Open Door Review III

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FB7##0$9!=_!A230M!I_!K2<(0%!Q_!V$Y$2*$!5![+,-P^!=!7<$*$72! Q#"+,)%#(&)+&9>$@+&0%>#"(?)%+?% >! For the first time the Ulm study group explored the feasibility of single case research approach of an ongoing psychoanalysis using repeated fMRI measurements. We pursued the integration of clinical presentation, of operationalized formal instruments to describe the individual psychotherapeutic process (PQS), and of neuroimaging techniques to monitor the psychotherapeutic process on both the clinical and the neural levels. In the fMRI scans, the individualized attachment paradigm was used again (see also Buchheim et al. 2012). Clinically, this patient presented defense mechanisms that influenced the relationship with the therapist and that was characterized by fluctuations of mood that lasted whole days, following a pattern that remained stable during the year of the study. The two modes of functioning associated with the mood shifts strongly affected the interaction with the therapist, whose quality varied accordingly (‘easy’ and ‘difficult’ hours). In the fMRI data, the modes of functioning visible in the therapy hours were significantly associated with modulation of the signal elicited by personalized attachment-related scenes in the posterior cingulate. This region has been associated in previous studies to self-distancing from negatively valenced interactions presented during the scan. @)15-1.*$#! This pilot study may provide indications of the possible involvement of this brain area in spontaneously enacted self-distancing defensive strategies, which may be of relevance in resistant patient reactions in the course of a specific phase in psychoanalytic psychotherapy (Buchheim et al. 2013). G$#.1/.\! Univ. Prof. Dr. Anna Buchheim, Institute of Psychology, University of Innsbruck, Innrain 52, 6020 Innsbruck, Austria, e-mail: anna.buchheim@uibk.ac.at. !

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