Interaction Structures Formed in the Psychodynamic Therapy of a Man Diagnosed with Compulsive Sexual Behavior Disorder and Comorbid Borderline Personality Disorder

ABSTRACT

This study examined the psychotherapy process-outcome of a man diagnosed with compulsive sexual behavior disorder and comorbid borderline personality disorder. This mentalization-informed psychodynamic therapy (N = 52 sessions) was audio-recorded, transcribed, and coded for psychotherapy process using the Psychotherapy Process Q-Set (PQS). The patient completed the Outcome Questionnaire (OQ) prior to each session. A principal components factor analysis was conducted on the PQS data. A simulation modeling analysis was also conducted on the PQS and OQ data. Four process factors were identified, and psychological distress preceded the activation of one of these process factors observed in the following session.

Acknowledgments

The authors would like to thank the patient and therapist for participating in this study. The authors appreciate the assistance of the eight expert raters who provided Psychotherapy Process Q-Set (PQS) ratings—Palakrajiv Agrawal, Bryan Blum, Matthew Fastman, Eli Kraiem, Amanda Oliva, Taylor Perlman, Margarita Savchuk, and Deepak Seshadri—and the nine transcribers who transcribed the sessions— Palakrajiv Agrawal, Stephanie Ganor, Justin Lombardo, Anna Rivera, Holly Rosen, William Rung, Kayla Sanchez, Julia Solomon, and Kasia Staniaszek. The authors also wish to thank Valeda Dent for her indispensable assistance with acquiring references.

Disclosure statement

No potential conflict of interest was reported by the authors.