Implicit relational aspects of the therapeutic relationship in psychoanalytic treatments: an examination of linguistic style entrainment over time

OBJECTIVE

In an attempt to operationalize an implicit aspect of the therapeutic relationship, this study assesses reciprocal linguistic style entrainment (rLSM) between the patient and therapist. rLSM is defined as the dynamic adjustment of function word usage to synchronize or to be in rhythm with another person as they change over time.

METHOD

In this exploratory study, levels of rLSM per talk turn were analyzed for 540 sessions of 27 long-term psychoanalytic treatments in relation to treatment outcomes.

RESULTS

Within sessions, rLSM appeared to decrease by the end of sessions and followed a negative linear trajectory, βlinear = -0.0002, SE < .001, t = -13.04, p < .001. Between sessions, rLSM showed significant variability such that neither a linear, nor a quadratic, nor a cubic trend line fit the session-by-session change over treatment. On average, therapist talk turns had significantly lower rLSM than patient talk turns, while accounting for the nested nature of the data using multilevel models βSpeakerT = -0.033, SE = 0.009, t = -3.65, p < .001. Levels of rLSM did not relate to treatment outcome.

CONCLUSION

Most of the rLSM variance was at the within-patient and within-session level. rLSM was no indicator of psychoanalytic treatment outcomes.

Patient and mentor language style matching as a predictor of working alliance, engagement with treatment as usual, and eating disorders symptoms over the course of an online guided self-help intervention for anorexia nervosa

OBJECTIVE

The aim of this study was to examine the processes involved in a guided self-help (GSH) pre-treatment intervention (RecoveryMANTRA) for patients with anorexia nervosa (AN), by measuring the levels of patient/mentor Language Style Matching (LSM). RecoveryMANTRA was supported by student mentors or peer mentors (recovered individuals) over six weekly chat-based sessions. We examined whether LSM during RecoveryMANTRA predicted patients'working alliance with the clinic therapist, motivation, eating disorder (ED) and general psychopathology. A further aim was to examine differences in LSM between student mentors and peer mentors.

METHOD

87 AN adults received RecoveryMANTRA plus treatment as usual. The LSM algorithm was used to calculate verbal attunement between patient and mentor. Participants were assessed at baseline and at the end of the intervention.

RESULTS

Both early (1^st session) and late (6^th session) LSM predicted higher working alliance with the clinic therapist. Moreover, late LSM predicted lower EDs symptoms at the end of the RecoveryMANTRA intervention. Patient/peer mentor dyads showed higher late verbal attunement than patient/student mentor dyads.

CONCLUSIONS

These findings suggests that in the early phase of treatment relational aspects can impact on engagement with treatment. Verbal attunement in a GSH for AN is associated with working alliance and better clinical outcome.

Recognition of Emotion from Verbal and Nonverbal Expressions and Its Relation to Effective Communication: A Preliminary Evidence of a Positive Link

Previous work has shown that emotion recognition is positively related to effective social interactions, but the mechanism underlying this relationship has remained largely unclear. Here, we examined the possibility that people who understand others' emotions also talk to them using similar language. In the current study participants (N = 106) listened to emotional stories people shared from their own lives. They were later asked to recognize the storytellers' feelings and finally provide written support messages. Perceivers' ability to accurately recognize others' feelings was assessed using the Emotional Accuracy Test (EAT), which uses naturalistic verbal and nonverbal emotional cues, and using two standard tests of nonverbal emotion recognition (GERT, RMET). The language of the expressor (target) was compared to the language of the supporter (participant) to quantify Language Style Matching, a proxy for effective communication. People who perform better in emotion recognition with verbal cues (EAT) also communicate their understanding and support using language similar to the expresser (r = .22, p = .02). This relation was insignificant for tests without verbal information (RMET, GERT). The result provides additional construct validation for the EAT and supports the view that understanding the emotions of others and communicating with them are two manifestations of a broader interpersonal skill.

Examining Social Capital, Social Support, and Language Use in an Online Depression Forum: Social Network and Content Analysis

BACKGROUND

The use of peer-to-peer online support groups and communities has grown into a social phenomenon. Many people use online support groups and communities to seek and provide social support. It is essential to examine how users' participation behaviors may contribute to different outcomes.

OBJECTIVE

This study aimed to (1) use the structural positions of online depression forum users in their reply network to predict received support and (2) examine their language use reflecting their health conditions.

METHODS

A total of 2061 users and their 62,274 replies posted on a depression forum from July 2004 to July 2014 were extracted using a web crawler written in Python. The content of the forum users' posts and replies and their reply patterns were examined. A social network analysis method was used to build the reply networks of users. The computerized text analysis method was used to measure features of the forum users' language styles.

RESULTS

Forum users' bridging social capital (operationalized as network betweenness) was positively associated with the level of communication accommodation in their received replies (P=.04). Forum users' bonding social capital (operationalized as network constraint) was negatively associated with the level of communication accommodation in their received replies (P<.001). The forum users' change in their use of self-referent words and words expressing negative emotions were examined as linguistic proxies for their health conditions and mental states. The results revealed a general negative association between the number of received replies and the degree of decrease in the use of words expressing negative emotion (P=.007).

CONCLUSIONS

The structural positions of online depression forum users in the reply network are associated with different participation outcomes in the users. Thus, receiving replies can be beneficial to online depression forum users.

Therapist-Client Language Matching: Initial Promise as a Measure of Therapist-Client Relationship Quality

While research suggests that the therapeutic alliance is important in predicting outcomes of psychotherapy, relatively little is known about the development of the alliance or the moment-to-moment components of the relationship and how they combine to create an alliance, which may represent a serious limitation in existing methods of measurement. Language style matching (LSM), or the degree to which unconscious aspects of an interactional partner's language mimic that of the other partner, is a promising, unobtrusive measure of interaction quality that could provide novel insight into the therapist-client alliance. In this article, we present a theoretical argument regarding the trajectory of therapist-client LSM across therapy sessions, as well as potential precursors and consequences of LSM. We then report on a pilot test of our hypotheses that examined how LSM, clients' relational histories, and clients' symptoms were associated within a therapeutic context. Using a small sample of substance dependent mothers (N = 7, 100% Caucasian women) enrolled in a randomized controlled trial of psychodynamic psychotherapy lasting 12 sessions, we examined client and therapist LSM across 4 of the 12 sessions. We found that, on average, LSM decreases over the course of treatment. Furthermore, greater client interpersonal problems prospectively predict lower early LSM in therapist-client dyads, which in turn predicts greater posttreatment psychiatric distress. Results generate questions for future research and support further investigations of LSM as one index of the quality of interactions between therapist and client.

Mimicry Is Presidential: Linguistic Style Matching in Presidential Debates and Improved Polling Numbers

The current research used the contexts of U.S. presidential debates and negotiations to examine whether matching the linguistic style of an opponent in a two-party exchange affects the reactions of third-party observers. Building off communication accommodation theory (CAT), interaction alignment theory (IAT), and processing fluency, we propose that language style matching (LSM) will improve subsequent third-party evaluations because matching an opponent's linguistic style reflects greater perspective taking and will make one's arguments easier to process. In contrast, research on status inferences predicts that LSM will negatively impact third-party evaluations because LSM implies followership. We conduct two studies to test these competing hypotheses. Study 1 analyzed transcripts of U.S. presidential debates between 1976 and 2012 and found that candidates who matched their opponent's linguistic style increased their standing in the polls. Study 2 demonstrated a causal relationship between LSM and third-party observer evaluations using negotiation transcripts.