Diade paziente-terapeuta: sincronizzazione psicofisiologica e attività referenziale

Background: Psychophysiological entanglement (e.g., synchronization and de-synchronization in skin conductance and hearth activity parameters between two members of interacting dyad) in psychotherapy has been recently suggested as associated to complex pattern of clinical interaction. To further investigate such insight, we applied Referential Activity (RA) to a psychodynamic psychotherapy audio- and psychophysiological recorded. Referential process is associated with both improved connection between sub-symbolic and symbolic components of emotional and cognitive patterns and their elaboration. Computerized discourse-analysis of RA allows investigating variations of the referential process during psychotherapeutic sessions. For these reasons we investigated the possible associations between RA and physiological activity during clinical interactions. Method: Psychophysiological parameters of interacting patient and therapist were continuously and simultaneously recorded during 16 psychotherapy sessions. Different lags of synchronization were analysed: simple, leading and pacing. Association between direction of lagged synchronization and variation in RA were investigated through linear mixed effect models. Results: Preliminary analysis showed an association between RA and physiological synchronization, suggesting that referential process increases during phases of simultaneous synchrony. Discussion: patterns of psychophysiological synchronization between patient and therapist during psychotherapy sessions appear tied to enhanced referential process, supporting the hypothesis that dyad synchronization is associated with both the connection in the patient between sub-symbolic and symbolic component of the referential process and their processing. Theoretical and clinical implication will be discussed.