"#0!pT%$7#ER<9!Q(B&4!):!&%0296?!=DD%0D2($*D!6$*D<0!72606![RQO^ &&
A0BC$*D0%EF)#<030%_!@>![-\b\^>!V0%J*&0%B*D!M)D*$($Y0%!/%)C0660!$*!/647#)2*2<460*>!F&!+?!'$*0!D%B110*E 6(2($6($67#0!R*(0%6B7#B*D![8#2*D0!):!8)D*$($Y0!/%)706606!$*!/647#)2*2<4606>!V)<>!+!=!S%)B1E6(2($6($72! F0%<$*?!Q1%$*D0%>! IJ7#0<0_!H>_!G!A0BC$*D0%EF)#<030%_!@>![+,,\^>!O%029!60%$06!26!1%)7066!())<>!;*!H>!IJ7#0<0_!i>!Q7#27#(0%!G!H>! "#)9J!['&6>^_!L%)9!/647#)2*2<4($7!a2%%2($Y0!()!'91$%$72!+ggE+db^>!a0Z!e)%M?! 5)B(<0&D0>! >-001(3! This study initially described and analysed changes in the problem-solving cognitive processes of five patients during their long-term psychoanalyses. Modifications of the way the patients themselves handled their dreams during psychoanalytic sessions were focused upon. In the first phase of the study, hypotheses were derived by exploring dream associations as recorded in a patient's diary during the first and last hundred hours of his psychoanalysis (Leuzinger-Bohleber, 1987). In the second phase, the hypotheses were tested by studying the verbatim materials of four psychoanalytic cases from the Ulm Textbank (Leuzinger-Bohleber, 1989). Using two kinds of theory- guided content analysis, the dream reports taken from the first hundred along with those from the last hundred psychoanalytic sessions were evaluated case by case. At this point, the clinical outcome assessments - provided by independent clinicians - were compared to the findings on the cognitive changes. Across the five cases the estimation of clinical change corresponded very well to the changes in the cognitive functions measured by the patients' handling of dreams supporting the study hypotheses. An extension study was performed on material from one of the patients (Kächele & Leuzinger- Bohleber, 2009). In this study, all dreams were subjected to an analysis of changes in relationship pattern, dream atmosphere and problem solving. There was an impressive change of the dream atmosphere from negative to more positive affects and to more variation in affects and an impressive change in a variety of problem-solving activities. @)15-1.*$#! This is an innovative approach to the process-outcome problem. Changes in dream quality would not be predicted by any theory other than the psychoanalytic. The methods developed here need validating by other centres but the use of replicative single case design is one with many possible applications in this field. The careful investigation of transformations of dreams has also been one major tool for studying changes in psychoanalyses and psychoanalytic longterm therapies in the frame of the LAC depression study (main investigator: M. Leuzinger-Bohleber). G$#.1/.\!
M. Leuzinger-Bohleber@sigmund-freud-institut.de Horst Kaechele
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