۹7-96 دانشگاه بوعلی سینا همدان(خوابگاه ها- سایت مرکزی) بودند که ۲۶ نفر از آنها با نمونه‌گیری داوطلبانه در دسترس (انتخاب غیر‌تصادفی و جایگزینی تصادفی) در دو گروه آزمایش و گواه قرارگرفتند. داده‌ها به وسیله پرسشنامه‌های سبک‌های دفاعی، اضطراب حالت- صفت و ترس از صمیمیت جمع‌آوری شد. درمانجویان گروه آزمایش هرکدام مداخلات ( تکنیک پرسش‌گری، فشار و چالش را براساس پروتکل روان درمانی پویشی فشرده و کوتاه مدت ) را در ۱۰ جلسه‌ی ۴۵ دقیقه‌ای دریافت کردند و برای درمانجویان گروه گواه مداخله‌ای صورت نگرفت. یافته‌ها نشان داد که خنثی‌سازی دفاع‌های تاکتیکی باعث کاهش استفاده از سبک‌های دفاعی رشد‌نایافته، روان رنجور، اضطراب حالت و اضطراب صفت شده است، ولی برای افزایش استفاده از سبک دفاعی رشد‌یافته و کاهش ترس از صمیمیت اثری نداشته است. نتایج این پژوهش نشان می‌دهد که حذف دفاع‌های تاکتیکی یا بیرونی که ریشه در ترس از دوباره ناکام شدن صمیمیت و نزدیکی هیجانی دارد، می‌تواند تنش‌های بین‌فردی و درون‌فردی را کاهش دهد. به علاوه، این روش مداخله می‌تواند برخی از انواع سبک‌های دفاعی را تغییر دهد.
کلیدواژه‌ها

عنوان مقاله English

The Effectiveness of Tactical Defenses Neutralization in Intensive Short-Term Dynamic Psychotherapy on Defensive Styles, Anxiety, and Fear of Intimacy in Non-Clinical Sample

نویسندگان English

amir nabizadeh
mehran farhadi
khosro rashid
rasoul kordnoghabi
Bu-Ali Sina University
چکیده English

The purpose of this study was to examine the effectiveness of the neutralization of tactical defenses in Intensive Short-Term Dynamic Psychotherapy (ISTDP) on Defensive Styles, Anxiety, and Fear of Intimacy. In fact, the purpose of this research that distinguishes it from the few studies in the Psychotherapy field is to study the structure of the conflict triangle (feeling, anxiety and defense) with an emphasis on interpersonal defenses. The method of this research was quasi-experimental (pre-test and post-test with control group). Population of this study was all students from Bu-Ali Sina University in Hamedan (dormitories-central site) in the years 2017-2018. Twenty-six of them selected by voluntarily accessible sampling (non-randomized and random replacement sampling) in both experimental and control groups. Data of the research were collected by defense styles questionnaires, state- trait anxiety and fear of intimacy. Clients in the experimental group received each of the interventions (Questioning technique, Pressure, and challenge of the therapeutic protocol ISTDP) during 10 sessions in 45 minutes. Control group received no intervention. Results indicated that the neutralization of tactical defenses reduces the use of immature and neurotic defensive styles, and state and trait anxiety. However, treatment was not effective for increasing the use of mature defensive style and reducing fear of intimacy. The results of this study indicate that the removal of tactical or external defenses that rooted in fear of re-failure in the intimacy and emotional closeness can be effective in reducing interpersonal and interpersonal tensions. In addition, this kind of intervention could change some kind of defensive styles.

کلیدواژه‌ها English

Tactical Defenses
Defensive Styles
fear of intimacy
anxiety
intensive short-term dynamic psychotherapy
Abbass, A. (2016). The emergence of psychodynamic psychotherapy for treatment resistant patients: intensive short-term dynamic psychotherapy. Psychodynamic psychiatry, 44(2), 245-280.
Abbass, A. A., Joffres, M. R., & Ogrodniczuk, J. S. (2008). A naturalistic study of intensive short-term dynamic psychotherapy trial therapy. Brief Treatment and Crisis Intervention, 8(2), 164.‌
‌Abbass,A. Bringing Character Changes with Davanloo’s Intensive Short-term Dynamic Psychotherapy. Abbass A, Bechard D,(2007) AD HOC Bulletin of Short-term Dynamic Psychotherapy 11 (2): 26-40.
Aminaee M, Roshan Chesli R, Shairi M R, Moharreri F.(2015). Compare Trait-state Anxiety and Perfectionism Dimensions of Mothers of Children with Anxiety Disorders and Healthy Children. journal of clinical psychology& personality; 2 (12) :25-36. (in Persian).
Andrews,G., Singh, M., & Bond, M. (1993). The Defense Style Questionnaire. Journal of Nervous and mental Disease.‌
Atashpour H, Ebrahimi L, kazemi E. (2013). Intimacy and fear of intimacy. Ghatreh publications. (in Persian).
Augsburger, T. (2000). Davanloo's technique of mobilization of the unconscious. International Journal of Intensive Short‐Term Dynamic Psychotherapy, 14(2), 75-91.‌
Basharat MA, Sharifi M, & Irwani M.(2000). Investigation the Relationship between Attachment Styles and Defensive Mechanisms. Journal of Psychology, No. 3, page 277-289.
Besharat MA. (2008). Relation of alexithymia with ego defense styles, Journal of Fundamentals of Mental Health. 3 (39); Page(s) 181 To 190. (in Persian).
Blaya, C., Dornelles, M., Blaya, R., Kipper, L., Heldt, E., Isolan, L., ... & Manfro, G. G. (2006). Do defense mechanisms vary according to the psychiatric disorder?. Brazilian Journal of Psychiatry, 28(3), 179-183.
Bond, M., & Perry, J. C. (2005). Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders. Focus, 161(3), 1665-437
Cramer, P. (2012). Psychological maturity and change in adult defense mechanisms. Journal of Research in Personality, 46(3), 306-316.‌
Davanloo, H. (1996). Management of tactical defenses in intensive short‐term dynamic psychotherapy, Part I: Overview, tactical defenses of cover words and indirect speech. International Journal of Short‐Term Psychotherapy, 11(3), 129-152.‌
Davanloo, H. (1996). Management of tactical defenses in intensive short‐term dynamic psychotherapy, Part II: Spectrum of tactical defenses. International Journal of Short‐Term Psychotherapy, 11(3), 153-199.‌
Della Selva, P. C. (1996). Intensive short-term dynamic psychotherapy: Theory and technique. Routledge.‌
Descutner, C. J., & Thelen, M. H. (1991). Development and validation of a Fear-of-intimacy Scale. Psychological assessment : A Journal of consulting and clinical psychology, 3(2), 218.
Doi,S.C.,& Thelen,M.H.(1993).The fear-of-intimacy scale: Replication and extension. Psychological Assessment, 5, 377-377.
Eppel, A. (2018). Short-Term Psychodynamic Psychotherapy. Springer International Publishing.
Falahzadeh H, Farzad‎ V, Falahzadeh‎ M.(2011). A study of the Psychometric Characteristics of Fear of Intimacy Scale (FIS), Journal of Research in Psychological Health 5 (1) :70-79.(in Persian).
Farhadi M, ghorbani N, bahrami ehsan H.(2011). Discharge patterns of anxiety: Preparation, factor structure and validity of the developed scale in a sample of university students. Journal of psychoscience, Vol 10, No 39. (in persian).
Fathi ashtiani A.(2009). Psychological Tests Personality And Mental Health. Besaat publication.(in Persian).
Firestone, R. W., & Catlett, J. (1999). Fear of intimacy. American Psychological Association.
Frederickson, J. J., Messina, I., & Grecucci, A. (2018). Dysregulated anxiety and dysregulating defenses: Toward an emotion regulation informed dynamic psychotherapy. Frontiers in psychology, 9.‌
Frederickson, Jon.(2013). Co-Creating Change: effective dynamic therapy techniques. Translation of sigaroodi. Arjmand publication.(in Persian).
Ghorbani N. (2016). From line of triangle of conflict. binesh-no publications.(in Persian).
Ghorbani N.(2003). Intensive short-term dynamic psychotherapy: basics and techniques. Samt publications.(in Persian).
Gottwik, G., Orbes, I., Tressel, F., & Wagner, G. (1998). Application of Davanloo's Intensive Short‐Term Dynamic Psychotherapy in the treatment of patients with agoraphobia, fainting attacks, anxiety, panic, somatization and functional disorders. Part I: technical and metapsychological roots of the technique; initial phase of trial therapy. International Journal of Intensive Short‐Term Dynamic Psychotherapy, 12(2), 77-103.‌
Heidarinasab L, Khorianian M, Tayyebi Z.(2014). Effectiveness of Intensive Short-Term Dynamic Psychotherapy in Reducing Symptoms and changing Defense Styles in Patients with Depression, Clinical Psychology Studies, 7(26), 37-46.(in Persian).
Jamieson, L. (1999). Intimacy transformed? A critical look at the ‘pure relationship’. Sociology, 33(3), 477-494.‌
Jarareh J, Talehpasand S. (2011). The Effects of Management of Tactical Defenses in Intensive Short-term Dynamic Psychotherapy on Couples Satisfaction, Journal of Clinical Psychology, 3(2), 13-21.(in Persian).
Johansson, R., Town, J. M., & Abbass, A. (2014). Davanloo’s Intensive Short-Term Dynamic Psychotherapy in a tertiary psychotherapy service: overall effectiveness and association between unlocking the unconscious and outcome. PeerJ, 2, e548.‌
Laurenceau, J. P., Barrett, L. F., & Pietromonaco, P. R. (1998). Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges. Journal of personality and social psychology, 74(5), 1238.‌
Lilliengren, P., Johansson, R., Town, J. M., Kisely, S., & Abbass, A. (2017). Intensive Short‐Term Dynamic Psychotherapy for generalized anxiety disorder: A pilot effectiveness and process‐outcome study. Clinical psychology & psychotherapy, 24(6), 1313-1321.Eppel, A. (2018). Short-Term Psychodynamic Psychotherapy. Springer International Publishing.‌
Lyddon, W. J., & Sherry, A. (2001). Developmental personality styles: An attachment theory conceptualization of personality disorders. Journal of Counseling & Development, 79(4), 405-414.‌
PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Phillips, T. M., Wilmoth, J. D., Wall, S. K., Peterson, D. J., Buckley, R., & Phillips, L. E. (2013). Recollected parental care and fear of intimacy in emerging adults. The Family Journal, 21(3), 335-341.‌
Reis, S., & Grenyer, B. F. (2004). Fear of intimacy in women: Relationship between attachment styles and depressive symptoms. Psychopathology, 37(6), 299.‌
Roseneil, S., & Budgeon, S. (2004). Cultures of intimacy and care beyond ‘the family’: Personal life and social change in the early 21st century. Current sociology, 52(2), 135-159.‌
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Philadelphia: Wolters Kluwer.
Shekari H, Hosseinsabet F, Borjali A.(2018). The Effectiveness of Tactical Defenses Management based on Intensive Short-Term Dynamic Psychotherapy on the Interpersonal Conflict. Research in Clinical Psychology and Counseling. 7(2), 23-37.( in Persian).
Solbakken, O. A., & Abbass, A. (2015). Intensive short-term dynamic residential treatment program for patients with treatment-resistant disorders. Journal of Affective Disorders, 181, 67-77.‌
Solbakken, O. A., & Abbass, A. (2016). Symptom-and personality disorder changes in intensive short-term dynamic residential treatment for treatment-resistant anxiety and depressive disorders. Acta neuropsychiatrica, 28(5), 257-271.‌
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the state-trait anxiety inventory.
Spilberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Taheri‎ F, Shahgholian M, Kashefi Neyshaboori‎ J.(2014) The Relationship between Attachment Styles, Ambivalence over ‎Emotional Expressiveness and Alexithymia. Journal of Research in Psychological Health. rph.; 8 (1) :31-40.( in Persian).
Town, J. M., Abbass, A., & Hardy, G. (2011). Short-term psychodynamic psychotherapy for personality disorders: a critical review of randomized controlled trials. Journal of Personality Disorders, 25(6), 723-740.‌
Vaillant, G. E. (2000). Adaptive mental mechanisms: Their role in a positive psychology. American psychologist, 55(1), 89.
Wei, M., Vogel, D. L., Ku, T. Y., & Zakalik, R. A. (2005). Adult attachment, affect regulation, negative mood, and interpersonal problems: The mediating roles of emotional reactivity and emotional cutoff. Journal of counseling psychology, 52(1), 14.‌
Whittemore, J. W. (1998). The application of Davanloo's Intensive Short‐Term Dynamic Psychotherapy to a complex masochistic patient with panic, functional and somatization disorders: from the “frying pan” into freedom. Part I. International Journal of Intensive Short‐Term Dynamic Psychotherapy, 12(3), 151-181.
‌Zeidner, M., & Endler, N. S. (Eds.). (1996). Handbook of coping: Theory, research, applications (Vol. 195). John Wiley & Sons.‌