Organización temporal de voces discursivas y su asociación con los resultados en un caso de psicoterapia
DOI:
https://doi.org/10.21615/cesp.7585Palabras clave:
voces discursivas, cambio en psicoterapia, estudio de casos, auto-regresión vectorial, entropía, trastorno de personalidad límite, teoría del self dialógicoResumen
Las voces en psicoterapia se refieren a la expresión de estados subjetivos de pacientes y terapeutas en su discurso durante la misma. Algunas voces pueden ser monológicas, pudiendo llegar a ser rígidas y limitar la experiencia, y otras dialógicas, permitiendo una mayor flexibilidad y reflexividad. La interacción de las voces puede ser desorganizada u organizada a lo largo de la psicoterapia. Se presenta un análisis secundario de un estudio de caso de una paciente diagnosticada con Trastorno Límite de la Personalidad (TLP). En esta psicoterapia exitosa de 44 sesiones (OQ-45.2), se identificaron diferentes voces utilizando el Modelo de Análisis del Posicionamiento Discursivo en Psicoterapia (MAPP), y se evaluaron los niveles de entropía (Hs) en la interacción de estas voces utilizando la técnica State Space Grid (SSG). El objetivo de este estudio fue describir la asociación temporal entre la interacción de las voces reflexivas de la paciente y del terapeuta, su nivel de organización (entropía) y los resultados de la paciente en la psicoterapia. Para lograr este objetivo, se realizó un análisis idiográfico basado en el modelo de auto-regresión vectorial (VAR). Los resultados sugieren un buen ajuste del modelo para un retraso de una sesión (lag 1). Se presentó estabilidad temporal (auto-regresión) [p < 0,01] y una tendencia positiva [p < 0,001] de los resultados de la paciente; y una regresión cruzada positiva entre el grado de organización de las voces (t-1) y los resultados de la paciente (t) [p < 0,01]. Se sugiere una dinámica temporal en la que una mayor organización de las interacciones de voz paciente-terapeuta influye en la calidad de los resultados de la paciente. No se pudo establecer una asociación significativa entre los resultados y las voces reflexivas a pesar de su correlación sincrónica positiva (lag 0). Se necesitan estudios a nivel nomotético para probar una extensión de este modelo.
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