The components of psychoanalysis: Factor analyses of process measures of 27 fully recorded psychoanalyses

In an empirical study of psychoanalytic processes, the authors identify therapist, patient, and interaction factors from 2 instruments totaling 31 items based on clinicians' evaluation of 540 sessions from 27 completely recorded psychoanalyses. The 2 instruments, developed over 30 years studying recorded psychoanalyses, are the Analytic Process Scales (APS; Waldron, Scharf, Hurst, Firestein, & Burton, 2004b) and the Dynamic Interaction Scales (DIS; Waldron, Gazzillo, Genova, & Lingiardi, 2013). This article reports the authors' simplification of the complex patterns produced by the items via factor analysis. Guided by past process-outcome literature (Lambert, 2013), therapist, patient, and interaction items were factor analyzed in 3 separate analyses. Three patient factors emerged: the patient's experience of the world, the patient's experience of the analyst, and a factor the authors call patient dynamic competence. Components contributed by the therapist reduced to therapist's relational competence and therapist's dynamic competence. Interaction items produced just 1 factor, interaction quality. The authors describe the items contributing to each of these 6 factors and the correlations among these factors to permit the reader to better understand how they interact. Moreover, 2 second-order factors emerged which show what the authors describe as a parallel process between patient and analyst, allowing for a conceptualization of the intricate process of analyst and patient working together, with differing foci, in a potentially mutually enriching way.