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[in

This is to certify that the
dissertation entitled

Mystification and Projective Identification
in Psychotherapy with Schizophrenics

presented by

Polly L. Crisp

has been accepted towards fulfillment
of the requirements for

Ph.D. degfiwin Psychology

M rprofessor
BEKDRAM P. KAKDN

Dam 1/31/84

MSUi: an Affirmun'w- Acll'un/Equul Opportunily Inxlilwinn

gamma?
5 Michigan State
University

a.—

 

012771

 

)V1ESI_} RETURNING MATERIALS:
Place in book drop to
LlBRARlES remove this checkout from
your record. FINES will

be charged if book is
returned after the date
stamped below.

‘

 

 

 

 

 

WM

 

 

 

MYSTIFICATION AND PROJECTIVE IDENTIFICATION IN
PSYCHOTHERAPY WITH SCHIZOPHRENICS

By

Polly Crisp

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Psychology

1984

 

G) Copyright by +-
POLLY LENORE CRISP ‘
1984

ABSTRACT

MYSTIFICATION AND PROJECTIVE IDENTIFICATION IN
PSYCHOTHERAPY WITH SCHIZOPHRENICS

By

Polly Crisp

Much of the focus of research dealing with families of
schizophrenics has been lack of clarity in communication patterns.

One major contribution in this area is Laing and Esterman's work on
Mystification. Mystification is an important concept in helping to
delineate why one particular member of a family becomes schizophrenic
or who in the family exhibits symptoms at a particular time. If the
concept of Mystification is transferred to the therapy context, it
should help to delineate more successful from less successful therapy
with schizophrenics in that the mystifying therapist should produce
confusion in patients and activate and maintain thought disorders.

A content analysis scheme measuring Mystification developed by
the author was applied to a sample of 19 schizophrenics from the
Michigan State Psychotherapy Project carried out by Karon and others.
Sessions representing the beginning, midpoint, and end of the recorded
therapy were coded. Each complete therapist statement between two
patient statements was the coding unit. The contextual unit was the
total session. Interrater reliability was obtained and these

alternative ways of scoring Mystification were analyzed.

Mystification was correlated with a number of six month outcome
variables: the Thorndike-Gallup Vocabulary Test, the Porteus Mazes,
the Nechsler Adult Intelligence Scale, the Feldman-Drasgow Visual
Verbal Test, the Clinical Status Interview, and the amount of time
that the patient was in the hospital. Mystification was also correlated
with therapist Pathogenis.

Significant relationships were obtained between Mystification and
the NAIS (r = —.63, a = .05, one-tailed, df = 6) and Mystification and
the Clinical Status Examination (r = -.75, a .05, df = 6, one-, and
two-tailed test). Two out of the four variables found to be significant
in Karon's six-month outcome data were strongly related to Mystification.
In general greater Mystification resulted in worse therapy outcome.

Future research in the area needs to concentrate on the relationship
of Mystification with symptom patterns within specific sessions.

Whether or not a mystifying therapist affects nonschizophrenics to the
same extent as schizophrenics should also be considered. Such research
should help to clarify the interactional nature of psychotic symptoms

and the effects of confusion on communication.

 

For my mother

   

ACKNOWLEDGEMENTS

I would like to express appreciation to the members of my
dissertation committee for their support throughout this research and
for reading and commenting on the manuscript: Dr. Albert Aniskiewicz,
Dr. Joel Aronoff, Dr. Imogene Bowers, and my chairman, Dr. Bertram
'Karon.

I would especially like to thank Dr. Karon for his support in
this research and throughout graduate school and for making the data
available from the Michigan State Psychotherapy Research Project.

Also, thanks goes to Bill Ledford for his help in the construction
of the training tape. In addition, I am grateful to Nancy McCrohan
for coding the reliability tapes.

I would also like to thank Dr. Ronald Simons, Dr. Brigetta Jordan,
Dr. Frederick Erickson and the other members of the group for their

stimulation in the Michigan State Interactional Analysis Laboratory.

 

TABLE OF CONTENTS

.1.

 

a; ,LRNP'ER I
INTRODUCTION ......................
CHAPTER II
METHOD ......................... 10
Subjects ..................... 10
Procedure ..................... 12
CHAPTER III
RESULTS ........................ 17
CHAPTER IV
DISCUSSION ....................... 22
APPENDICES
APPENDIX A ....................... 28
APPENDIX B ....................... 29
REFERENCES ......................... 159

 

CHAPTER I
INTRODUCTION_

Communication problems have been studied repeatedly in families
of schizophrenics. Most of the research in the area centers around
four types of communication deviance: 1) problems in focusing, 2)
the double-bind, 3) generational and sexual role confusion, and 4)
mystification.

Lidz and his colleagues at Yale (Lidz, Fleck, Cornelison, 1965;
Lidz, 1973) were among the first researchers to consider communication
problems in families of schizophrenics. In brief they repeatedly
observed sexual and generational boundary confusion. Parents would
often expect children to parent them, or to function in the role of a
wife or husband. Within these patterns sex differences occurred.
Families of females tended to be "schizmatic,” while those of males
were more often ”skewed.” To be more explicit, the male schizophrenic
would typically be in a close symbiotic relationship with the mother.
In contrast, the father would function in a passive distant role. The
female schizophrenic, on the other hand, would not be a part of a
coalition with either parent, but would very likely be caught between
two fighting parents.

Singer and Wynne (1963, 1965a, 1965b) and Wynne and Singer (1963a,
1963b) found focusing problems in families of schizophrenics. Chronic
schizophrenics exhibited what were termed "amorphous” communication
patterns. There was very little focus in the communication at any

1

 

time, an overall drifting, and no apparent goal. In contrast, families
of acutes showed ”fragmented” connmnication. In this communication
there is an overall goal, but many ideas disrupt the flow.

The Stanford group focused attention on what they called the
"double bind" theory of communication (Bateson, Jackson, Haley, &
Weakland, 1956). Such communication is defined as:

1. two conflicting messages on different communication levels

2. the contradiction cannot be commented on

3. the victim cannot leave the situation
Thus, the contradiction cannot be resolved.

The fourth approach to looking at communication in schizophrenic
families is best represented by Laing and Esterson (1964). These
investigators speak of "Mystification” and ”induction.“ They found
that thoughts or feelings are imputed to the patient. This process of
impution however is not acknowledged by the parents as occurring, but
is rather denied. What the patient actually feels or believes and
what he is said to feel or believe becomes fuzzy and confused.

A great deal of literature considers these and other variables in
families of schizophrenics. A review of this vast field is beyond the
focus here since this research is not concerned with families per se
but rather attempts to deal with similar communication in the therapy
process.

As a result of such communication deviance in the family one
would expect that if communication deviance occurs and continues,
the thinking disorder in the patient cannot ultimately be solved.

However, it can be argued that the therapist needs to enter into

the crazy world of the patient, including reenacting family pathology,

 

in order to work through the symbiotic relationship that manifests
itself in work with such patients. On the other hand, it may be
that the therapist should not enter into such “illness."

More specifically, Searles (1965) stresses the importance of ego
boundary loss as a necessary component of the therapeutic relationship.
According to Searles, the therapist may need to carry a part of the
patient's craziness at times. However during this process the
therapist must be strong enough to contain the craziness and lead the
patient back through the door of ”reality."

Whether or not ego boundary loss should occur in the therapy
relationship, if it does occur how does it manifest itself? What
happens as the patient projects aspects of himself onto the therapist
or vice versa?

Klein (1946, 1973) makes use of the concept of projective
identification to help answer such questions. Parts of the self are
projected onto the other person, but the other person is not seen as
a separate individual. As the process takes place, the therapist
may feel what the patient is not able to feel. If the schizophrenic
is feeling confusion and becomes involved in projective identification
with the therapist, the therapist may start to feel the confusion of
the patient. The therapist's thinking and speech may then become
confused.

Such a concept attributes the effects primarily to the patient.
Suppose that the therapist for whatever reason has a tendency to
communication deviance and projectively identifies with the patient.
As the therapist splits off the crazy parts of himself onto the

patient, the patient may experience the craziness.

 

The third alternative is that both patient and therapist are
engaging in projective identification. Each may split off parts of
themselves and identify with each other. Craziness can then be
produced in both people.

This passing around of craziness has often been noted in
families of schizophrenics. As one patient gets better (the
identified patient at the moment), other members may develop
symptoms. The critical issue for the family system is for the family
to be able to function adequately without the need for craziness in a
particular member.

How the craziness gets passed around the family is best explained
by a combination of projective identification and systems theory
constructs. What determines who projects what onto whom? Freud noted
that projection can never occur in a vacuum but can only be effective
when there is a thread of external reality to which to attach the
projection. For really successful projective identification to occur,
two people must be engaged in the interaction. If the patient is
projecting confusion, there must be a certain part of the family that
responds to the confusion and plays out the confusion by being
confused. If there are no elements in the members that lean towards
confusion at the particular moment, the projective identification
cannot be totally successful as a defense mechanism. Boszormenyi—Nagy
(1965), Laing (1969), and Skynner (1976) describe theoretical concepts
that integrate object relations and family systems theory. A child
may act out a parent's aggressive impulses when these impulses are
being denied in the parent. The parent projectively identifies onto

the child his or her own feelings of anger. Such feelings in the

 

parent are totally unacceptable to his or her self-concept. As the
author previously noted, the acting out serves a function for the
family system and the particular individuals involved in the projective
identification.

Such relationships are important when transferred to the therapy
relationships for a number of reasons. As long as projective
identification takes place and parts of the self are split off, ego
and object integration cannot take place (Fairbairn, 1952; Guntrip,
1969). If one looks at thought disorder, the central symptom of
schizophrenia, as a function of such splitting as do theoreticians of
the British and Scottish object-relations school, then thought disorder
cannot improve if projective identification continues to be a primary
mode of defense.

Since projective identification is a primary defense in
schizophrenia, it will most noteably be a major part of the therapy
process. Whether or not analysis with schizophrenics will be
successful depends on the extent to which the therapist recognizes
projective identification in himself or the patient, interprets the
phenomena, and explores why it is necessary on both an emotional and
intellectual level. As Searles (1965) stresses, the therapist will
at times experience the patient's craziness and must be able to make
use of the experience. If the therapist due to his own needs engages
in the process without conscious awareness, then projections cannot be
reintrojected by the therapist or the patient. In other words, if
the therapist plays out the good or bad breast without exploration
the process cannot be resolved. In particular if the therapist plays

out the bad breast, there will be problems. He will not function as

 

a good enough object to replace the bad objects in the patient's life
and in addition will not be able to explore what is going on. If
these seemingly ineffable constructs can be measured quantitatively in
the therapy process, such measurements should help to predict therapy
outcome, as well as the presence or absence of projective
identification in a particular session.

Meyer and Karon (1967) developed a measure for what they termed
"pathogenesis” as a trait variable. The concept is based on dependent
and independent figures in TAT stores. If an independent figure in a
story is interacting with a dependent figure with potentially
conflicting needs and takes the needs of the dependent figure into
account, the story is scored as benign. If the independent figure does
not take the dependent figure's needs into account, the story is scored
as pathogenic. Each TAT story is scored and the results are tabulated
by making use of the following formula: P/P+B (P=number of pathogenic
stories, B=number of benign stories). A number of studies have
differentiated parents of normals from parents of schizophrenics on
the basis of such scores (Meyer & Karon, 1967; Mitchell, 1968, 1969;
Nichols, 1970). Parents of schizophrenics receive higher Pathogenesis
scores than parents of normals. Nichols (1970) found parent
Pathogenesis to be significantly related to the severity of thought
disorder in their children. VandenBos and Karon (1971) meaSured
Pathogenesis of therapists with the same instrument and found therapy
outcome to be directly related - the higher the Pathogenesis scores
the worse the therapy outcome.

What do such global relationships mean when dealt with on the

level of the therapeutic interaction? If the therapist is pathogenic,

 

this should be manifested in the communication patterns. The
therapist should not take the needs of the patient into acc0unt in
the session.

One way of looking at problems in the interaction is to make use
of Laing's (Laing, 1959, 1961, 1965, 1969, 1970; Laing & Esterson,
1964) mystification concept. The therapist may not recognize the
patient's feelings or ideas, or the therapist may attribute certain
ideas or feelings to the patient which are not those of the patient.

If the patient is feeling sad, the therapist may indicate that the
patient has no such feelings. The therapist may say that the patient

is thinking a certain thought when the patient is not. In other words,
the therapist is not recognizing the patient's concept of reality.

The helpful therapist may legitimately interpret unconscious mechanisms,
that is mechanisms of which the patient is unaware, but will not
mystify. In contrast, the mystifying therapist will not present
adequate data for his interpretation. This process can be considered

as a manifestation of not recognizing the patient's needs, and

should be similar to Pathogenesis as measured by Meyer and Karon.

Prediction 1: Mystification should be directly related to
Pathogenesis. The more pathogenic the therapist the more

he should engage in Mystification.

If Mystification is occurring in the therapy, projective
identification is not being worked through. As a result of this there
should continue to be high rates of thought disorder. Mystification
should be directly related to thought disorder at outcome in that

mystifying therapists do not help the patient out of the psychosis.

 

Prediction 2: Mystification should be directly related to the
amount of thought disorder. Greater Mystification should

result in more thought disorder in the long run.

Mystification should affect other measures of outcome other than thought
disorder but not to the same degree in that other measures of outcome

are more apt to be affected by other variables as well.

Prediction 3: Mystification will be directly related to all measures
of outcome. The more that the therapist mystifies, the worse

the therapy outcome.

Prediction 4: Mystification should be related to outcome measures
of thought disorder to a greater extent than to the other

measures of outcome.

So far I have looked at the mystification process in terms of
projective identification and have argued that projective identification
is taking place. Perhaps this phenomenon is not a part of the
interaction. Perhaps the therapist tends towards Mystification in
most instances. One way to get some sense of this is to look at the
therapist's Mystification scores across sessions with several patients.
Another possibility is that projective identification by the patient is
simply adding to this underlying trait factor in the therapist.
Projective identification can only take place when there is a certain
amount of reality onto which to project. It may also be that a
therapist who tends to be mystifying in most situations engages in
projective identification process more in the session or only in

relation to schizophrenia. If one thinks along these lines the

 

 
   
     
 

., 73:: than a variable that relates to the §§E

  
  

11
1 ,. no instances, Mystification should occur across one's patients.

Prediction 5: Mystification scores across a therapist's patients

should be positively related.

 

CHAPTER II
METHOD

Data for this study was taken from the Michigan State Psychotherapy
Project. Details of the investigation can be found in Karon and
VandenBos (1981). Karon and VandenBos studied a total of 36
schizophrenics hospitalized at the Detroit Psychiatric Institute. Group
A patients received psychoanalytic therapy and no medication. Group B
patients received “ego analytic” therapy and medication. Group C patients
received medication only. Outcome measures were obtained at 6 months,
12 months, and 20 months. Patients were given the Thorndike-Gallup
Vocabulary Test (TGV), the Porteus Mazes (PM), the Wechsler Adult
Intelligence Scale (WAIS), the Feldman-Drasgow Visual Verbal Test (VVT),
the Rorschach and the TAT. All of thesemeasurements were collected by
examiners not connected with the treatment service staff. These
instruments were administered before treatment, at 6 months, 12 months,
and 20 months. Hospitalization data were gathered up to and beyond the
20 month time period (through 44 months). Patients were also given the
Clinical Status Interviews (CSI) before treatment, at 6 months, 12
months, and 20 months. A psychoanalytic psychiatrist not connected

with the treatment service carried out these interviews.

Subjects
Patients in Group C, those not receiving psychotherapy, obviously
did not have psychotherapy sessions recorded and are thus not a part

of this study. When these control patients are taken out, 24 subjects

10

 

11

remain. Three patients were removed from the project because of
organic difficulties. I was not able to find the tapes for one subject
and another subject said only a couple of words in a number of
sessions. Thus a total of 19_schizophrenics were considered in this
investigation.

Patients were primarily relatively young, poor, black, inner-city
schizophrenics with little or not previous hospitalization. See
Appendix A for demographic data. Very few had attended the university
(16%). Only about a quarter were married at the time of the initial
investigation (26%). About half were female (53%). Most were
Protestant (74%).

There were a total of 12 therapists — 2 experienced therapists and
10 students. The experienced therapists had about ten years of experience
specifically with schizophrenic patients. Inexperienced therapists or
students had 3 months to 1 years of residency or practicum experience.
Data from these three therapists saw one patient. As mentioned
previously, one patient's psychotherapy tapes could not be located.
Another therapist was seeing a patient who turned out to have organic
difficulties. The third therapist was not used in this particular
study because the patient said little or nothing during the sessions.
Thus a complete session was at most 1 or 2 coding units. In addition
since the patient was not saying anything, almost everything that the
therapist said appeared to be Mystification. Because of the unusual
nature of this particular interaction it was felt best not to include
these data. There were three graduate students in clinical psychology
and four psychiatric residents among the inexperienced therapists.

Of those therapists that were not included in the sample, there were

 

12

two graduate students in clinical psychology and one psychiatric
resident. Only one of the therapists included in this sample was

female. A11 therapists were white.

Procedure

Only the initial parts of therapy were taped. There was a great
deal of variability in the numbers of sessions recorded per patient.
In order to adequately sample within the therapy, the author looked at
the first recorded session, the last recorded session, and the session
representing the midpoint between these two. Some tapes were not
dated and it could not be determined which sessions they were. Seven
tapes could not be dated for two subjects. Thus seven tapes were thrown
out for each of them. One tape was thrown out for each of two other
subjects. Only tapes that were dated were included in the selection
of tapes representing the beginning, midpoint, and end of therapy. Only
two tapes were analyzed for one patient because only two interviews
had been recorded. One subject's tapes were incredibly difficult to
hear. The last interview could not be understood. The investigator
went back several interviews and could not find any that were clear.
Thus only two sessions were coded for this patient.

Within a particular session the coding unit was a complete
therapist statement between two patient statements. Uh, hu's, ah's
were excluded when defining coding units. All other brief statements
were included. The first coding unit within a session was the first
therapist statement after a patient statement. If the therapist began
the session, this statement was not coded. The patient had to make a
statement before the therapist statement could be cited. The

contextual unit was the whole session.

 

13

Interrater reliability (r = .99) was obtained for 10 sessions
(1 for each of 10 patients). These sessions were randomly selected by
use of a random numbers table. The present investigator coded all
the tapes. An undergraduate student receiving credit in psychology
coded 10 of the tapes with the investigator. These particular tapes
were coded at the same time so that the coding units could be kept
track of.

The other rater was trained on a tape prepared by the present
researcher in which this researcher was pretending to be the therapist
and another graduate student was playing the role of the patient. In
this ”session” the author attempted to give examples of the various
types of Mystification in the coding manual. After the author and
the other rater went through this ”session” together and discussed the
codings, they both coded part of a session of one of the subjects that
had initially been thrown out of the project as a result of organic
difficulties. Ratings were then discussed for this tape.

Each coding unit was coded for Mystification. The present
investigator coded a number of types of Mystification. The other
rater made use of the coding manual to code for the presence or absence
of Mystification in general. Specific types of Mystification were
not coded by her. Since the author was coding the specific types of
Mystification, each of her coding units could thus have more than one
score. When determining reliability the author looked simply at whether
or not Mystification occurred. Each unit of Mystification was then added
to obtain a total Mystification score (the present investigator did not
make predictions about the subcategories of Mystfication but only

wanted to explore possible patterns). Reliability was calculated by

 

14

by making use of the total score for each of the patients in the
reliability sample.

Mystification was scored as O, l, or 2. Part Mystification was
scored as 1, total Mystification as 2. (See Appendix B for
Mystification Manual.) The score for a whole session was the total
number of Mystifications divided by the total number of coding units.
Each coding unit was simply the presence or absence of Mystification.
Subcategories were not considered in the formal analysis. Scorer
reliability was also not determined for these subcategories.

To determine if this was the best method for measuring
Mystification two other techniques were tried after the data has been
analyzed. The author noted that the Mystification process was often
a complex state of affairs. If one type of Mystification occurred in
a coding unit, several other types were typically present as well.
Thus the author reanalyzed the data when all these Mystification
categories were added. In this analysis each coding unit was therefore
not bounded by a total score of two. It could have an upper bound of
6, 8, etc. The total number of Mystification was then divided by the
number of coding units as had previously been the case. The third
analysis concerned the change of subject Mystification category.
Abrupt changes of subject were thought to reflect the Mystification
process in that such categories appear to represent fragmented
communication. However with some therapists it was noted that change
of subject is a ”medical history" type of approach for conducting
therapy interviews. In such instances change of subject may not
represent an adequate measure of Mystification. Thus the data analysis

was rerun to see if change of subjected affected the results obtained.

 

15

(Since these alternative ways of scoring did not make any difference,
no reliability was rerun.)

Mystification (as measured by the three above approaches) was
correlated with the Pathogenesis score of the therapist and with the
following outcome measures: Thorndike-Gallup Vocabulary Test (TGV),
Porteus Mazes (PM), Weschler Adult Intelligence Scale (WAIS), Feldman-
Drasgow Visual-Verbal Test (VVT), Clinical Status Interview (CSI), and
amount of time that patient was in hospital. Karon had also obtained
data from the Rorschach and TAT. These two instruments were not used
in this study since they at no time were related to the psychotherapy
process. (This was also true of the TGV which was selected because it
was an intellectual test likely to be impaired by the schizophrenic
process and hence least likely to show improvement with psychotherapy.)

Only the 6th month outcome data was used since it was during this
period that psychotherapy was most intensive and all recorded therapy
sessions were from this period. One would expect the greatest impact
of the therapist to be at this time. When the patient is back in the
community and seeing the therapist less often if at all, many other
variables become important and affect the outcome scores. The
corrected scores from Karon's initial investigation were used instead
of raw scores. These scores had been corrected for their regression
on the initial scores and demographic variables and thus represented
the effects of treatment. The Porteus Maze had been corrected for
initial PM and Take-not Take initially. The Clinical Status Interview
was corrected for initial CSI and Social Class. WAIS was corrected for
initial WAIS. VVT was corrected for initial VVT and Take-not Take

initially. Days hospitalized was corrected for initial Porteus Maze

 

16

and sex. (Demographic variables were corrected for only if there
was a significant regression of outcome scores on that demographic
variable.)

Prediction 5 posed particular problems since the therapists saw
a number of patients. If a therapist had only one patient, the
relationship among his or her patients could not be looked at. If
therapists had two or more patients, the relationship between these
patients was considered. All the therapists that had more than one
patient saw either two or three patients. If the therapist had three

patients a random numbers table was used to pick out two of them.

 

CHAPTER III
RESULTS

As noted previously Mystification and Pathogenesis should show a
positive relationship. On one level Mystification is an example of
not meeting the patient's needs and thus should be similar to
Pathogenesis as measured by Meyer and Karon in the TAT. Both
Mystification (Laing & Esterson, 1964) and Pathogenesis (Meyer &
Karon, 1967; Mitchell, 1968, 1969; Nichols, 1970) have been found to

exist in parents of schizophrenics.

Prediction 1: Mystification should be directly related to
Pathogenesis. The more pathogenic the therapist the more

he should engage in Mystification.

Prediction 1 was not supported. Mystification and Pathogenesis
were not significantly related (r = .13, N = 7 therapists). When the
data analysis was rerun with all categories of Mystification added
(complex mystification), the correlated remained the same (r = .13).
When the change of subject category was taken out, little change
resulted in the correlation (r = .19).

Similarly Mystification should be related to outcome. Mystification
should particularly affect the thought disorder in that mystifying
therapists do not help the patient work through the psychosis.

Mystifying therapists create confusion in the patient.

 

18

Prediction 2: Mystification should be directly related to the
amount of thought disorder. Greater Mystification should

result in more thought disorder in the long run.

General intellectual functioning is best measured by the Thorndike—.
Gallup Vocabulary Test and the Weschler Adult Intelligence Scale
(Parallel form, Weschler Belluevue II). However the TGV was chosen as
a general measure of intellectual functioning least likely to be
affected by thought disorder. The other measures of thought disorder
are the Porteus Mazes and the Visual-Verbal Test. The PM is a measure
of “foresight” or "planfulness." The VVT measures concept formation.

Significant correlations between Mystification and the WAIS were
obtained (r = -.63, c = .05, one-tailed, df = 6). There were no
significant relationships between Mystification and the Thorndike-
Gallup (r = .46), Porteus Mazes (r = -.27), VVT (r = .24). With the
complex Mystification score the correlations were basically similar -
Mystification and: TG (r = .45), PM (r = —.27), WAIS (r = —.62),

VVT (r = .22). When Mystification was measured with the change of
subject taken out little change resulted (TG, r = .47; PM, r = -.20;
VVT, r = .18). In summary Prediction 2 was supported when thought
disorder was measured by the WAIS, but not when thought disorder was
measured by the VVT, TG, or PM. More will be said about these
relationships subsequently.

Mystification should not only affect thought disorder but other
measures of outcome as well. However, Mystification should affect
measures of the thought disorder to a greater extent than other
measures of outcome in that these particular measures of outcome are

more apt to be affected by other variables as well.

 

19

Prediction 3: Mystification will be directly related to all measures
of outcomes. The more that the therapist mystifies, the worse

the therapy outcome.

Prediction 4: Mystification should be related to outcome measures of
thought disorder to a greater extent than to the other measures

of outcome.

Measures of outcome that are not specifically related to thought
disorder, but at the same time are not independent of thought disorder
are the CSI and days hospitalized. The CSI is a ”Global" outcome
measure of mental health. Karon and VandenBos (1981) asked raters and
interviewers to take note of the following: "ability to take care of
self, ability to work, sexual adjustment, social adjustment, absence
of hallucinations and delusions, degree of freedom from anxiety and
depression, satisfaction with life and self, achievement of capabilities,
and benign verses malignant affect on others“ (p. 407). Days
hospitalized may indicate overall functioning to some extent but is
also affected by the availability of beds, whether or not placement
can be obtained in the community, family attitudes, etc.

Mystification was found to be significantly and strongly related
to the CSI (r = -.75, a .05, df = 6, one and two-tailed test). When
corrected for attenuation the correlation rose to -.83 (CSI interrater
reliability .82, Mystification interrater reliability .99).
Mystification was not significantly related to days hospitalized
(r = .17). The other two exploratory measures of Mystification made
little difference in the results (complex Mystification and Clinical

Status, r = —.75, complex Mystification and days hospitalized, r = .16).

 

20

When change of subject is taken out, the relationship between
Mystification and the Clinical Status Interview is r = -.81 and
Mystification and days hospitalized is r = .21.

Prediction 4 did not hold. Mystification was not found to be
related to measures of thought disorder to a greater extent than to
other measures of outcome. The two significant correlations were
Mystification and WAIS (r = -.63) and Mystification and CSI (r = -.75).
Little difference was found in the strengths of these correlations.
However the CSI is not independent of thought disorder. Thus
Prediction 4 cannot really be adequately tested. Nevertheless, there
are no strong patterns between those measures which more directly
measure thought disorder versus those that represent more global aspects
of outcome.

As the author noted previously,the first four predictions can be
conceptualized in terms of projective identification. As such it is
part of an interaction between two people. It may be that Mystification
is a trait variable or that the therapist becomes a part of the
projective identification process across time and persons. Projective
identification by the patient may add to the underlying factor in the
therapist. However there is some underlying factor in the therapist

which can be seen across his patients.

Prediction 5: Mystification scores across a therapist's patients

should be positively related.

Prediction 5 was strongly supported. Therapists were extremely
consistent across their patients (r = .94, df = 4) (Guilford's

intraclass correlation). The complex Mystification measure (r = .98,

 

 

 

CHAPTER IV
DISCUSSION

The following variables reached significance in Karon's six
month outcome data, as being related to psychotherapy (WAIS, p §_.03,
VVT, pi: .01, corrected days in hospital p §_.02, and CSI, p 5_.05).
Of these four significant variables in Karon's study, two were
significantly related to Mystification (WAIS and CSI). The reasons for
these particular relationships are not totally clear.

Surprisingly no relationship was found between Mystification and
Pathogenesis. It may be that Mystification represents a specific
type of communication deviance, whereas Pathogenesis is a more global
measure of not meeting someone's needs. All forms of communication
deviance could possibly be represented by Pathogenesis. Part of the
problem may be a restriction of range in the Pathogenesis scores - thus
lowering correlations that could have occurred had no range restriction
been present. Unfortunately the most pathogenic and least pathogenic
therapist's scores had to be thrown out of the data analysis. The
tapes from the least pathogenic therapist were missing. The therapist
with the highest Pathogenesis scores had patients that turned out to
have organic difficulties and thus were removed from the project.

It is more difficult to discuss why particular other measures
were significant or not significant. Specific measures of thought
disorder other than the WAIS were not strongly affected by Mystification.
It may be that the Porteus Maze and VVT are measures of some “core''

22

 

23

amount of thought disorder which does not readily change. However
Karon found that therapy affects measures of the VVT at six months.
The thought disorder as measured by the VVT does not remain constant.
Mystification would be thought to affect the VVT since the VVT is a
concept-formation task. Confusing statements would most likely result
in confusing conceptualization. However Mystification is not simply

a measure of problem in thinking. A large part of the Mystification
Scale is concerned with induction and disagreement. This measure
represents much more than confusion in communication.

The other significant relationship that Karon found was that
psychotherapy affected days hospitalized. However it is not surprising
that there was little relationship between Mystification and days
hospitalized. The amount of time in hospital is affected by many
variables such as the number of hospital beds and placement facilities
in the community. In addition the amount of acting out that the patient
is engaged in is most likely to determine length of hospitalization.
Mystification may or may not affect such variables as physical aggression.

The most important relationship observed in the study is that
between Mystification and the Clinical Status Interview. This is the
measure of outcome that has the highest face validity. In many ways
this measure represents overall mental functioning. This relationship
shows that the mystifying therapist has an impact on functioning.

This is a particularly important relationship in that the concept
of Mystification was initially taken from families of schizophrenics.
The mystifying therapist does not help the patient to get better.
Experience in a mystifying family has the same kind of impact. If

inductions are being made, an adequate concept of self cannot be

 

24

developed. For example, if the therapist insists that a person is
crazy the person will more apt to be crazy. (Remember that induction
does not include interpretations about crazy behavior, etc.) Similarly
if confusing or contradictory statements are made, an adequate
representation of self or the external world cannot exist.

The last relationship found in this study was the high correlation
of Mystification across therapists' patients; mystifying therapists
were not just mystifying in relation to one patient but showed
consistent Mystification across their patients. This pattern is a
helpful start in looking at what occurs in a mystifying interaction
and in defining if projective identification is a helpful conceptual
tool in thinking about Mystification. Fortunately or unfortunately,
this highly significant correlation results in more questions than
answers in this study.

This research represents a preliminary investigation into
Mystification in the therapeutic relationship. It shows that
Mystification is important in determining the outcome of psychotherapy.

An even more interesting aspect is the relationship between
Mystification and symptom patterns. During my coding of these tapes I
noted what appears to be an inverse relationship between Mystification
and symptoms when the therapist who scored highest on Mystification
was observed. This particular inverse relationship is intriguing in
that it helps to show connections in the manifestation of symptom
patterns. When these relationships are observed in the therapy, it
can indirectly show how symptoms are often manifested in the family.
When the patient projects his craziness onto the therapist, the

therapist takes on the confusion and engages in mystifying communication.

 

25

Since projective identification has occurred, the patient no longer
exhibits symptoms of the particular moment. It the opposite happens
the therapist's communication will be clear and concise. Since the
confusionis projected onto the patient in the given instance, the
patient will manifest confusion in the form of psychotic symptoms.
Thus at any one point in time the therapist's communication will be
clear and the patient will show confusion or vice versa.

Such associations are extremely important to investigate more fully
in further research projects.

Another area of interest is whether or not a mystifying therapist
would affect the therapeutic outcome in nonschizophrenics to the same
degree as with schizophrenics. Such an investigation might also help
in determining patterns in schizophrenic families. One could for
example look at the extent to which a mystifying family member might
affect another family member who does not exhibit thought disorder.

A third research project that needs to be done in the future
is to look specifically at ego boundary loss in relation to
Mystification. What is the relationship between subjective accounts
of ego boundary loss at a particular moment and Mystification? Such
an investigation would help to delineate what the components of
projective identification are or if projective identification is an
adequate way to conceptualize Mystification. A way to look at this
would be to have the patient and therapist relisten to their session
just after it has been recorded and independently identify when they
felt ego boundary loss.

Another interesting project is the relationship of Mystification

to depth of interpretation. Does the mystifying therapist interpret

 

26

”deep” unconscious material or are these two variables independent?
Mystification as measured here includes much more than interpretation,
but ”deep“ interpretation might possibly be one part of the phenomena.
The weakness of this investigation represents primarily its
exploratory nature. One major problem is that the Mystification Scale
needs to be more adequately developed. Mystification varies from
inductions and disagreements to confusing and contradictory statements.
The scale was developed from Laing's conceptualizations and from
listening to one particularly mystifying therapist in this project.
Psychotherapy sessions from other mystifying therapists need to be
obtained and made use of in further developments of the scale. In
addition various types of weighting for the different categories need
to be explored. It may be that some types of Mystification represent
greater Mystification than other categories. One thing that was
especially noted in this study was that when a therapist scores high on
Mystification, the process is far from simple. The various levels of
communication need to be investigated to adequately describe the
phenomena. In addition, Mystification occurs across coding units.
Thus Mystification needs to be studied both quantitatively and
qualitatively. A minute descriptive analysis should be carried out.
Such an analysis was done in the preliminary development of this
scale. However, further analysis needs to be carried out in the
future. In spite of all of these issues Mystification appears to be
an extremely robust phenomena in that a highly mystifying therapist
is easy to spot. In this study such therapists scored high across
most dimensions. When samples of one therapist's sessions were

played to a group of anthropologists and others engaged in extensive

 

27

studies of interactions, chaos was created in the group. Extremely
strong affects were evident in the group. In my initial explorations
of the problem, I found that I got severe headaches and had great
difficulty in listening to the sessions. Since I am not a person who
typically gets headaches, I felt that this was further evidence of the
destructive impact of Msytification.

Another weakness is that Mystification as a specific manifestation
of projective identification was also only briefly explored. Perhaps
the process cannot be seen as an interaction but must be seen as
something specifically in the therapist or as a trait variable. 0n
the other hand, this interaction may occur just with schizophrenics
and not with patient's who do not show thought disorder. The
relationship between Mystification and projective identification needs
to be more specifically delineated. The author used projective
identification as a helpful way of conceptualizing the process but
such conceptualization needs to be explored further if it is to
become more than a loose conceptual tool or simply a possible way of
thinking about the data.

Mystification is an extremely important variable for a number of
reasons. It is one important factor in determining outcome in
psychotherapy. In addition it has been shown to represent a large
factor in schizophrenic families. If one wants to take a radical
position, all of psychotherapy can be seen as a type of Mystification.
Is the therapy process insight or persuasion? What is the fine line
between Mystification and explanation? If Mystification is done in
a deliberate sense can it result in positive change? These questions

are only a few of the possibilities for further research in the area.

 

 

APPENDICES

 

 

APPENDIX A

PATIENT CHARACTERISTICS OF SAMPLE USED
IN MYSTIFICATION STUDY

 

APPENDIX A

PATIENT CHARACTERISTICS OF SAMPLE USED
IN MYSTIFICATION STUDY

Marital Status Religion

47%
26%
11%
16%

single 74% Protestant
married 21% Catholic
divorced 5% none
separated

Race

74%
26%

Negro
White

Education

5%
11%
32%
26%
21%
5%

college graduates

some college

12th grade

9th through 11th _
6th through 8th x
less than 6th grade 0

Current Occupation

11%
16%
16%
11%
37%
5%

5%

Age
)2:

none

unemployed

hospitalized

housewife

unskilled, semiskilled or skilled laborer
trade school

not listed

29 02 = 55.4

(age not listed for one person)

Previous Hospitalization

 

5%

68%
16%
11%

§21

47%
53%

not listed
none

one admission
two admissions

.6 days
7.4

Q><|
N

010‘!

male
female

28

 

 

APPENDIX B
MYST I FICATION SCALE

 

 

 

APPENDIX B
MYSTIFICATION SCALE
Examples of Working ThrOugh Defenses Versus Mystification

Working through unconscious material is not the same as Mystification.
Mystification occurs when the therapist does not have an adequate basis
for his position or is not consistent in the position that he takes.

If the therapist backs up his position with any of the following, do
not score as Mystification:

l. Therapist points to specific nonverbal behaviors of the patient, or
it seems evident that the therapist is noting nonverbal behaviors
in the session.

2. Therapist points to information that the patient has told him.

3. Therapist points to behaviors that he has noted outside the
interview.

4. Therapist gives explanation of why he has taken the stance that he
takes. This is in contrast to simply stating a disagreement or
attribution.

5. The data that the therapist is making use of is apparent in the
session.

Ex. Patient: I'm supposed to take care of my mother.
Therapist: No you are not. Your mother used to make you believe
that you should take care of her. We talked about her making you
do all the work. You do not have the responsibility as an adult
to care for your mother.

(This is not Mystification. The therapist gives the patient an
explanation of why he feels he must care for his mother. In addition
he tells the patient that caring for his mother does not represent the
cultural norm.)

Ex. Patient: I don't have anything to say.
Therapist: If you don't have anything to say, why do you look
like you are trying to hold things back?

(This is ngt_scored as Mystification. The therapist points to
nonverbal behavior.)

Ex. Therapist: Your parents are not always nice. You told me how
they used to hit you all the time.

(This is ngt_scored as Mystification. The therapist points to
contradictions based on what the patient has told him.)

29

 

30
Ex. Patient: I don't have anything to say.
Therapist: Yes you do.

(This is scored as Mystification. The reason for the therapist's
position is not clear.)

Comments

More than one type of Mystification may apply to a coding statement.
Score as many as apply.

If both childhood and adulthood are referred to, score both categories.
If the time period is not specified and you cannot tell whether the
adult or childhood system should be used, use the adult system.

In the adult system past and present are scored on the categories.
Separate categories exist for future or conditional events.

Some Definitions
Family means the patient's extended or nuclear family.

Others refers to all living things, objects, or concepts. (The word
person is usually used to simplify the language.

Therapist refers to the therapist that is being looked at in this
study.

Internal behavior refers to images, dreams, and fantasy, as well as
thoughts and feelings.

Self concept, family concept, person concept refer to enduring
characteristics over time.

(Other definitions will be dealt with in the manual.)

 

31

Mystification Scale
(adulthood and general)

Adulthood - this part of the scale applies to phenomena after
adolescence.

Coding unit — complete therapist statement between two complete patient
statements.

Therapist statement is rated after preceding patient statement.

When determining coding unit disregard mm's, mmhm's.

Context - complete psychotherapy session.

External and Internal Physical Reality (includes past as well as present
perceptions in adulthood)

1 Therapist attributes a visual perception or lack of visual perception
to the patient when there is no data to indicate that this
attribution is accurate.

Ex. The man was there. You saw him.
Ex. The man was not there. You did not see him.

2 Therapist disagrees with patient's visual perception when it is
not clear whether or not patient's perception is accurate.

Ex. You did not see the woman walk across the street.
Ex. You did see the woman walk across the street.

3 Therapist attributes an auditory perception or lack of auditory
perception to the patient when there is no data to indicate
that this attribution is accurate.

Ex. You heard the nurse talking to you.
Ex. You did not hear the man walk across the room.

4 Therapist disagrees with patient's auditory perception or
lack of auditory perception when it is not clear whether or
not patient's perception is accurate.

Ex. Your aunt talked to you.
Ex. Your grandfather did not say anything. You did not
hear him.

5 Therapist attributes a tactile perception or lack of tactile
perception to the patient when there is no data to indicate
that this attribution is accurate.

Ex. You felt her touch you.
Ex. A bug did not crawl across your feet.

 

32

Therapist disagrees with patient's tactile perception when it is
not clear whether or not patient's perception is accurate.

Ex. You did not feel a flower yesterday.
Ex. You can feel the floor when you walk.

Therapist attributes an olfactory perception or lack of olfactopy
perception to the patient when there is no data to indicate
that this attribution is correct.

 

Ex. You smelled smoke yesterday.
Ex. You did not smell perfume.

Therapist disagrees with patient's olfactory perception when it is
not clear whether or not patient's perception is accurate.

 

Ex. There was no skunk smell outside.
Ex. You did smell perfume.

Therapist attributes a gustatory perception or lack of ggstatory
perception to the patient when there is no data to indicate
that this attribution is accurate.

 

Ex. You did not taste salt in the pudding.
Ex. You taste foods when you eat.

Therapist disagrees with patient' 5 gustatgyy perception when it
is not clear whether or not the patient' 5 perception is
accurate.

 

Ex. You did not taste sugar.
Ex. You did taste milk yesterday.

Therapist attributes a kinesthetic perception or lack of
kinesthetic perception to the patient when there is no data
to indicate that this attribution is accurate.

 

 

Ex. You felt like you were moving when you were going to
sleep yesterday.
Ex. You did not feel that you were traveling through space.

Therapist disagrees with patient' 5 kinesthetic perception when
it is not clear whether or not patient' 5 perception is accurate.

 

Ex. You do not feel that your leg is moving.
Ex. You do feel that you move out of your body.

Therapist attributes a pain perception or lack of pain perception
to the patient when there is no data to indicate that this
attribution is accurate. (Note: This category involves
physical and not psychological pain.)

 

Ex. You do not feel like nails are sticking in you.
Ex. You are in constant pain.

20

21

33

Therapist disagrees with patient' 5 pain perception when it is
not clear whether or not patient' s perception is accurate.

Ex. You are not in pain. Stop this nonsense.
Ex. Your leg does constantly hurt you.

Therapist attributes a perception of hotness or coldness or lack
of perception of hotness or coldness to the patient when there
is no data to indicate that this attribution is accurate.

Ex. You do not feel cold.
Ex. You feel as if it is extremely cold outside.

Therapist disagrees with patient's perception of hotness or
coldness when it is not clear whether or not patient's perception

is accurate.

Ex. You do not feel cold in this room.
Ex. You feel like you need to put on a coat.

Therapist attributes sexual sensations or lack of sexual sensations
to the patient when there is no data to indicate that this
attribution is accurate.

 

 

Ex. You have sexual feelings most of the time.
Ex. You feel no sexual sensations at all.

Therapist disagrees with patient's perceptions of his sexual
sensations when it is not clear whether or not patient's
perception is accurate.

Ex. You do have sexual feelings.
Ex. You do not have sexual sensations while you are here
at the hospital.

Therapist attributes a perception of time or lack of perception
of time to the patient when there is no data to indicate that

this attribution is accurate.

Ex. You feel as if everything is going very slowly.
Ex. You do not feel that it is evening.

Therapist disagrees with patient' s time perceptions when it
is not clear whether or not patient' 5 perception is accurate.

 

Ex. You don't feel that time stands still.
Ex. You feel that it is evening not morning.

Therapist attributes an overall body state or lack of such a
state to the patient when there is no data to indicate that
this attribution is accurate.

 

 

Ex. You do not feel as if your body is dying.
Ex. You feel as if you are perfectly well physically.

 

34

22 Therapist disagrees about patient's overall body state or lack
of such a state when it is not clear whether or not patient's
perception is accurate.

 

Ex. You do not feel sick.
Ex. You feel as if your body will break into bits. You
do not feel like you have one body.

23 Therapist makes attributions about external or internal physical
reality, but the particular mode of sensation is not specified.
This category refers to modes of physical perception in general.
Note: If specific behaviors are indicated the behavioral
category should be scored and not this one. This category
should only be used when none of the other physical reality
categories specifically apply.

Ex. The woman was there.
Ex. The car did not pass.

These examples could refer to visual or auditory perception.
The mode of perception is not clearly specified.

24 Therapist disagrees about external or internal physical reality,
but the particular mode of sensation is not specified. There
is no data to indicate whether or not the patients perception
is accurate.

Ex. The woman was there. You do not know what you are
talking about.

Ex. The nurse was not in your room yesterday.

Patient Affect

25 Therapist states that patient feels fear or anxiety or does pp:
feel fear or anxiety when it is not clear whet er or not the
patient feels these affects. The therapist does ppp_point to
specific behaviors of the patient or refer to statements in
the interview, etc.

Ex. You are frightened.
Ex. You are not anxious.

26 Therapist disagrees about patient's statement of fear or anxiety
or lack of fear or anxiety when it is not clear whether or not
patient feels anxious or afraid.

Ex. You are not afraid.
Ex. I know that you are frightened all the time no matter
what you say.

 

27

28

29

3O

31

32

33

34

35

35

Therapist states that patient feels anger or does not feel anger
when it is not clear whether or not the patient feels anger.

 

Ex. You were angry all day yesterday.
Ex. You are not angry now.

Therapist disagrees about patient's statement of anger or lack
of anger when it is not clear whether or not the patient feels
angry.

 

Ex. You are angry. I don't care what you say.
Ex. You were not angry at the nurses yesterday.

Therapist states that the patient feels or does not feel
startled when it is not clear whether or not this is the case.

Ex. You were startled last night.
Ex. You don't feel startled at the moment.

Therapist disagrees about patient's statements of being or not
being startled without providing justification.

Ex. I know that you were startled when the new patient came
in.
Ex. You didn't feel startled when your husband came last week.

Therapist states that patient feels or does not feel surprised
when it is not clear whether or not this is the case.

Ex. You were surprised to see your brother.
Ex. You are not surprised that you had group therapy yesterday.

Therapist disagrees about patient's statements of being or not
being surprised without providing justification.

Ex. I know that you were surprised to see him.
Ex. You are surprised now even if you think that you are not.

Therapist states that patient feels or does not feel distress-
anguish when it is not clear whether or not this is the case.

Ex. You are in constant anguish.
Ex. You're not distressed any longer.

Therapist disagrees about patient's statements of being or not
being distressed without providing justification.

Ex. You are in distress. You just want me to think that you
are not. I know that you are.

Therapist states that patient feels or does not feel disgust
when it is not clear whether or not patient feels disgust.

 

36

37

38

39

40

41

42

36

Ex. You were disgusted with the social worker.
Ex. You don't feel disgusted with the therapy. I know that.

Therapist disagrees about patient's statements of being or not
being disgusted without providing justification.

Ex. I know that you are disgusted with being here.
Ex. You are disgusted. Why do you tell me that you are?

Therapist states that patient feels or does not feel envious
when it is not clear whether or not this is the case.

Ex. I know that you are envious of your mother.
Ex. You don't envy her.

Therapist disagrees about patient's statement of being or not
being envious without providing justification.

Ex. You are full of envy.
Ex. You don't envy your husband.

Therapist states that patient feels or does not feel jealousy
when it is not clear whether or not this is the case.

Ex. You are jealous of your husband's relationship to your
mother.
Ex. You never have feelings of jealousy.

Therapist disagrees about patient's statement of being or not
being jealous without providing justification.

Ex. You are jealous. I know that you are feeling this.
Ex. You are not feeling jealous at the moment. Maybe you
felt jealous yesterday but not today.

Therapist states that patient feels or does not feel sad when
it is not clear whether or not this is the case.

Ex. You don't feel sad. You have nothing to feel sad about.
Ex. I know that you feel sadness most of the time.

Therapist disagrees about patient's statement of feeling or not
feeling ppg_without providing justification.

Ex. You have been sad for a year. I know that. I am a
therapist.

Ex. You don't feel sad here. You don't have to do any work
here.

 

43

44

45

46

47

48

49

50

37

Therapist states that patient feels or does not feel shame when
it is not clear whether or not this is the case.

Ex. I know that you are ashamed to be in the hospital.
Ex. You don't feel shame. You just think that you do.

Therapist disagrees about patient's statements of being or not
being ashamed without providing justification.

Ex. Stop denying. You feel shame about every day.
Ex. You are ashamed at being a patient even if you say
that you are not.

Therapist states that patient feels or does not feel guilt when
it is not clear whether or not this is the case.

Ex. You feel guilty because you got yourself put in here.
Ex. You probably think that you feel guilty. I know that
you don't.

Therapist disagrees about patient's statements of feeling or not
feeling guilty without providing justification.

Ex. You don't feel guilty. You feel nothing.
Ex. You felt guilty about being born.

Therapist states that patient feels or does not feel happiness
or joy when it is not clear whether or not this is the case.

Ex. You are happy that you are getting out of the hospital.
Ex. You haven't been happy for a long time.

Therapist disagrees about patient's statement of feeling or not
feeling happiness or joy without providing justification.

Ex. You don't feel joy at seeing her.
Ex. Don't tell me that you are happy. That is a lie.

Therapist states that the patient feels or does not feel
excited when it is not clear whether or not this is the case.

Ex. I know that you are excited about going to the game.
Ex. You haven‘t been excited about anything.

Therapist disagrees about patient's statement of feeling or not
feeling excitement without providing justification.

Ex. You can't be excited. There is no reason to be.
Ex. You never get excited about anything.

 

51

52

53

54

55

56

57

58

38

Therapist states that patient feels or does not feel hatred
when it is not clear whether or not this is the case.

Ex. I know that you hate your mother.
Ex. You don't hate anybody.

This category includes a more global affective state than
anger.

Therapist disagrees about patient's statement of feeling or not
feeling hatred.

Ex. I know that you hate him. Don't tell me that you don't.
Ex. You've had hatred for a long time. You must realize this.

Therapist states that patient feels or does not feel love when
it is not clear whether or not this is the case.

Ex. I know that you love your children.
Ex. You don't love anyone. You don't know how to love anyone.

Therapist disagrees with patient's statement of feeling or not
feeling love.

Ex. You don't love your mother. I know that you don't.
Ex. You love your husband even when you think you don't.

Therapist states that patient feels or does not feel positive
affects in general when it is not clear whether or not this is
the case.

Ex. You feel good since you have been in therapy.
Ex. You don't feel great all the time.

Therapist disagrees with patient's statement of feeling or not
feeling positive affects.

Ex. You don't feel good. Why do you want me to think that?
Ex. You feel wonderful. Don't tell me that you don't.

Therapist states that the patient feels or does not feel negative
affects in general when it is not clear whether or not this is
the case.

Ex. You feel lousy today.
Ex. You didn't feel terrible last week.

Therapist disagrees with patient's statement abOut feeling or not
feeling negative affects without providing justification.

Ex. You feel rotten.
Ex. You don't feel as bad as you think.

 

(Note:

59

6O

61

62

63

64

65

66

39

If an overall body state is indicated, code for body state. If
the general affect statements do not refer specifically to a
physical body state, code the general affect categories.)

Therapist states that the patient feels or does not feel confusion
or craziness when it is not clear whether or not this is the case.

Ex. You feel confused day and night.
Ex. You don't feel crazy. The therapy has made you better.

Therapist disagrees with patient's statement of feeling or not
feeling confused or crazy without providing justification.

Ex. Certainly you feel confused. You can't make me think
that you don't.
Ex. You're not feeling crazy at the moment.

Therapist states that patient feels or does not feel emptiness
when it is not clear whether or not this is the case.

Ex. You go around feeling empty most of the time.
Ex. You don't feel empty when you are in therapy.

Therapist disagrees abOut patient's statements about feeling or
not feeling empty without providing justification.

Ex. You don't feel empty anymore.
Ex. You feel empty when you don't think that you do.

Therapist states that patient feels or does not feel loneliness
when it is not clear whether or not this is the case.

Ex. You feel lonely when you are working.
Ex. You don't typically have feelings of loneliness.

Therapist disagrees about patient's statement about feeling
or not feeling loneliness.

Ex. You haven't felt lonely for quite a while.
Ex. You feel lonely when you leave the hospital.

Therapist states that patient feels or does not feel hope
when it is not clear whether or not this is the case.

Ex. You feel hope for the first time.
Ex. You don't know what it is to feel hope.

Therapist disagrees about patient's statements about feeling or
not feeling hope.

Ex. I don't agree that you have hope. You don‘t.
Ex. You have hope whether you think so or not.

 

40
67 Therapist states that patient feels or does not feel anything
when it is not clear whether or not this is the case.

Ex. You are able to feel nothing.
Ex. You do not feel anything. Why do you think that?

68 Therapist disagrees about patient's statement about feeling or pp;
feeling anything without providing justification.

Ex. You can feel.
Ex. You think that you can feel. You cannot.

Patient's Self Concept

69 Therapist makes positive statements about the patient as a person
without providing data for his views.

Ex. You are a strong person.
Ex. You are always a nice person.

' 70 Therapist disagrees with patient's statement of patient's
positive views of himself. Therapist does not justify.

 

Ex. You are not a good person.
Ex. You are not a bright person.

71 Therapist makes negative statements about the patient as a person
without data for his views.

Ex. You are crazy.
Ex. You are bad.

72 Therapist disagrees with patient's statement of patient's
negative view of himself. Therapist does not justify his point.

Ex. You are not crazy.
Ex. You are a nice person.

73 Therapist makes neutral statements about the patient as a person
without providing data for his view.

Ex. You are a busy person.
Ex. You are a scholar.

74 Therapist disagrees with patient's statement of patient's neutral
view of himself. Therapist does not justify his point.

Ex. You are not a busy person.
Ex. You are not a business type.

 

(Note:

(Note:

41

The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is
not specified. Ex. ”You are not a crazy person." The
therapist says that the person is not crazy. He does not go
on to specify something positive or negative. For example,
he does not go on to say that the patient is a healthy
person.) ,

The self concept category applies to enduring characteristics
over time. For example, if the therapist states that the
patient is crazy and an enduring characteristic is stated or
implied, the self concept category should be scored. If the
therapist states that the patient is engaging in crazy
behavior or is feeling crazy, then the behavior or affect
category is scored.)

Patient's Motives or Intentions Towards Self

 

75

76

77

78

79

Therapist states that patient wants or has the intention of doing
such and such (positive intention) to himself. Therapist does
not provide adequate data for his position.

Ex. You want to help yourself.
Ex. You want to do well in school.

Therapist disagrees with patient's statements about his positive
self motivation. Therapist does not provide data for his point.

Ex. You do not want to help yourself.
Ex. You want to hurt yourself.

Therapist states that patient wants or has the intention of doing
such and such (negative intention) to himself.

Ex. You want to hurt yourself.
Ex. You want to fail in school.

Therapist disagrees with patient's statements about his negative
self motivation. Therapist does not provide data for his point.

Ex. You don't want to hurt yourself.
Ex. You want to help yourself.

Therapist states that patient wants or has the intention of doing
such and such (neutral intention) to himself.

Ex. You want to take a bath.
Ex. You want to gain some weight.

 

80

42
Therapist disagrees with patient's statements about his neutral
self motivation. Therapist does not provide data for his point.

Ex. You don't want to wash your hair.
Ex. You don't want to give yourself some water right now.

Patient's Motives or Intentions Towards Family

81

82

83

84

85

86

Therapist states that patient wants or has the intention of
doing such and such (positive intention) to his family.

Ex. You want to help your father.
Ex. You want to understand your brother.

Therapist disagrees with patient's statements about his positive

motivation towards his family. Therapist does not provide data

for his point.

Ex. You do not want to do nice things for your grandfather.
Ex. You want to kill-your father.

Therapist states that patient wants or has the intention of
doing such and such (negative intention) to his family.
Ex. Before you came into the hospital you wanted to make
your mother do all the work even though she was feeling bad.
Ex. You want to make your children take care of you.

Therapist disagrees with patient's statements about his negative

motivation towards his family.

Ex. You did not want to hurt your wife.
Ex. You do not have the intentions of being nasty to your
cousin.

Therapist states that patient wants or has the intention of
doing such and such (neutral intention) to his family. Therapist
does not provide data.

Ex. You want to go visit your parents.
Ex. You have the intention of seeing your mother today.

Therapist disagrees with patient's statements about his neutral

motivation towards his family.

Ex. You don't want to take your mother to the store.
Ex. You don't want to go fishing with your uncle.

 

43

Patient's Motives or Intentions Towards Others (aside from family)

87 Therapist states that patient wants or has the intention of
doing such and such to others (positive intention). Therapist
does not provide data for his point.

 

Ex. You want to praise your friend.
Ex. You are trying to be nice to your teacher.

88 Therapist disagrees with patient's statements about his
positive motivations towards others.

Ex. You don't want to help your friend.
Ex. You do not mean to help the woman across the street.

89 Therapist states that patient wants or has the intention of
doing such and such to others (negative intention .

 

Ex. You want to be nasty to the psychiatrist.
Ex. You want to go to the ward and hit the nurse.

90 Therapist disagrees with patient's statements about his negative
motivation towards others.

 

Ex. You don't want to be a pain to the psychologist.
Ex. You don't want to give the dog such a hard time.

91 Therapist states that patient wants or has the intention of doing
such and such to others (neutral intention).

 

Ex. You want to see the grocer today.
Ex. You want to give the dog a bath.

92 Therapist disagrees with patient's statements about his neutral
intentions towards others.

Ex. You do not want to go for a walk with the other patient.
Ex. You do not want to see the grocer.

Patient's Motives or Intentions Towards Therapist

 

93 Therapist states that patient wants or has the intention of
doing such and such to the therapist (positive intentions).

 

Ex. You want to spare me some of the pain that you feel.
Ex. You have the intention of being nice to me.

94 Therapist disagrees with patient's statements about his positive
intentions towards the therapist.

Ex. You don't want me to be a good therapist.
Ex. You don't want to be nice to me.

 

95

96

97

98

44

Therapist states that patient wants or has the intention of
doing such and such to the therapist (negative intention).
Therapist does not provide data for his point.

 

Ex. You want to destroy this therapy so you can make me fail.
Ex. You have the intention of being as nasty as you can to me.

Therapist disagrees with patient's statements about his negative
intentions towards the therapist.

Ex. You don't really want to hurt me.
Ex. You don't want to be uncooperative in your therapy so
that I will fail.

Therapist states that patient wants or has the intention of doing
such and such to the therapist (neutral intentions).

Ex. You want to change the time of our sessions.
Ex. You want to see me today.

Therapist disagrees with patient's statements about his
netral intentions towards the therapist.

Ex. You don't want to change the time of our sessions.
Ex. You don't want to see me today.

Patient's Motives or Intentions (recipient not specified)

99

100

101

102

Therapist states that patient wants or has the intention of doing
such and such. The recipient of the intention is not specified

(positive intention).

Ex. You want to care.
Ex. You have the intention of being nice.

Therapist disagrees with patient's statements about his positive

intentions.

Ex. You don't want to care.
Ex. You don't have the intention of being nice.

Therapist states that patient wants or has the intention of

doing such and such (negative intention). The recipient of the
intention is not specified. Therapist does not provide data for
his point.

Ex. You want to hurt.
Ex. You don't have the intention of being nasty.

Therapist disagrees with patient's statements about his negative

intentions.

Ex. You don't want to cause problems.
Ex. You don't have the intention of being nasty.

 

103

104
(Note:

(Note:

45

Therapist states that patient wants or has the intention of
doing such and such (neutral intention). The recipient of the
intention is not specified. Therapist does not provide data
for his point.

Ex. You have the desire to go to the play.
Ex. You want to clean your house.

(disagreement of neutral intention)

In the intention categories others includes all living things,
objects, or concepts. Family includes nuclear and extended
family. Therapist refers to the therapist studied in this
project.)

Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist states
that the patient does not want to hurt his family, but does not
specify or imply that the patient wants to help them, the neutral
category should be coded. If the therapist implies or states
positive intent, the statement should be scored under positive
attribution. The same applies for negations of positive
intentions. This instruction only refers to attribution
categories. Disagreement categories are scored in the usual
manner.)

External Behavior Attribution in Self

105

106

107

108

 

Therapist states that patient behaves in a certain way (positive
behavior). Therapist does not provide data.

Ex. You take care of your children.
Ex. You want to help your mother the other day.

Therapist disagrees with patient's statements that the patient
engaged in a specific behavior. Therapist does not provide data
for his point of view (positive behavior).

Ex. You don't care for your children. You hurt them.

Ex. You don't do the things that you are supposed to do at

your house. Don't tell me that you do.

Therapist states that patient behaves in a certain way (negative

behavior). Therapist does not provide data.

Ex. You hit your children.
Ex. You haven't been doing things that a mother is supposed
to be doing. You leave your children out in the streets.

Therapist disagrees with patient's statements that the patient
engaged in a specific behavior (negative behavior). Therapist
does not provide data.

Ex. You don't hit your children.
Ex. I know that you have been giving your children food even though
you say that you have not.

 

46

109 Therapist states that patient behaves in a certain way (neutral
behavior). Therapist does not provide data.

Ex. You went to work the other day.
Ex. You went for a walk with the other patient.

110 Therapist disagrees with patient's statements that the patient
engaged in a specific behavior (neutral behavior). Therapist
does not provide data.

Ex. I know that you didn't go to the store even though you
say that you did.

Ex. You didn't take a bath yesterday. Don't try to make me
think that you did.

Internal Behavior Attribution in Self

 

lll Therapist states that patient had certain feelings or thoughts
(ppsitive internal behavior). Therapist does not provide data.

 

Ex. You thought that you would go help your husband.
Ex. You feel certain about what you are doing.

112 Therapist disagrees with patient's statements about patient's
thoughts or feelings (positive internal behavior). Therapist
does not provide data.

 

Ex. You do not think that you are being cooperative.
Ex. You don't feel certain about what you are doing.

113 Therapist states that patient had or has certain feelings or
thought (negative internal behavior). Therapist does not
provide data.

 

Ex. You doubt constantly.
Ex. You thought about hurting your son.

114 Therapist disagrees with patient's statements about patient's
thoughts or feelings (negative internal behavior). Therapist
does not provide data.

 

Ex. No you didn't feel inferior the other day.
Ex. You have no thoughts about hurting your family. How
can you tell me that.

115 Therapist states that patient had or has certain thoughts or
feelings (neutral internal behavior). Therapist does not provide
data.

 

Ex. You have the feeling that you should go to the movie.
Ex. You think that you are talking to me at the moment.

 

47

116 Therapist disagrees with patient's statements about patient's
thoughts or feelings (neutral internal behavior). Therapist
does not provide data.

 

Ex. You are not thinking about going to 0.T. right now.
Ex. You do not feel that you are about to move to another
state.

(Note: The behavior categories refer to events which are more complicated
than the physical reality categories in that in the behavior
categories specific modes of perception cannot be clearly
inferred. This category includes external events that are
occurring or have occurred. It also includes internal feelings
or thoughts. If a feeling refers to affects, the affect
category should be coded. If intention or motivation is
mentioned, the motivation category should be coded.)

(Note: Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution
is implied or stated. For example, if the therapist indicates
that the patient does not feel inferior, but does not indicate
that he feels good, the neutral category should be coded. The
same applies to negations that concern negative material.
Disagreement categories should be scored in the usual manner.)

Hypothetical Situations

 

117 Therapist states that patient can or cannot have sensations or

erce tions. Therapist does not provide data for his point.
(See attached list of affects and code these)

Ex. You can hear the plane.
Ex. It is possible that you can see the woman across the
street.

118 Therapist disagrees with patient's statement about the possibility
of the patient experiencing or not experiencing sensations or

perceptions.

Ex. I know that it is possible that you can feel it if a bug
crawls on your feet.

Ex. You cannot feel that your body is dying. How could you
feel that?

119 Therapist states that patient can or cannot feel affects.
Therapist does not provide data. (See attached lists of affects
and code these)

Ex. You can't feel anger. It is not possible that you would
be able to feel this.
Ex. You could feel sadness.

 

120

121

122

123

124

125

126

(Note:

48

Therapist disagrees with patient's statement about the possibility
of the patient feeling or not feeling affect.

Ex. You could not feel empty.
Ex. It is not possible that you could feel good.

Therapist states the possibility of a positive patient- -self concept.
Therapist does not provide adequate data for his point.

 

Ex. You could be a nice person.
Ex. You can be a good person.

Therapist disagrees with patient's statements about the possibility
of a positive self concept in the patient.

Ex. You can't be a good person.
Ex. It is not possible that you could be an intelligent person.

Therapist states the possibility of a negative patient-self concept.

 

Therapist does not provide adequate data for his point.

Ex. You can be a totally incompetent person.
Ex. You could be an extremely dumb person.

Therapist disagrees with patient's statements about the
possibility of a negative self concept in the patient.

Ex. It is not possible that you could be dumb.
Ex. You cannot be incompetent.

Therapist states the possibility of a neutral patient-self concept.
Therapist does not provide adequate data for his point.

 

Ex. You could be a scholar.
Ex. You could be a business type.

Therapist disagrees with patient' 5 statements about the possibility
of a neutral self concept in the patient.

 

Ex. You could not be a business type. I don't know why you
think that would be possible.
Ex. You could not be an athletic type.

>

negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient could not be a dumb person, but does
not imply or state a positive emphasis, the statement should
be scored as neutral. The same applies to negations of
positive self-concept statements. These instructions apply
only to attributions. Disagreements are scored as usual.)

 

127

128

129

130

131

132
133

134

49

Therapist states that the patient could have a positive intention
or motivation toward himself (patient). Therapist does not
provide data for his assertion.

Ex.
Ex.

You could want to help yourself.
You can want to give yourself what you need.

Therapist disagrees with patient's statement of the possibility
of a positive intention or motivation toward himself (patient).

Ex.
Ex.

You cannot want to make things good for yourself.
It is not possible that you could want to get those

things that you need.

Therapist states that the patient could have a negative intention
or motivation toward himself (patient). Therapist does not
provide data for his assertion.

Ex. You could want to kill yourself.
Ex. It is possible that you have the desire to be nasty to
yourself.

Therapist disagrees with patient's statement of the possibility
of a negative intention or motivation toward himself.

Ex.
Ex.

You could not wish to kill yourself.
It is not possible that you have the desire to be nasty

to yourself even though you tell me that you do.

Therapist states that the patient could have a neutral intention
or motivation towards himself (patient). Therapist does not
provide data for his assertion.

Ex.
Ex.

You could want to give yourself a bath.
You could want to get that dress for yourself.

(disagreement of neutral intention)

Therapist states that the patient could have a positive intention
or motivation towards his family. Therapist does not provide
data for his assertion.

Ex.
Ex.

You could want to help your mother with her work.
You could want to show affection to your family.

Therapist disagrees with patient's statement of the possibility
of a positive intention or motivation towards his family.

Ex.

It is not possible that you would want to do nice things

for your children.

Ex.

I know that you would not want to care for your children.

 

135

136

137

138

139

140

141

142

50

Therapist states that the patient could have negative intentions
or motivations towards his family. Therapist does not provide
data for his assertion.

Ex. You could want to hit your children.
Ex. You could want to hate your family as much as possible.

Therapist disagrees with patient's statements of the possibility
of a negative intention or motivation towards his family.

Ex. You could not want to hit your children.
Ex. You could not want to hate your family as much as
possible even though you think that you do.

Therapist states that the patient could have neutral intentions
or motivations towards his family. Therapist does not provide
data for his assertion.

Ex. You could want to take your mother to the store.
Ex. You could want to take your son to a movie.

Therapist disagrees with patient's statements of the possibility
of a neutral intention or motivation towards his family.

Ex. You could not want to take your mother to the store.
Ex. You could not want to take your son to a movie.

Therapist states that the patient could have positive intentions
or motivations towards others.

Ex. You could want to be nice to your neighbor.
Ex. You could want to give affection to your friend.

Therapist disagrees with patient's statements of the possibility
of positive intentions or motivations towards others.

 

Ex. You could not want to be nice to your neighbor.
Ex. You could not want to give affection to your friend.

Therapist states that the patient could have negative intentions
or motivations towards others.

 

Ex. It is possible that you would want to kick the dog.
Ex. It is possible that you would want to be nasty to the
psychologist.

Therapist disagrees with patient's statements of the possibility
of negative intentions or motivations towards others.

Ex. You could not want to hit your friend.
Ex. You could not want to be hateful to the nurse.

 

143

144

145

146

147

148

149

51

Therapist states that the patient could have neutral intentions
or motivations towards others.

Ex. You could want to take the cat and go across the street.
Ex. You could want to show the other patient the ward.

Therapist disagrees with patient's statements of the possibility
of neutral intentions or motivations towards others.

Ex. You could not want to take the cat and go across the
street.

Ex. You could not want to show the other patient the ward
even though you tell me that you would want to do this.

Therapist states that the patient could have positive intentions
or motivations towards the therapist. Therapist does not give
data for his assertion.

Ex. You could want to like me.
Ex. You could want to try to help me by giving me information.

Therapist disagrees with patient's statements of the possibility
of positive intentions or motivations towards the therapist.

Ex. You could not want to do something nice for me.
Ex. You could not want to like me.

Therapist states that the patient could have negative intentions
or motivations towards the therapist. Therapist does not give
data for his assertion.

Ex. You could have feelings of wanting to hurt me.
Ex. You could want me to fail in this therapy so you could
get even with me.

Therapist disagrees with patient's statements of the possibility

of negative intentions or motivations towards the therapist.
Therapist does not give data for his assertion.

Ex. You could not have feelings of wanting to hurt me.
Ex. You could not want me to fail in this therapy. Why do
you tell me that you could want this?

Therapist states that the patient could have neutral intentions
or motivations towards the therapist. Therapist does not give
data for his assertions.

Ex. You could want to move my coat for me.
Ex. You could want to move the books off my table.

 

52

150 Therapist disagrees with patient's statements of the possibility
of neutral intentions or motivations towards the therapist.
Therapist does not give data for his assertion.

Ex. You could not want to move my coat for me.
Ex. You could not want to move my books off the table.

151 Therapist states that patient could have positive intentions
or motivations. The recipient of these intentions is not specified.
Therapist does not give data for his assertion.

Ex. You could want to care.
Ex. You could want to be nice.

152 Therapist disagrees with patient's statements of the possibility
of positive intentions or motivations. The recipient of these
intentions is not specified. Therapist does not give data for
his assertion.

 

Ex. You could not want to care.
Ex. You could not want to do nice things.

153 Therapist states that patient could have negative intentions or
motivations. The recipient of these intentions is not specified.
Therapist does not give data for his assertion.

Ex. You could want to engage in destructive behavior.
Ex. You could want to go around hurting or destroying.

154 Therapist disagrees with patient's statements of the possibility
of negative intentions or motivations. The recipient of these

intentions is not specified.

Ex. You could not want to engage in destructive behavior.
Ex. You could not want to go around hurting or destroying.

155 Therapist states that patient could have neutral intentions or
motivations. The recipient of these intentions is not specified.

Ex. You could have the desire to go to the play.
Ex. You could want to clean your house.

156 Therapist disagrees with patient's statements of the possibility
of neutral intentions. The recipient of these intentions is

not specified.

Ex. You could not have the desire to go to the play.
Ex. You could not want to clean your house.

(Note: Family refers to patient's nuclear and extended family. Others
refers to all living things, (but the family), objects, or
concepts. Therapist refers to the therapist being looked at
in this study.)

 

(Note:

157

158

159

160

161

162

163

53

Negations should be scored as neutral intentions unless a
positive or negative aspect is also stated or implied. For
example, if the therapist states that the patient w0u1d not
want to hurt his family, but does not state or imply a
positive intention, the neutral intention should be coded.)

Therapist states that patient could engage in positive external
behavior. Therapist does not provide data.

Ex. You could care for your children adequately.
Ex. You could do nice things for your husband.

Therapist disagrees with the patient's statement that the patient
could behave in a certain way (positive external behavior).
Therapist does not provide data for his statement.

 

Ex. You could not care for your children adequately.
Ex. You could not do nice things for your husband.

Therapist states that patient could engage in negative external

behavior. Therapist does not provide data.

Ex. You could hit your children everyday.
Ex. You could refuse to give your children food.

Therapist disagrees with the patient's statement that the patient
could behave in a certain way (pggative external behavior).

 

Ex. You could not be rude to the psychiatrist.
Ex. You could not refuse to talk to your son.

Therapist states that patient could engage in neutral external

behavior. Therapist does not provide data for his point.

Ex. You could walk across the yard with the other patient.
Ex. You could take your dog out for a walk.

Therapist disagrees with the patient's statement that the patient
could behave in a certain way (neutral external behavior).

 

Ex. You could not go over to the store.
Ex. You could not have your hair cut.

Therapist states that the patient could have certain thoughts
or feelings (positive internal behavior).

 

Ex. You could have thoughts of helping your mother.
Ex. You could feel certain about what you are doing.

 

164

165

166

167

168

(Note:

(Note:

169

54

Therapist disagrees about the possibility of the patient having
certain thoughts or feelings (positive internal behavior).

 

Ex. You could not have thoughts of providing care for your
children.
Ex. You could not have thoughts of being nice to your family.

Therapist states that the patient could have certain thoughts or
feelings (negative internal behavior).

Ex. You could think about hurting your father.
Ex. You could think about attacking me.

Therapist disagrees about the possibility of the patient having
certain thoughts or feelings (negative internal behavior).

Ex. You could not have thoughts about hurting your father. Why
do you tell me that you could?
Ex. You could not have thoughts about hurting me.

Therapist states that the patient could have certain thoughts or
feelings (neutral internal behavior).

 

Ex. You could not think about going to the play.
Ex. You could not think about reading the book.

Therapist disagrees about the possibility of the patient having
certain thoughts or feelings (neutral internal behavior).

 

Ex. You could not think about going to the play.
Ex. You could not think about reading the book.

Negations are coded under the neutral internal or external behavior
categories unless a positive or negative attribution is implied

or stated. For example, if the therapist indicates that the
patient could not feel inferior but does not indicate that the
patient could feel good, the neutral category should be coded.

The same applies to negations that concern negative material.
Disagreement categories should be scored in the usual manner.)

Since hypothetical situations are hypothetical it may be

difficult to judge whether or not mystification is occurring.

Look at the context of the session. Look at whether the therapist
has data to support his comments.

Therapist states that patient will or will not experience
sensations or perceptions. Therapist does not provide data for his

 

point. (See attached lists of sensations and code these)

Ex. You will hear the plane.
Ex. You will see your sister.

170

171

172

173

174

175

176

55

Therapist disagrees with patient's statement that the patient will
or will not experience sensations or perceptions. There is not
adequate data for the assertions.

 

Ex. You will feel the bug crawling across your foot. Don't
tell me that you will not.
Ex. You will not hear your mother's voice.

Therapist states that the patient will or will not feel affects.
(See attached list of affects and code these.

Ex. You will have feelings of sadness most of the time.
Ex. You will be angry at your family continuously.

Therapist disagrees with patient' 5 statement that the patient will
or will not experience certain affects.

Ex. You will not be feeling sad most of the time.
Ex. You will not be angry at your family continuously.

Therapist makes ositive statements about the patient as a person
(future time period).

Ex. You will be a good woman.
Ex. You will be a bright person.

Therapist disagrees with patient's ositive statements about the
patient as a person (future time period).

Ex. You will not be an adequate person even though you say
that you will.
Ex. You will not ever be normal.

Therapist makes ne ative statements about the patient as a person
(future time period).

Ex. You will always be crazy.
Ex. You will never be a good mother.

Therapist disagrees with patient's ne ative statements about the
patient as a person (future time period).

Ex. You will not be as abnormal as you are indicating.
Ex. You will not be a bad father.

Therapist makes neutral statements about the patient as a person
(future time period .

Ex. You will be a teacher.
Ex. You will be a talking person.

 

178

179

180

181

182

183

184

185

56

Therapist disagrees with patient's neutral statements about the
patient as a person (future time period .

Ex. You will not be a student.
Ex. You will not be a red haired person.

Therapist states that the patient will have positive intentions
or motivations towards himself.

Ex. You will want to help yourself after you leave the hospital.
Ex. You will want to be nice to yourself.

Therapist disagrees with patient's statements about positive
intentions or motivations towards himself.

Ex. You will not want to be kind to yourself.
Ex. You will not want to provide for your needs.

Therapist states that the patient will have negative intentions or
motivations towards himself.

Ex. You will always want to hurt yourself.
Ex. You will always want to think that you are bad.

Therapist disagrees with patient's statements about negative
intentions or motivations towards himself.

Ex. You will not want to be destructive towards yourself.
Ex. You will not always want to feel that you are inferior.

Therapist states that the patient will have neutral intentions or
motivations towards himself.

Ex. You will always want to fix your dress.
Ex. You will always want to comb your hair at a certain time.

Therapist disagrees with patient's statements about neutral
intentions or motivations towards himself.

Ex. You will not always want to fix your dress.
Ex. You will not always want to comb your hair at a certain
time.

Therapist states that the patient will have positive intentions or
motivations towards his family.

Ex. You will want to go over and help your mother with the
garden.
Ex. You will want to be nice to your sister.

 

186

187

188

189

190

191

192

193

57

Therapist disagrees with patient' 5 statements about positive
intentions or motivations towards his family.

Ex. You will not want to be affectionate towards your husband.
Ex. You will not want to prepare the food for your children.

Therapist states that the patient will have negative intentions or
motivations towards himself.

Ex. You will have the desire to hurt your uncle.
Ex. You will want to be nasty to your grandfather.

Therapist disagrees with patient's statements about negative
intentions or motivations towards his family.

Ex. You will not want to go about doing unkind things to your
family. Why do you tell me that you will have such a
motivation?

Therapist states that the patient will have neutral intentions or
motivations towards his family.

Ex. You will want to fix fish for your family instead of
chicken.

Therapist disagrees with patient's statements about neutral
intentions or motivations towards his family.

Ex. You will not want to fix fish for your family instead of
chicken.

Therapist states that the patient will have positive intentions
or motivations towards others.

 

Ex. You will want to help your neighbor take care of her
children.

Ex. You will have the desire to be with your friend when he
needs you.

Therapist disagrees with patient's statements about positive
intentions or motivations towards others.

 

Ex. You will not want to help your friend with his work.
Ex. You will not want to help your neighbor take care of
her children.

Therapist states that the patient will have negative intentions
or motivations towards others.

Ex. You will have the impulse to hurt the psychologist.
Ex. You will want to hit the doctor.

 

194

195

196

197

198

199

200

201

58

Therapist disagrees with patient's statements about negative
intentions or motivations towards others.

Ex. You will not want to hurt the psychologist even though
you think that you will.
Ex. You will not want to hit the doctor.

Therapist states that the patient will have neutral intentions
or motivations towards others.

Ex. You will want to help your friend pick out a dress.
Ex. You will want to show your friend the new buildings.

Therapist disagrees with patient's statements about neutral
intentions or motivations towards others.

Ex. You will not want to help your friend pick out a dress.
Ex. You will not want to show your friend the new buildings.

Therapist states that the patient will have positive intentions
or motivations towards the therapist.

Ex. You will want to be nice to me if you see me in the future.
Ex. You will want to have good thoughts about me.

Therapist disagrees with patient's statements about positive
intentions or motivations towards the therapist.

Ex. You will not want to be nice to me if you see me in
the future.
Ex. You will not want to have good thoughts about me.

Therapist states that the patient will have negative intentions
or motivations towards the therapist.

Ex. You will have the desire to be rude to me in the future.
Ex. You will have the impulse to hit me.

Therapist disagrees with patient's statements about negative
intentions or motivations towards the therapist.

Ex. You will not have the desire to be rude to me in the future.
Ex. You will not have the impulse to hit me.

Therapist states that the patient will have neutral intentions or
motivations towards the therapist.

Ex. You will want to move my plants to a different place.
Ex. You will want to put my book on the table.

202

203

204

205

206

207

208

(Note:

59

Therapist disagrees with patient's statements about neutral
intentions or motivations towards the therapist.

Ex. You will not want to move my plants to a different place.
Ex. You will not want to put my book on the table.

Therapist states that patient will have positive intentions or
motivations. The recipient of the intentions is not specified.

Ex. You will want to love.
Ex. You will want to do nice things.

Therapist disagrees with patient's statements about positive
intentions or motivations. The recipient of the intention is

not specified.

Ex. You will not want to love.
Ex. You will not want to do nice things.

Therapist states that patient will have negative intentions
or motivations. The recipient of the intentions is not specified.

Ex. You will want to go around being angry most of the time.
Ex. You will want to be destructive.

Therapist disagrees with patient's statements about negative
intentions or motivations. The recipient of the intention is

not specified.

Ex. You will not want to go around being angry most of the
time.
Ex. You will not want to be destructive.

Therapist states that patient will have neutral intentions or
motivations. The recipient of the intention is not specified.

Ex. You will want to go to the store.
Ex. You will want to study math.

Therapist disagrees with patient's statements about neutral
intentions or motivations. The recipient of the intention is

not specified.

Ex. You will not want to go to the store.
Ex. You will not want to study math.

Family refers to patient's nuclear or extended family. Others
refers to all living things, objects, concepts. Therapist
refers to the therapist in this study.)

 

60

(Note: Negations are scored as neutral intentions unless otherwise
stated or implied. If the therapist states that the patient
does not want to hurt anyone but does not add that the patient
wants to help, the statement would be coded under neutral. This
instruction applies to attributions. Disagreements are scored
as usual.)

209 Therapist states that patient will do such and such, (positive
behavior). Therapist does not provide data for his assertion.

Ex. You will go over and give some money to your children.
Ex. You will listen to your daughter when she needs you.

210 Therapist disagrees with the patient's statement that the patient
will do such and such (positive behavior).

Ex. You will not help your mother with her work.
Ex. You will not give your son food.

211 Therapist states that patient will do such and such (negative
behavior).

Ex. You will go around yelling at your neighbors.
Ex. You will hit your children.

212 Therapist disagrees with the patient's statement that the patient
will do such and such (negative behavior).

Ex. You will not go around yelling at your neighbor.
Ex. You will not hit your children.

213 Therapist states that patient will do such and such (neutral
behavior .

Ex. You will go walking in the mountains.
Ex. You will learn to sew.

214 Therapist disagrees with the patient's statements that the
patient will do such and such (neutral behavior).

Ex. You will not go get the book at the store.
Ex. You will not paint landscapes.

215 Therapist states that patient will have certain thoughts or
feelings (positive internal behavior).

Ex. You will think that things are O.K. for you.
Ex. You will feel that you are doing nice things.

216 Therapist disagrees with the patient's statements that the patient
will have certain thoughts or feelings (positive internal behav1or).

Ex. You will not think that things are O.K. for you.
Ex. You will not feel that you are doing nice things.

 

61

217 Therapist states that patient will have certain thoughts or
feelings (negative internal behavior).

Ex. You will feel that you have been destructive to your
children.
Ex. You will think that you hit people all of the time.

218 Therapist disagrees with the patient's statements that the patient
will have certain thoughts or feelings (negative internal behavior).

Ex. You will not think that you have been a bad mother.
Ex. You will not think that you hit people all of the time.

219 Therapist states that patient will have certain thoughts or
feelings (neutral internal behavior).

Ex. You will think about going to swim quite often.

220 Therapist disagrees with the patient's statements that the patient
will have certain thoughts or feelings (neutral internal behavior).

 

Ex. You will not think about going to swim.

(Note: Negations are scored as neutral unless a positive or negative
element is stated or implied. For example, if the therapist
states that patient will not hurt her children but does not
imply or state that she will care for them, the statement
should be scored as neutral. This note only applies to
attributions. Disagreements are scored as usual.)

Attributions About Causation of Patient's Illness

 

221 Therapist states that such and such caused the patient to become
crazy when it is not evident that this is the case. Therapist
does not provide adequate data to justify his assertion.

Ex. Your mother made you crazy.
222 (disagreement about causation of patient's illness)

Disagreements Concerning Opinions and Judgments

223 Therapist disagrees with patient's opinion or judgment without
providing adequate data to justify his disagreement.

Ex. It is not the case that you should be out of the hospital.

Therapist's Presumed Omnipotence

 

224 Therapist indicates that he knows all about the patient or that
he is all knowing.

Ex. I know all about what you're thinking. I can tell you
all about your life.

 

62
225 Therapist states that he will have ultimate control over the
patient's life.

Ex. You cannot move to another state. I won't let you.
Ex. You cannot have any more children. I will not permit it.

World Seen as Punishing Agent for Wishes or Desires

226 Therapist states that world will punish patient for wishes and
desires. Therapist does not present data to indicate his
reasoning.

Ex. Your wish for love can only bring trouble.
Ex. You should not have sexual feelings or you will be punished.

Part Mystification - Psychic Reality and Therapist's Presumed
Consensually Validated Reality

 

 

227 This category represents the therapist's attempts to acknowledge
the patient's psychic reality at the same time that he overrides
this reality with his own views. This category differs from pure
mystification in that the patient's reality is recognized.
However, the patient's reality is not accepted. Therapist does
not provide data for his point or his point is not apparent to
the observer.

Ex. I know how you feel, but the woman did not break into
your house.

(Note: Part mystification is given a weight of 1. Pure mystification
is given a weight of 2.)

(Note: If part mystification occurs, add this as a second score to the
other categories so that it is clear whether the part
mystification is behavior, intention, affect, etc.)

 

63

Family Attributions
(nuclear and extended family)

Family Effect

228

229

230

231

232

233

234

235

236

Therapist states that patient's family felt or feels fear or
anxiety or does not feel fear or anxiety when it is not clear
whether or not this is the case. The therapist does not present
data for his position.

Ex. Your mother was frightened.

Therapist disagrees about patient's statement of fear or anxiety
or lack of fear and anxiety in his family.

Ex. I know that your father is not anxious.

Therapist states that patient's family feels anger or does not
feel anger when it is not clear whether or not this is the case.

Ex. Your cousin was not angry.

Therapist disagrees about patient's statement of anger or lack of
anger in his family. Therapist does not provide data.

Ex. Your mother had feelings of anger last week.

Therapist states that patient's family feels or does not feel
startled when it is not clear whether or not this is the case.

Ex. Your brother is not startled.

Therapist disagrees about patient's statement of a family member
being or not being startled.

Ex. Your mother was not startled last night.

Therapist states that patient's family feels or does not feel
surprised when it is not clear whether or not this is the case.

Ex. Your grandfather was surprised to see you.

Therapist disagrees about patient's statement of surprise or lack
of surprise in his family.

Ex. Your grandfather was not surprised. You know that.
Therapist states that patient's family feels or does not feel
distress-anguish when it is not clear whether or not this is
the case.

Ex. Your mother is in constant anguish.

 

237

238

239

240

241

242

243

244

245

246

64
Therapist disagrees about patient's statement of his family
being or not being distressed. Therapist does not provide data.

Therapist states that patient's family feels or does not feel
disgust when it is not clear whether or not this is the case.

Ex. Your father is disgusted with you.

Therapist disagrees with patient's statement of his family being
or not being disgusted. Therapist does not provide data.

Ex. Your father is not disgusted.

Therapist states that patient's family feels or does not feel
envious when it is not clear whether or not this is the case.

Ex. Your mother is envious of your wealth.

Therapist disagrees with patient's statement of his family being
or not being envious. Therapist does not provide data.

Ex. Your sister is not envious. You just imagine that.

Therapist states that patient's family feels or does not feel
jealous when it is not clear whether or not this is the case.

Ex. Your cousin was jealous of you and your wife.

Therapist disagrees with patient' 5 statement of his family being
or not being jealous. Therapist does not provide data.

Ex. Your cousin is jealous. Don't tell me that he is not.

Therapist states that patient's family feels or does not feel
sadness when it is not clear whether or not this is the case.

Ex. Your aunt is not sad.

Therapist disagrees with patient's statement of his family being
or not being peg, Therapist does not provide data.

Ex. Your grandfather is sad about you being in here.

Therapist states that patient's family feels or does not feel
shame when it is not clear whether or not this is the case.

Ex. Your father feels shame about you.

Therapist disagrees with patient's statement of his family being
or not being ashamed.

Ex. Your family is ashamed. Don't tell me that they are not.

 

248

249

250

251

252

253

254

255

256

257

65
Therapist states that patient's family feels or does not feel
guilt when it is not clear whether or not this is the case.
Ex. Your family has no feelings of guilt.

Therapist disagrees with patient's statement of his family feeling
or not feeling guilty.

Ex. Your grandmother does feel guilty.
Therapist states that patient's family feels or does not feel
happiness or joy when it is not clear whether or not this is the
case.

Ex. Your family is feeling happy that you are doing better.

Therapist disagrees with patient's statement of his family feeling
or not feeling happiness or joy.

Ex. Your father is not happy. Don't try to think that he is.

Therapist states that patient's family feels or does not feel
excited when it is not clear whether or not this is the case.

Ex. Your mother is excited that you are going home from the
hospital.

Therapist disagrees with patient's statement of his family feeling
or not feeling excitement. Therapist does not provide data.

Ex. Your mother never is excited. You are wrong.

Therapist states that patient's family feels or does not feel
hatred when it is not clear whether or not this is the case.

Ex. Your mother hates you.

Therapist disagrees with patient's statements of his family feeling
or not feeling hatred. Therapist does not provide data.

Ex. Your mother does not hate.

Therapist states that patient's family feels or does not feel
love when it is not clear whether or not this is the case.

Ex. Your family loves you.

Therapist disagrees with patient's statements of his family
feeling or not feeling love. Therapist does not provide data.

Ex. Your father does not love anything.

 

 

258

259

260

261

262

263

264

265

266

66

Therapist states that patient's family feels or does not feel
positive affects in general when it is not clear whether or not
this is the case.

Ex. Your father feels good about life.
Therapist disagrees with patient's statements of his family feeling
or not feeling positive affects in general. Therapist does not
provide data.

Ex. Your father does feel good about life.
Therapist states that patient's family feels or does not feel
negative affects in general when it is not clear whether or not
this is the case.

Ex. Your brother felt bad for quite some time.
Therapist disagrees with patient's statements of his family feeling

or not feeling negative affects in general. Therapist does not
provide data.

 

Ex. Your brother feels bad. Don't say that he doesn't.

Therapist states that patient's family feels or does not feel

confusion or craziness when it is not clear whether or not this

is the case.

Ex. Your family feels confused a lot.
Therapist disagrees with patient's statements of his family
feeling or not feeling confusion or craziness. Therapist does not
provide data.

Ex. Your mother was not confused last night.

Therapist states that patient's family feels or does not feel
emptiness when it is not clear whether or not this is the case.

Ex. Your cousin felt empty for several years.

Therapist disagrees with patient's statements of his family
feeling or not feeling emptiness. Therapist does not provide data.

Ex. No one in your family feels empty.

Therapist states that patient's family feels or does not feel
loneliness when it is not clear whether or not this is the case.

Ex. Your father never feels lonely.

267

268.

269

270

271

67

Therapist disagrees with patient's statements of his family
feeling or not feeling lonely. Therapist does not provide
data.

Ex. Your mother always feels lonely. You know that.

Therapist states that patient's family feels or does not feel
hope when it is not clear whether or not this is the case.

Ex. Your father has hope. That is extremely important.

Therapist disagrees with patient's statements of his family
feeling or not feeling hope. Therapist does not provide data.

Ex. Your father does have hope. There is no point in you
indicating otherwise.

Therapist states that patient's family feels or does not feel
anything when it is not clear whether or not this is the case.

Ex. Your sister is able to feel nothing.

Therapist disagrees with patient's statements of his family feeling
or not feeling anything. Therapist does not provide data.

Ex. Your whole family feels nothing.

Family Concept

272

273

274

275

276

Therapist makes positive statements about patient's family as
people without providing data for his view.

Ex. Your mother is a good woman.

Therapist disagrees with patient's statement of patient's views
of his family as people (positive views .

 

Ex. Your mother is not a good woman.

Therapist makes negative statement about patient's family as
people without providing data for his view.

Ex. Your mother is a bitch.

Therapist disagrees with patient's statement of patient's views
of his family as people (negative views).

 

Ex. Your father is not the bad person that you say.

Therapist makes neutral statement about patient's family pg
people without providing data for his view.

Ex. Your family is a busy family.

 

277

(Note:

(Note:

68

Therapist disagrees with patient's statement of patient's views
of his family as people (neutral views).

Ex. Your mother is not an artist.

The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is not
specified. Ex.. "Your mother is not a crazy person.“ The
therapist says that the mother is not crazy. He does not go
on to specify something positive or negative. For example,
he does not go on to say that the mother is healthy.)

The family concept category applies to enduring characteristics
over time. For example if the therapist states that the mother
is crazy and an enduring characteristic is stated or implied,
the family concept category should be scored. If the therapist
states that the mother is engaging in crazy behavior or is
feeling crazy, then the behavior or affect category is scored.)

Family's Motives or Intentions

 

278

279

280

281

282

283

Therapist states that patient's family has the intention of doing
such and such to the patient (positive intention).

Ex. Your mother wants to understand you.

Therapist disagrees with patient's statement about his family's
intentions or motivation towards him (positive intention).

Ex. Your mother does not want to help you.

Therapist states that patient's family has the intention of doing
such and such to the patient (negative intention).

Ex. Your cousin wants to have you do his work.

Therapist disagrees with patient's statements about his family's

intentions towards him (negative intention).

Ex. Your family does not want to hurt you. You just think
that.

Therapist states that patient's family has the intention of doing
such and such to the patient (neutral intention).

Ex. Your mother wants to bring you your dress.

Therapist disagrees with patient's statements about his family's
intentions or motivations towards him (neutral intentions).

Ex. Your mother does not want to bring you your dress.

 

284

285

286

287

288

289

(Note:

69

Therapist states that patient's family has the intention of doing
such and such (positive intention). Recipient is anyone but the
patient or recipient may not be specified.

Ex. Your sister wants to care.

Therapist disagrees with patient's statements about his family's
intentions or motivations (positive intention). Recipient is
anyone but the patient or recipient may not be specified.

Ex. Your father does not want to care about your brother.

Therapist states that patient's family has the intention of doing
such and such (negative intention). Recipient is anyone but the
patient or recipient may not be specified.

Ex. Your uncle wants to be desrtuctive.

Therapist disagrees with patient's statements about his family's
intentions or motivation (negative intention). Recipient is
anyone but the patient or recipient may not be specified.

Ex. Your father does not have the impulse to be rude.

Therapist states that patient's family has the intention of doing
such and such (neutral intention). Recipient is anyone but the
patient or recipient may not be specified.

Ex. Your brother wants to see his friend.

Therapist disagrees wfith patient's statements about his family's
intentions or motivations (neutral intention). Recipient is
anyone but patient or recipient may not be specified.

Ex. Your brother does not want to go to the movie. Why do
you tell me that he does? -

Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist states
that the patient's family does not want to hurt the patient,
but does not specify or imply that the family wants to help him,
the neutral category should be coded. If the therapist implies
or states positive intent, the statement should be scored under
positive attributions. The same applies for negations of
positive intentions. This instruction only refers to
attribution categories. Disagreement categories are scored in
the usual manner.)

External Behavior Attribution in Family

 

290

Therapist states that patient's family behaves in a certain way
(positive behavior). Therapist does not provide data for his
points.

Ex. Your mother has been doing nice things.

 

291

292

293

294

295

70

Therapist disagrees with patient's statements that the patient's
family engaged in specific behaviors. Therapist does not provide
data for his point of view (positive behavior).

Ex. Your father has not been taking care of you even though
you think that he has.

Therapist states that patient's family behaves in a certain way

(negative behavior). Therapist does not provide data for his
points.

Ex. Your mother hit your brother.
Therapist disagrees with patient's statements that the patient's
family engaged in specific behaviors. Therapist does not provide
data for his point of view (negative behaviors).

Ex. Your mother did not talk nasty to you.
Therapist states that patient's family behaves in a certain way
(neutral behavior). Therapist does not provide data for his
points.

Ex. Your father went to work the other day.
Therapist disagrees with patient's statements that the patient's
family engaged in specific behaviors. Therapist does not provide
data for his point of view (neutral behavior).

Ex. Your father did not go to work the other day. Why do you
tell me that he did?

Internal Behavior Attribution in Family

 

296

297

298

Therapist states that patient's family had certain feelings or
thoughts (positive internal behavior). Therapist does not provide
data for his points.

 

Ex. Your mother felt that she cared for you.

Therapist disagrees with patient's statements about patient's
family's thoughts or feelings (positive internal behavior).

Ex. Your mother does not think about doing nice things for you.
Therapist states that patient's family has certain feelings or

thoughts (negative internal behavior). Therapist does not provide
data for his points.

 

Ex. Your mother feels that she is no good.

 

299

300

301

(Note:

(Note:

71

Therapist disagrees with patient's statements about patient's
family's thoughts or feelings (negative internal behavior).
Therapist does not provide data for his points.

 

Ex. Your mother does not feel that she is no good.

Therapist states that patient' 5 family has certain feelings or
thoughts (neutral internal behavior). Therapist does not provide
data for his points.

 

Ex. Your brother thinks about his math.

Therapist disagrees with patient's statements about patient's
family's thoughts or feelings (neutral internal behavior).

Ex. Your sister has not been thinking about physics.

The behavior categories refer to events which are more
complicated than the physical reality categories in that in
the behavior categories specific modes of perception cannot be
clearly inferred. This category includes external events that
are occurring or have occurred. It also includes internal
feelings or thoughts. If a feeling refers to affects, the
affect category should be coded. If intention or motivation
is mentioned, the motivation category should be coded.)

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution
is implied or stated. For example, if the therapist indicates
that the patient's family does not feel inferior, but does not
indicate that they feel good, the neutral category should be
coded. The same applies to negations that concern negative
meterial. Disagreement categories should be scored in the
usual manner.)

Hypothetical Situations

 

302

303

304

Therapist states that patient' 5 family can or cannot feel affects.
Therapist does not provide data for his view. (See attached list
of affects and code these)

Ex. Your mother could be angry.

Therapist disagrees with patient's statements about the
possibility of the patient's family feeling or not feeling affect.

Ex. Your mother could not feel empty.

Therapist states the possibility of a positive family concept.
Therapist does not provide data for his point.

 

Ex. Your father could be a nice person.

 

305

306

307

308

309

(Note:

310

311

312

72

Therapist disagrees with patient's statement of the possibility
of a positive family concept.

 

Ex. Your mother could not be a good person.

Therapist states the possibility of a negative family concept.
Therapist does not provide data for his point.

 

Ex. Your sister could be a stupid woman.

Therapist disagrees with patient's statement of the possibility
of a negative family concept.

Ex. Your sister could not be a stupid woman.

Therapist states the possibility of a neutral family concept.
Therapist does not provide data for his point.

Ex. Your family could be a busy family.

Therapist disagrees with patient's statement of the possibility
of a neutral family concept.

 

Ex. Your family could not be a busy family.

A negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient's brother could not be a dumb person,
but does not imply or state a positive emphasis, the statement
should be scored as neutral. The same applies to negations
of positive family concept statements. These instructions
apply to attributions. Disagreements are scored as usual.)

Therapist states that the patient's family could have a positive
intention or motivation toward the patient. Therapist does not

 

provide data for his assertion.

Ex. Your family could want to help you.
Therapist disagrees with patient's statement of the possibility
that patient's family could have a positive intention or motivation
toward the patient. Therapist does not provide data for his
assertion.

Ex. Your family could not want to help you.

Therapist states that the patient's family could have a negative
intention or motivation toward the patient. Therapist does not

 

provide data for his assertion.

Ex. Your mother could want to see you remain crazy.

 

313

314

315

316

317

318

319

73

Therapist disagrees with patient's statement of the possibility
that patient's family could have a negative intention or motivation
toward the patient. Therapist does not provide data for his
assertion.

 

Ex. Your mother could not want to see you remain crazy.

Therapist states that the patient's family could have a neutral
intention or motivation toward the patient. Therapist does not
provide data for his assertion.

Ex. Your aunt could want to take you over to visit some
friends.

Therapist disagrees with patient's statement of the possibility
that patient's family could have a neutral intention or motivation
toward the patient. Therapist does not provide data for his
assertion.

 

Ex. Your aunt could not want to take you over to visit some
friends.

Therapist states that the patient's family could have a positive
intention or motivation. Recipient of the intention is anyone other

than the patient or recipient may not be specified.

Ex. Your family could want to help your brother.

 

Therapist disagrees with patient's statement of the possibility
that patient's family could have a positive intention or motivation.
Recipient of the intention is anyone other than the patient or

recipient may not be specified.

Ex. Your family could not want to help your brother.

 

 

Therapist states that the patient's family could have a negative
intention or motivation. Recipient of the intention is anyone other

than the patient or recipient may not be specified. Therapist does
not provide data for his assertion.

 

Ex. Your family could want to be destructive.

Therapist disagrees with patient's statement of the possibility
that patient's family could have a negative intention or motivation.
Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data
for his assertion.

 

 

Ex. Your family could not want to be destructive.

 

320

321

(Note:

322

323

324

325

326

74

Therapist states that the patient's family could have a neutral
intention or motivation. Recipient of the intention is anyone
other than the patient or recipient may not be specified. Therapist
does not provide data for his assertion.

 

 

Ex. Your mother could want to go visiting.

Therapist disagrees with patient's statement of the possibility

that patient's family could have a neutral intention or motivation.
Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data for
his assertion.

 

 

Ex. Your mother could not want to go visiting.

Negations should be scored as neutral intentions unless a positive
or negative aspect is also stated or implied. For example,

if the therapist states that the patient's family does not

want to hurt the patient, but does not state or imply a positive
intention, the neutral intention should be coded.)

Therapist states that the patient's family could engage in
positive external behavior. Therapist does not provide data.

 

Ex. Your mother could care for her children adequately.

Therapist disagrees with the patient's statement that the patient's
family could behave in a certain way (positive external behavior).
Therapist does not provide data for his statement.

 

Ex. Your mother could not care for her children adequately.

Therapist states that the patient's family could engage in
negative external behavior. Therapist does not provide data.

 

Ex. Your brother could go around making people feel bad.
Therapist disagrees with the patient's statement that the patient's
family could behave in a certain way (negative external behavior).
Therapist does not provide data for his statement.

Ex. Your brother could not go around making people feel
bad. You just think that.

Therapist states that the patient's family could engage in neutral
external behavior. Therapist does not provide data.

Ex. Your mother could go visiting.

 

327

328

329

330

331

332

333

(Note:

75

Therapist disagrees with patient's statement that the patient's
family could behave in a certain way (neutral external behavior).
Therapist does not provide data for his statements.

 

Ex. Your mother could not go visiting.
Therapist states that the patient's family could have certain
thoughts or feelings (positive internal behavior). Therapist
does not provide data.

Ex. Your cousin could think nice things about you.

Therapist disagrees with patient's statement that the patient's
family could have certain thoughts or feelings (positive internal

behavior). Therapist does not provide data for his statements.

Ex. Your cousin could not think nice things about you.

Therapist states that the patient's family could have certain
thoughts or feelings (negative internal behavior). Therapist
does not provide data.

 

Ex. Your mother could feel that she is not a good person.

Therapist disagrees with patient's statement that the patient's
family could have certain thoughts or feelings (negative internal

behavior). Therapist does not provide data for his statements.

Ex. Your mother could not feel that she is not a good person.

Therapist states that the patient's family could have certain
thoughts or feelings (neutral internal behavior). Therapist
does not provide data.

 

Ex. Your mother could have been thinking that she needs to
go to the store.

Therapist disagrees with patient's statements that the patient's
family could have certain thoughts or feelings (neutral internal
behavior). Therapist does not provide data for his statements.

Ex. Your mother could not have been thinking that she needs
to go to the store. Don't tell me that.

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution
is implied or stated. For example, if the therapist indicates
that the patient's mother could not feel inferior but does not
indicate that she could feel good, the neutral category should
be coded. The same applies to negations that concern negative
material. Disagreement categories should be scored in the
usual manner.)

 

76

(Note: Since hypothetical situations are hypothetical it may be
difficult to judge whether or not mystification is occurring.
Look at the context of the session. Look at whether the
therapist has data to support his comments.)

334 Therapist states that the patient's family will or will not feel
affects. (See attached list of affects and code these)

Ex. Your father will have feelings of sadness most of the
time.

335 Therapist disagrees with patient's statement that the family will
or will not experience certain affects.

Ex. Your father will not have feelings of sadness most of
the time.

336 Therapist makes ositive statement about the patient's family as a
family (future time period).

Ex. Your mother will be a good woman.
337 Therapist disagrees with patient's ositive statements about his
family as a family (future time period). Therapist does not provide
data.

Ex. Your mother will not be a good woman.

338 Therapist makes ne ative statements about the patient's family as
a family (future time period).

Ex. Your mother will be a mystifying woman.

339 Therapist disagrees with patient's ne ative statements about the
patient's family as a family (future time period).
Ex. Your mother will not be a mystifying woman. You just

imagine that.

340 Therapist makes neutral statements about the patient's family as
a family (future time period).

Ex. Your father will be a busy man.

341 Therapist disagrees with patient's neutral statements about the
patient's family as a family (future time period).

Ex. Your father will not be a busy man.
342 Therapist states that patient's family will have a positive intention
or motivation toward the patient. Therapist does not provide data
for his assertion.

Ex. Your uncle will want to be nice to you.

 

343

344

345

346

347

348

349

350

77

Therapist disagrees with patient's statement that the patient's
family will have a positive intention or motivation toward the
patient. Therapist does not provide data for his assertion.

Ex. Your uncle will not want to be nice to you.

Therapist states that patient's family will have a negative
intention or motivation toward the patient. Therapist does not
provide data for his assertion.

Ex. Your child will want to hit you.

Therapist disagrees with patient's statement that the patient's
family will have a negative intention or motivation toward the
patient. Therapist does not provide data for his assertion.

Ex. Your child will not want to hit you.

Therapist states that patient's family will have a neutral intention
or motivation toward the patient.

Ex. Your sister will want you to wear the blue dress instead
of the green dress.

Therapist disagrees with patient's statement that the patient's
family will have a neutral intention or motivation toward the
patient. Therapist does not provide data for his assertion.

Ex. Your sister will not want you to wear the blue dress
instead of the green dress. You do not know what you are
talking about.

Therapist states that patient's family will have a positive
intention or motivation. The recipient of the intention is anyone
other than the patient or the recipient may not be specified.
Therapist does not provide data for his assertion.

 

Ex. Your daughter will want to help her father.

Therapist disagrees with patient's statement that the patient's
family will have a positive intention or motivation. The
recipient of the intention is anyone other than the patient or
the recipient may not be specified. Therapist does not provide
data for his assertions.

Ex. Your brother will want to be kind.

Therapist states that patient's family will have a negative
intention or motivation. The recipient of the intention is anyone
other than the patient or the recipient may not be specified.
Therapist does not provide data for his assertion.

 

Ex. Your mother will want to be evil.

 

351

352

353

(Note:

354

355

356

357

78

Therapist disagrees with patient's statement that the patient's
family will have a negative intention or motivation. The recipient
of the intention is anyone other than the patient or the recipient
may not be specified. Therapist does not provide data for his
assertion.

 

Ex. Your mother will not want to be evil. You think that
all the time.

Therapist states that patient's family will have a neutral intention
or motivation. The recipient of the intention is anyone other than
the patient or the recipient may not be specified. Therapist does
not provide data for his assertion.

Ex. Your mother will want to work in the family garden.

Therapist disagrees with patient's statement that the patient's
family will have a neutral intention or motivation. The recipient
of the intention is anyone other than the patient or the recipient
may not be specified. Therapist does not provide data for his
assertion.

 

Ex. Your mother will not want to sew her dress.

Negations should be scored as neutral intentions unless a positive
or negative aspect is also stated or implied. For example, if

the therapist states that the patient's family will not want to
hurt the patient, but does not state or imply a positive intention,
the neutral intention should be coded.

Therapist states that the patient's family will engage in positive

external behavior. Therapist does not provide data.

Ex. Your mother will care for her children adequately.

Therapist disagrees with the patient's statement that the patient's
family will behave in a certain way (positive external behavior).
Therapist does not provide data for his statement.

 

Ex. Your mother will not care for her children adequately.

Therapist states that the patient's family will engage in negative

external behavior. Therapist does not provide data.

Ex. Your brother will go around making people feel bad.
Therapist disagrees with the patient's statement that the patient's
family will behave in a certain way (negative external behavior).
Therapist does not provide data.

Ex. Your brother will not go around making people feel bad.

 

358

359

360

361

362

363

364

365

(Note:

79
Therapist states that the patient's family will engage in neutral
external behavior. Therapist does not provide data.
Ex. Your mother will go visiting.
Therapist disagrees with the patient's statement that the patient's

family will behave in a certain way (neutral external behavior).
Therapist does not provide data.

 

Ex. Your mother will not go visiting.

Therapist states that the patient's family will have certain thoughts
or feelings (ppsitive internal behavior). Therapist does not
provide data.

 

Ex. Your cousin will think nice things about you.

Therapist disagrees with patient's statement that the patient's
family will have certain thoughts or feelings (positive internal
behavior). Therapist does not provide data for his statements.

Ex. Your cousin will not think nice things about you.
Therapist states that the patient's family will have certain thoughts

or feelings (negative internal behavior). Therapist does not
provide data.

 

Ex. Your mother will feel that she is not a good person.

Therapist disagrees with patient's statement that the patient's
family will have certain thoughts or feelings (negative internal
behavior). Therapist does not provide data for his statements.

Ex. Your mother will not feel that she is not a good person.
Therapist states that the patient's family will have certain

thoughts or feelings (neutral internal behavior). Therapist
does not provide data.

 

Ex. Your mother will think that she needs to go to the store.

Therapist disagrees with patient's statements that the patient's
family will have certain thoughts or feelings (neutral internal
behavior). Therapist does not provide data for his statements.

Ex. Your mother will not think that she needs to go to the
store.

Negations are coded under neutral internal or external behavior
categories unless a positive or negative attribution is implied
or stated. For example, if the therapist indicates that the
patient's mother will not feel inferior but does not imply
or state that she will feel good, the neutral category should
be coded. The same applies to negations that concern negative

 

 

 

81

Attributions in Others Besides Patient's Family
(all living things {other than family},
objects, or concepts)

 

Affect in Others

366

367

368

369

370

371

372

373

Therapist states that a person felt or feels fear or anxiety or
does not feel fear or anxiety when it is not clear whether or not
this is the case. Therapist does not present data for his
position.

Ex. Your friend was frightened.

Therapist disagrees with patient's statement of fear or anxiety
or lack of fear or anxiety in others.

Ex. I know that your friend is not anxious.
Therapist states that a person felt or feels anger or does not
feel anger when it is not clear whether or not this is the case.
Therapist does not present data for his position.

Ex. The man across the street is not angry.

Therapist disagrees with patient's statement of anger or lack of
anger in others.

Ex. The psychologist had feelings of anger last week.

Therapist states that a person felt or feels startled or does not feel

startled when it is not clear whether or not this is the case.

Therapist does not present data for his position.
Ex. Your friend is not startled.

Therapist disagrees with patient's statement of another person
being or not being startled.

Ex. Your friend was not startled last night.
Therapist states that a person felt or feels or does not feel
surprised when it is not clear whether or not this is the case.
Therapist does not present data for his position.

Ex. The psychiatrist was surprised to see you.

Therapist disagrees with patient's statement of another person
being or not being surprised.

Ex. The social worker was not surprised. You know that.

 

374

375

376

377

378

379

380

381

382

383

82
Therapist states that a person feels or does not feel distress-
anguish when it is not clear whether or not this is the case.
Ex. Your friend is not in constant anguish.

Therapist disagrees with patient's statement of another person
feeling or not feeling distress-anguish.

Ex. Your friend is in constant anguish. Don't tell me that
he is not.

Therapist states that a person feels or does not feel disgust when
it is not clear whether or not this is the case.

Ex. Your lover is disgusted with you.

Therapist disagrees with patient's statement of another person
feeling or not feeling disgust. Therapist does not provide data.

Ex. Your lover is not disgusted with you.

Therapist states that a person feels or does not feel envious when
it is not clear whether or not this is the case.

Ex. The scientist is envious of the artist.

Therapist disagrees with patient's statement of another person
feeling or not feeling envious. Therapist does not provide data.

Ex. Your friend is not envious. You just imagine that.

Therapist states that a person feels or does not feel jealous
when it is not clear whether or not this is the case.

Ex. Your friend is jealous of your relationship with your
lover.

Therapist disagrees with patient's statement of another person
feeling or not feeling jealOus. Therapist does not provide
data.

Ex. Your friend is jealous. Don't tell me that he is not.

Therapist states that a person feels or does not feel gpg when
it is not clear whether or not this is the case.

Ex. Your dog is sad about you being in here.

Therapist disagrees with patient's statement of another person
feeling or not feeling Egg. Therapist does not provide data.

Ex. The psychiatrist is going through some sadness right now.
Don't deny that.

 

384

385

386

387

388

389

390

391

392

393

83

Therapist states that a person feels or does not feel shame when
it is not clear whether or not this is the case.

Ex. The student feels shame because of the exam.

Therapist disagrees with patient's statement of another person
feeling or not feeling shame. Therapist does not provide data.

Ex. The patients were ashamed. Don't tell me that they were
not.

Therapist states that another person feels or does not feel guilt
when it is not clear whether or not this is the case.

Ex. The psychiatrist has no feelings of guilt.

Therapist disagrees with patient's statement of another person
feeling or not feeling guilt. Therapist does not provide data.

Ex. The plant does feel guilty.
Therapist states that another person feels or does not feel
happiness or joy when it is not clear whether or not this is the
case.

Ex. The teacher is feeling happy that school is out.
Therapist disagrees with patient's statement of another person
feeling or not feeling happiness or joy. Therapist does not provide
data.

Ex. Your friend is not happy. Don't try to think that he is.

Therapist states that another person feels or does not feel excited
when it is not clear whether or not this is the case.

Ex. The nurse is excited that you are going home from the
hospital.

Therapist disagrees with patient's statement of another person
feeling or not feeling excitement. Therapist does not provide data.

Ex. The doctor is never excited. You are wrong.

Therapist states that another person feels or does not feel hatred
when it is not clear whether or not this is the case.

Ex. The attendant has hated for a long time.

Therapist disagrees with patient's statement of another person
feeling or not feeling hatred. Therapist does not provide data.

Ex. The psychiatrist does not hate you even though he gave you
all that medicine. How can you tell me that he does.

 

394

395

396

397

398

399

400

401

402

84

Therapist states that another person feels or does not feel love
when it is not clear whether or not this is the case.

Ex. The woman feels love.

Therapist disagrees with patient's statements of another person
feeling or not feeing love. Therapist does not provide data.

Ex. The woman does not feel love.
Therapist states that another person feels or does not feel positive
affects in general when it is not clear whether or not this is the
case.

Ex. Your friend feels good about life.
Therapist disagrees with patient's statements of another person
feeling or not feeling positive affects in general. Therapist
does not provide data.

Ex. Your friend does feel good about life no matter what you
think.

Therapist states that another person feels or does not feel negative

affects in general when it is not clear whether or not this is the

case.
Ex. The artist felt bad for quite some time.
Therapist disagrees with patient's statements of another person
feeling or not feeling negative affects in general. Therapist
does not provide data.
Ex. The potter has never felt bad.

Therapist states that another person feels or does not feel
confusion or craziness when it is not clear whether or not this

 

is the case.

Ex. The biologist feels confused a lot.
Therapist disagrees with patient's statements of another person
feeling or not feeling confusion or craziness. Therapist does not
provide data.

Ex. The lady on the ward was not confused last night.

Therapist states that another person feels or does not feel
emptiness when it is not clear whether or not this is the case.

Ex. Your friend felt empty for several years.

 

85

403 Therapist disagrees with patient's statements of another person
feeling or not feeling empty. Therapist does not provide data.

Ex. Everyone that you know feels empty. You know that.

404 Therapist states that another person feels or does not feel lonely
when it is not clear whether or not this is the case.

Ex. The man never feeds lonely.

405 Therapist disagrees with patient's statements of another person
feeling or not feeling lonely. Therapist does not provide data.

Ex. Your friend always feels lonely. You know that.

406 Therapist states that another person feels or does not feel hope
when it is not clear whether or not this is the case.

Ex. The new patient feels hope.

407 Therapist disagrees with patient's statements of another person
feeling or not feeling hope. Therapist does not provide data.

Ex. Your friend does have hope. There is no point in you
indicating otherwise.

408 Therapist states that another person feels or does not feel anything
when it is not clear whether or not this is the case.

Ex. The other patient is able to feel nothing.

409 Therapist disagrees with patient's statements of another person
feeling or not feeling anything. Therapist does not provide this.

Ex. All of your friends feel nothing.

Person Concept

410 Therapist makes positive statements about others as people
without providing data for his view.

Ex. Your friends are intelligent people.

411 Therapist disagrees with patient's statement of patient's views
of others as people (positive views).

 

Ex. The psychiatrist is not a good person.

412 Therapist makes negative statements about others as people without
providing data for 515 v1ew.

Ex. Your friend is cruel.

 

413

414

415

(Note:

(Note:

Other'

86

Therapist disagrees with patient's statement of patient's views of
others as people (negative views).

 

Ex. Your friend is not cruel.

Therapist makes neutral statement about others as people
without providing data for his views.

Ex. The man is a busy man.

Therapist disagrees with patient's statement of patient's views
of others as people (neutral views). Therapist does not provide
data.

Ex. The man is not a busy man.

The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is
not specified. Ex., ”Your friend is not a crazy person.”

The therapist says that the friend is not crazy. He does not
go on to specify something positive or negative. For example
he does not go on to say that the friend is healthy.)

The person concept category applies to enduring characteristics
over time. For example, if the therapist states that the
friend is crazy and an enduring characteristic is stated or
implied, the person concept category should be scored. If
the therapist states that the friend is engaging in crazy
behavior or is feeling crazy, then the behavior or affect
category is scored.)

s Motives or Intentions Towards Patient

 

416

417

418

Therapist states that a person has the intention of doing such and
such to the patient (positive intention). Therapist does not
provide data.

 

Ex. The social worker wants to understand you.

Therapist disagrees with patient's statement about a person's
intentions or motivations toward the patient (positive intention).
Therapist does not provide data.

 

Ex. Your friend does not want to help you.

Therapist states that a person has the intention of doing such and
such to the patient (negative intention). Therapist does not
provide data.

 

Ex. Your friend wants to have you do his work.

419

420

421

422

423

424

425

426

87

Therapist disagrees with patient's statement about a person's
intentions or motivations toward the patient (negative intentions).
Therapist does not provide data.

 

Ex. Your friend does not want to hurt you. You just think
that.

Therapist states that a person has the intention of doing such and
such to the patient (neutral intention). Therapist does not
provide data.

Ex. The woman wants to bring you your dress.

Therapist disagrees with patient's statements about a person's
intentions or motivations toward the patient (neutral intention).
Therapist does not provide data.

Ex. The woman does not want to bring you your dress.

Therapist states that a person has the intention of doing such
and such (positive intention). Recipient is anyone but the patient
or recipient may not be specified.

Ex. The man wants to care.

Therapist disagrees with patient's statements about a person's
intentions or motivations (positive intention). Recipient is
anyone but the patient or recipient may not be specified.

Ex. Your friend does not care about his wife.

Therapist states that a person has the intention of doing such
and such (negative intention). Recipient is anyone but the patient
or recipient may not be specified.

Ex. The psychologist wants to be destructive.

Therapist disagrees with patient's statements about a person's
intentions or motivations (negative intention). Recipient is
anyone but the patient or recipient may not be specified.

Ex. The psychologist does not want to be destructive.
Therapist states that a person has the intention of doing such
and such (neutral intention). Recipient is anyone but the
patient or recipient may not be specified.

Ex. Your friend wants to see the woman on the ward.

 

88

427 Therapist disagrees with patient's statements about a person's
intentions or motivations (neutral intentions). Recipient is
anyone but the patient or recipient may not be specified.

Ex. Your friend does not want to see the woman on the ward.
You want to see her.

(Note: Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist states
that a person does not want to hurt the patient, but does not
specify or imply that the person wants to help him, the
neutral category should be coded. If the therapist implies or
states positive intent, the statement should be scored under
positive attributions. The same applies for negations of
positive intentions. This instruction only refers to attribution
categories. Disagreement categories are scored in the usual
manner.)

(Note: This category does not apply to intentions or motivations in the
therapist. The therapist can know what his own intentions or
motivations are.)

(Note: Others refers to any living thing, objects, or concepts. Even
though most of the examples have been of people, objects and
concepts can be coded as well.)

External Behavior Attribution in Others

428 Therapist states that others behave in a certain way (positive
behavior). Therapist does not provide data for his points.

Ex. The world has been doing nice things.

429 Therapist disagrees with patient's statements that others engaged
in specific behaviors. Therapist does not provide data for his

points (positive behavior).

Ex. The hospital has not been taking care of you even though
you think that it has.

430 Therapist states that others behave in a certain way (negative
behavior). Therapist does not provide data for his po1nts.

Ex. Your friend hit the woman across the street.

431 Therapist disagrees with patient's statements that others engaged
in specific behaviors. Therapist does not provide data for his

points (negative behavior).

Ex. Your friend did not hit the woman across the street.

 

432

433

89
Therapist states that others behave in a certain way (neutral
behavior). Therapist does not provide data for his point.
Ex. The patient went to work the other day.
Therapist disagrees with patient's statements that others engaged
in specific behaviors. Therapist does not provide data for his

points (neutral behavior).

Ex. The woman did not go to get the red dress. Don't tell
me that she did.

Internal Behavior Attribution in Others

434

435

436

437

438

439

 

Therapist states that others had certain thoughts or feelings
(positive internal behavior). Therapist does not provide data
for his points.

 

Ex. The doctor felt that she cared for you.

Therapist disagrees with patient's statements about other's
thoughts or feelings (positive internal behavior).

 

Ex. Your friend does not think about doing nice things for
you.

Therapist states that others had certain thoughts or feelings
(negative internal behavior). Therapist does not provide data
for his points.

 

Ex. The patient feels that she is no good.

Therapist disagrees with patient's statements about other's
thoughts or feeling (negative internal behaviors). Therapist
does not provide data for h1s p01nts. .

 

Ex. The patient does not feel that she is no good.

Therapist states that others had certain thoughts or feelings
(neutral internal behavior). Therapist does not provide data
for his points.

 

Ex. Your friend thinks about his math.

Therapist disagrees with patient's statements about other's
thoughts or feelings (neutral internal behavior). Therapist does
not provide data for his points.

 

Ex. The student has not been thinking about physics.

 

(Note:

(Note:

90

The behavior categories refer to events which are more complicated
than the physical reality categories in that in the behavior
categories specific modes of perception cannot be clearly
inferred. This category includes external events that are
occurring or have occurred. It also includes internal feelings
or thoughts. If a feeling refers to affects, the affect category
should be coded. If intention or motivation is mentioned, the
motivation category should be coded.)

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution

is implied or stated. For example, if the therapist indicates
that a person does not feel inferior, but does not indicate that
he feels good, the neutral category should be coded. The same
applies to negations that concern negative material. This
instruction only applies to attribution. Disagreement categories
should be scored in the usual manner.)

Hypothetical Situations

440

441

442

443

444

445

446

Therapist states that others can or cannot feel affects. Therapist
does not provide data for his views. (See attached list of affects
and code these)

Ex. The nurse could be angry.

Therapist disagrees with patient's statement about the possibility
of others feeling or not feeling affect.

Ex. The world could not feel empty.

Therapist states the possibility of a positive person concept.
Therapist does not provide data for his point.

Ex. The woman could be an intelligent woman.

Therapist disagrees with patient's statement of the possibility
of a positive person concept.

 

Ex. This hospital could not be a good place.

 

Therapist states the possibility of a pegative person concept.
Therapist does not provide data for his point.

Ex. Your friend could be a stupid man.

Therapist disagrees with the patient's statement of the
possibility of a negative person concept.

Ex. Your friend could not be a stupid man.

Therapist states the possibility of a neutral person concept.
Therapist does not provide data for his point.

Ex. Your friend could be a busy person.

 

91

447 Therapist disagrees with patient's statement of the possibility
of a neutral person concept. Therapist does not provide data for
his point.

 

Ex. Your friend could not be a busy person.

(Note: A negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient's friend could not be a dumb person,
but does not imply or state a positive emphasis, the statement
should be scored as neutral. The same applied to negations of
positive person concept statements. These instructions a ply
only to attributions. Disagreements are scored as usual.)

448 Therapist states that a person could have a positive intention
or motivation toward the patient. Therapist does not provide
data for his assertion.

Ex. The world could want to help you.

449 Therapist disagrees with patient's statement of the possibility
that a person could have a positive intention or motivation toward
the patient. Therapist does not provide data for his assertion.

Ex. The world could not want to help you.

450 Therapist states that a person could have negative intentions
or motivations toward the patient.

Ex. People could want to see you remain crazy.

451 Therapist disagrees with patient's statement of the possibility
that a person could have a negative intention or motivation
toward the patient.

Ex. People could not want to see you remain crazy.

452 Therapist states that a person could have neutral intentions or
motivations toward the patient.

Ex. Your friend could want to talk to you on Tuesday instead
of Monday.

4

01

3 Therapist disagrees with patient's statement of the possibility
that a person could have a neutral intention or motivation toward
the patient. Therapist does not provide data for his assertion.

Ex. That man could not want to take you over to visit some
friends.

 

454

455

456

457

458

459

(Note:

460

92

Therapist states that a person could have a positive intention or
motivation. Recipient of the intention is not specified or is
anyone other than the patient.

 

Ex. The social worker could want to help the woman.

Therapist disagrees with patient's statement of the possibility
that a person could have positive intentions or motivations.
Recipient of the intention is anyone other than the patient or
recipient may not be specified.'

 

 

Ex. The hospital could not want to help that woman.

Therapist states that a person could haven negative intentiOns or
motivations. Recipient of the intention is not specified or is
__yone other than the patient.

Ex. The hospital could want to be destructive.
Therapist disagrees with patient's statement of the possibility

that a person could have negative intentions or motivations.
Recipient of the intention is anyone other then the patient or

recipient may not be specified.

Ex. The hospital could not want to be destructive.

 

Therapist states that a person could have neutral intentions or
motivations. Recipient of the intention is not spec1fied or is
anyone other than the patient.

 

Ex. Your friend could want to go visiting.

Therapist disagrees with patient's statement of the possibility
that a person could have neutral intentions or motivations.
Recipient of the intention is anyone other than the patient or

recipient may not be specified.

Ex. Your friend could not want to go visiting.

 

Negations should be scored as neutral intentions unless a
positive or negative aspect is also stated or implied. For
example, if the therapist states that a person could not want
to hurt the patient, but does not state or imply a positive
intention, the neutral intention should be coded.)

Therapist states that a person could engage in positive external
behavior. Therapist does not provide data.

Ex. The patient could care for her children adequately.

 

461

462

463

464

465

466

467

468

469

93

Therapist disagrees with the patient's statement that a person
could behave in a certain way (positive external behavior).
Therapist does not provide data for his statement.

 

Ex. The patient could not care for her children adequately.

Therapist states that a person could engage in negative external

behavior. Therapist does not provide data.

Ex. Your friend could go around making people feel bad.

Therapist disagrees with the patient's statement that a person
could behave in a certain way (negative external behavior).
Therapist does not provide data for his statement.

 

Ex. The doctor could not go around making people feel bad.
You just think that.

Therapist states that a person could engage in neutral external

behavior. Therapist does not provide data.

Ex. The man could go visiting.

Therapist disagrees with the patient's statement that a person
could behave in a certain way (neutral external behavior).
Therapist does not provide data.

 

Ex. The man could not go visiting.

Therapist states that a person could have certain thoughts or
feelings (positive internal behavior). Therapist does not provide
data.

 

Ex. Society could think nice things about you.

Therapist disagrees with the patient's statement that a person
could have certain thoughts or feelings (positive internal behavior).
Therapist does not provide data.

 

Ex. Society could not think nice things about you. You just
think that.

Therapist states that a person could have certain thoughts or
feelings (negative internal behavior). Therapist does not provide
data.

 

Ex. Your friend could not feel that she is a good person.

Therapist disagrees with the patient's statement that a person
could have certain thoughts or feelings (negative internal behavior).
Therapist does not provide data.

Ex. The doctor could feel that he is O.K. You don't know what
you are talking about.

 

470

471

(Note:

(Note:

(Note:

472

473

474

475

94

Therapist states that a person could have certain thoughts or
feelings (neutral internal behavior). Therapist does not provide
data.

Ex. The woman across the street could have been thinking that
she need to go to the store.

Therapist disagrees with the patient's statement that a person could
have certain thoughts or feelings (neutral internal behavior).
Therapist does not provide data for his statements.

 

Ex. The woman across the street could not have been thinking
that she needs to go to the store. Don't tell me that.

Negations are coded under neutral internal or external behavior
categories unless a positive or negative attribution is implied
or stated. For example, if the therapist indicates that a
person could not feel inferior but does not indicate that he
could feel good, the neutral category should be coded. The
same applies to negations that concern negative material. This
instruction only applies to attribution categories. Disagreement
categories should be scored in the usual manner.)

Since hypothetical situations are hypothetical it may be
difficult to judge whether or not mystification is occurring.
Look at the context of the session. Look at whether the
therapist has data to support his comments.)

The thought or feeling (internal behavior) category does not
apply to specific affects. If specific affects are stated the
material should be coded under the affect category.)

Therapist states that a person will or will not feel affects.
(See attached list of affects and code these)

Ex. Your friend will have feelings of sadness most of the
time.

Therapist disagrees with patient's statement that a person will or
will not experience certain affects.

Ex. Your friend will not have feelings of sadness most of the
time.

Therapist makes positive statement about a person as a person

(future time period . Therapist does not provide data.

Ex. Your friend will be a good friend.
Therapist disagrees with patient's ositive statements about a
person as a person (future time period). Therapist does not
provide data.

Ex. Your friend will be a good friend. You should know that.

 

476

477

478

479

480

481

482

483

484

95

Therapist makes negative statement about a person as a person

(future time period . Therapist does not provide data.
Ex. The woman across the street will be a mystifying woman.

Therapist disagrees with patient's ne ative statements about a
person as a person (future time period). Therapist does not provide
data.

Ex. The psychiatrist will not be a mystifying woman.
Psychiatrists are not like that. You just imagine that.

Therapist makes neutral statement about a perSOn aS'a person
(future time period). Therapist does not prov1de data.

Ex. Your friend will not be a busy person.

Therapist disagrees with patient's neutral statements about a

person as a person (future time period). Therap1st does not
provide data.

Ex. Your friend will not be a busy person. Don't tell me
that he will be a busy person.

Therapist states that a person will have a positive intention or
motivation toward the patient. Therapist does not provide data
for his assertion.

Ex. The new patient will want to be nice to you.

Therapist disagrees with patient's statement that a person will
have a positive intention or motivation toward the patient.
Therapist does not provide data for his assertion.

Ex. The world will not want to be nice to you.

Therapist states that a person will have a negative intention or
motivation toward the patient. Therapist does not provide data
for his assertion.

Ex. Your friend will want to hit you.

Therapist disagrees with patient's statement that a person will
have a negative intention or motivation toward the patient.
Therapist does not provide data for his assertion.

Ex. Your friend will not want to hit you. Don't talk about
that in therapy.

Therapist states that a person will have a neutral intention or
motivation toward the patient. Therapist does not provide data
for his assertion.

Ex. The lady will want to wear the blue dress instead of the
red dress.

 

485

486

487

488

489

490

491

96

Therapist disagrees with patient's statement that a person will
have neutral intentions or motivations toward the patient.

Ex. The lady will not want to wear the blue dress instead of
the green dress. You do not know what you are talking about.

Therapist states that a person will have positive intentions or
motivations. The recipientlafthe intention 15 an one other than
the patient or the recipient may not be specified. Therapist does
not provide data for his assertions.

 

Ex. Your friend will want to help his daughter.

Therapist disagrees with patient's statement that a person will
have positive intentions or motivations. The recipient of the
intention is anyone other than the patient or the recipient may not
be specified. Therapist does not provide data for B15 assert1ons.

 

Ex. Your friend will not want to help his daughter.

Therapist states that a person will have negative intentions or
motivations. The recipient of the intention is anyone other than
the patient or the recipient may not be specified. Therapist does
not provide data for his assertions.

 

Ex. The world will want to be evil.

Therapist disagrees with patient's statement that a person will
have negative intentions or motivations. The recipient of the
intention is anyone other than the patient or the recipient may
not be specified. Therapist does not provide data for his
assertion.

 

Ex. Your friend will not want to be evil. You think that all
the time.

Therapist states that a person will have neutral intentions or
motivations. The recipient of the intention is anyone other than
the patient or the recipient may not be specified.

Ex. The woman will want to work in the garden.

Therapist disagrees with patient's statement that a person will have
neutral intentions or motivations. The recipient of the intention
is anyone other than the patient or the recipient may not be

specified.

Ex. The woman will not want to work in the garden.

 

 

97

(Note: Negations should be scored as neutral intentions unless a
positive of negative aspect is also stated or implied. For
example, if the therapist states that a person will not want
to hurt the patient, but does not state or imply a positive
intention, the neutral intention should be coded. This
instruction refers only to attribution categories.
Disagreement categories are scored as usual.)

(Note: Person refers to any living thing, object, or concept.)

492 Therapist states that a person will engage in pOSitive external
behavior. Therapist does not provide data.

Ex. Your friend will care for his children adequately.
493 Therapist disagrees with the patient's statement that a person
will behave in a certain way (positive external behavior .
Therapist does not provide data.

Ex. Your friend will not care for his children adequately.

494 Therapist states that a person will engage in negative external
behavior. Therapist does not provide data.

Ex. The man will go around making people feel bad.
495 Therapist disagrees with the patient's statement that a person

will behave in a certain way (pegative external behavior).
Therapist does not provide data.

 

Ex. The man will not go around making people feel bad.

496 Therapist states that a person will engage in neutral external
behavior. Therapist does not provide data.

Ex. Your friend will go visiting.

497 Therapist disagrees with the patient's statement that a person
will behave in a certain way (neutral external behavior).
Therapist does not provide data.

Ex. Your friend will not go visiting.
498 Therapist states that a person will have certain thoughts or

feelings (positive internal behavior). Therapist does not provide
data.

 

Ex. The social worker will think nice things about you.
499 Therapist disagrees with patient's statement that a person
will have certain thoughts or feeling (positive internal behavior).

Therapist does not provide data for his statements.

Ex. The social worker will not think nice things.

 

500

501

502

503

(Note:

(Note:

(Note:

98

Therapist states that a person will have certain thoughts or

feelings (negative internal behavior). Therapist does not

provide data.
Ex. Your friend will feel that he is bad.
Therapist disagrees with patient's statement that a person

will have certain thoughts or feelings (negative internal behavior).
Therapist does not provide data.

 

Ex. Your friend will not feel that he is bad.

Therapist states that a person will have certain thoughts or
feelings (neutral internal behavior). Therapist does not provide
data.

 

Ex. The woman across the street will think that she needs to
go to the store. ‘

Therapist disagrees with patient's statement that a person will
have certain thoughts or feeling (neutral internal behavior).
Therapist does not provide data.

 

Ex. The woman across the street will not think that she needs
to go to the store.

Negations are coded Under neutral internal or external behavior
categories unless a positive or negative attribution is implied
or stated. For example, if the therapist indicates that a
person will not feel inferior but does not imply or state that
he will feel good, the neutral category should be coded. The
same applies to negations that concern negative material. This
instruction only applies to attributions. Disagreement
categories should be scored in the usual manner.)

If the therapist states that a particular affect will be felt,
the affect category should be coded rather than the internal
behavior category.)

Person refers to all living things, objects, or concepts. The
word person is only used to simplify the language. Person,
however, does not include the patient's family.)

 

99

Patient Attributions and Inconsistent Therapist Behavior

Attributions Concerning Patient Responsibility

504

(Note:

Therapist indicates that patient is responsible for dream material.
Therapist criticizes or withdraws from the material or in other
ways does not deal with the material as a dress.

Ex. You should not have dreams about the man being a clown.
That is rude.

Ex. I don't want to hear such filthy material. How could
you dream about such things.

Most material concerning patient responsibility is scored under
the intention or motivation category. For example, if the
therapist states that the patient does not mean it when the
patient says that he is angry, the therapist is implying that
the patient does not have the intention of being angry.)

Content-Tone of Voice Inconsistency

 

505

506

507

508

509

510

511

512

513

514

Therapist states that he feels or does not feel a certain affect.
Therapist's tone of voice is inconsistent with content. (See
attached list of affects and code these)

Therapist states positive intention toward patient. Tone of voice
is inconsistent w1th content.

 

Therapist states negative intention toward patient. Tone of voice
is inconsistent with content.

Therapist states neutral intention towards patient. Tone of voice
is inconsistent with content.

Therapist states positive intention towards patient's family. Tone
of voice is inconsistent with content.

Therapist states negative intention towards patient's family. Tone
of voice is inconsistent with content.

Therapist states neutral intention towards patient's family. Tone
of voice is inconsistent with content.

Therapist states positive intention towards others. Tone of voice
is inconsistent with content.

Therapist states negative intention towards others. Tone of voice
is inconsistent with content.

Therapist states neutral intention towards others. Tone of voice
is inconsistent with content.

 

515

516

517

518

519

520

521

522

523

524

(Note:

100

Therapist states positive intentions. Recipient is not specified.
Tone of voice is inconsistent with content.

Therapist states negative intention. Recipient is not specified.
Tone of voice is inconsistent with content.

Therapist states neutral intention. Recipient is not specified.
Tone of voice is inconsistent with content.

Therapist states that he engages in pesitive external behaviors.
Tone of voice is inconsistent with content.

Therapist states that he engages in negative external behavior.
Tone of voice is inconsistent with content.

Therapist states that he engages in neutral external behavior.
Tone of voice is inconsistent with content.

Therapist states that he feels or thinks a certain thing
(positive internal behavior). Tone of voice is inconsistent with
content.

 

Therapist states that he feels or thinks a certain thing (negative

internal behavior). Tone of voice is inconsistent with content.

Therapist states that he feels or thinks a certain thing (neutral

internal behavior). Tone of voice is inconsistent with content.

Any therapist statement in which the content is inconsistent with
the tone of voice and which does not fit previous content—tone of
voice categories.

All of the above content-tone of voice categories apply to the
past, present, and future. The above categories also apply to
hypothetical situations or conditional events. In other words,
all time periods specified in this coding system are included.)

Therapist Inconsistency or Contradictions Within a Coding Statement

 

525

Therapist makes contradictory statements within a coding unit.
Inconsistency is judged by the content of the message.

Ex. It's O.K. for you to be involved in religion, but it
does not help you. I'm not against you being involved in
religion.

(The therapist is placing his values on the patient but does
not directly acknowledge that this is occurring. There are a
number of implicit contradictions.)

Ex. A lot of things that happen to you are delusional, but I
believe you that this happened even though you are often
delusional.

 

101

(The therapist is saying that he does and does not believe this
patient.)

Paradoxical Therapist Statements

 

526 Therapist's statements within a coding unit represent a paradox.
Paradox may not be represented by explicit content. One must think
about the coding unit as a whole to get a sense of the unit. For
example, the therapist may tell the patient to be independent but
treat him as dependent. The therapist may tell the patient that
they are equals but treat him as inferior.

Contaminated or Confgsed Categories

 

527 Therapist confuses or contaminates categories. For example, the
therapist mentions the mother's cock. The male organ is
contaminated with the concept of the mother. Instead of saying
the mother's breast the therapist says the mother's cock.

528 (contaminated or confused statements in general)

(Note: This is a therapist contamination. It is not a response to a
patient contamination. If the patient has spoken of the
mother's cock, and the therapist responds to this, the material
should not be coded here.)

(note: This category does not apply to standard psychoanalytic
interpretations such as the mother's breast or the father's
breast.)

Levels of Communication

 

529 Therapist abruptly switches level of communication without
acknowledging switch or without making use of interpretation to
make the switch. Thus patient and therapist end up on different
existential levels. '

Ex. Patient talks about feelings of loneliness in an
existential sense. Therapist talks about whether anyone is
present on a concrete level. The patient's existential
position is not acknowledged.

Change of Subject

530 Therapist changes subject. The therapist does not openly state
that a change of subject is occurring, or the change of subject is
not part of an interpretation in which the therapist is trying to
go deeper.

Ex. Patient: I have no money. Someone stole it.
Therapist: How was it for you when you were in the first
grade?

 

531

102

Therapist does not change the subject at the beginning of his
statement, but changes subject within the coding unit.

Ex. You grew up on the South. The sun is hot there. Why have
you been hitting people on the ward?

Attributions Concernipg Shoulds

 

532

533

534

535

536

(Note:

Therapist states that the patient should or should not experience
a particular sensation or perception. (See attached coding sheet
for sensations and perceptions and code these.)

Ex. You should not feel pain.
Therapist states that the patient should or should not experience
a particular affect. (See attached coding sheet for affects and
code these.)

Ex. You should not feel anger.

Therapist states that the patient should or should not feel or
think a certain thing.

Ex. You should think about feeling good.

Therapist states that the patient should or should not have
particular intentions or motivations.

Ex. You should not have the intention of being nasty.

Therapist states that the patient should or should not have
certain self concept.

Ex. You should not feel like you are a bad person.
The should categories apply to present, past, future, and

conditional tense. In other words, the categories apply to
all the time periods considered in this coding system.)

Disqualification of Importance of Material

 

537

538

Therapist states that what the patient says is of no consequence.
Therapist does not provide data.

Ex. I don't give a damn about that. I don't care about it.

Therapist reduces patient's statement to imagination, fantasy,
illness. Therapist does not provide data.

Ex. What you say is merely your imagination.

 

 

Perceptions and Sensations

 

g;¢g..n.3-m -h(D CLO U'QJ

visual perception

auditory perception

tactile perception

olfactory perception

gustatory perception
kinesthetic perception

pain perception

hotness or coldness perceptions
sexual sensations

perception of time

overall body state

external or internal physical reality in general

Affects

N‘<><E<CC+M‘S.O'UOSE

fear or anxiety

anger

startle

surprise

distress-anguish

disgust

envy

jealousy

sadness

shame

quilt

happiness or joy
excitement

hatred

love

positive affects in general
negative affects in general
confusion or craziness
emptiness

loneliness

hope

not able to feel anything (nothingness)

 

105

Mystification Scale
(childhood and adolescence)

Childhood and adolescence - this part of the scale applies to

 

phenomena through childhood and adolescence.

Coding unit - complete therapist statement between two complete patient

statements.

Therapist statement is rated after preceding patient statement. When
determining coding unit disregard mm's, mmhm's.

Context - complete psychotherapy session

External and Internal Physical Reality
(includes past perceptions in childhood and adolescence)

540

541

542

543

544

Therapist attributes a visual perception or lack of visual
perception to the patient when there is no data to indicate that
this attribution is accurate.

Ex. The man was there. You saw him when you were a child.
Ex. The man was not there. You did not see him when you were
a child.

Therapist disagrees with patient's visual perception when it is
clear whether or not patient's perception is accurate.

Ex. You did not see the woman walk across the street when you
were six years old.

Ex. You did see the woman walk across the street when you
were six years old

Therapist attributes an auditory perception or lack of auditory
perception to the patient when there is no data to indicate that
this attribution is accurate.

 

Ex. You heard the nurse talking to you when you were a child.
Ex. You did not hear the man walk across the room when your
mother died.

Therapist disagrees with patient's auditory perception or lack of
auditory perception when it is not clear whether or not patient‘s
perception is accurate.

 

Ex. Your aunt talked to you when you were little.
Ex. Your grandfather did not say anything. You did not hear
him.

Therapist attributes a tactile perception or lack of tactile per-
ception to the patient when there is no data to indicate that this
attribution is accurate.

Ex. You felt her touch you when you were eight.
Ex. A bug did not crawl across your feet at that time.

 

545

546

547

548

549

550

551

552

106

Therapist disagrees with patient's tactile perception when it is
not clear whether or not patient's perception is accurate.

Ex. You did feel a flower that day.
Ex. You did feel the floor after you broke your leg when you
were a child.

Therapist attributes an olfactory perception or lack of olfactopy
perception to the patient when thére is no data to indicate that
this attribution is correct.

 

Ex. You smelled smoke that year.
Ex. You did not smell perfume.

Therapist disagrees with patient's olfactory 'perCeption when it
is not clear whether or not patient's perception 1s accurate.

Ex. There was no skunk smell outside.
Ex. You did smell perfume.

Therapist attributes a gg§tatory perception or lack of gustatory
perception to the patient when there is no data to indicate that
this attribution is accurate.

 

Ex. You did not taste salt in the pudding when your mother
made it for you.
Ex. You tasted the food you ate as a child.

Therapist disagrees with patient's gustatory perception when it is
not clear whether or not the patient's perception is accurate.

Ex. You did not taste sugar.
Ex. You did not taste milk when you were a baby.

Therapist attributes a kinesthetic perception or lack of kinesthetic

 

perception to the patient when there is no data to indicate that
this attribution is accurate.

Ex. You felt like you were moving when you were going to sleep
as a child.
Ex. You did not feel that you were traveling through space.

Therapist disagrees with patient's kinesthetic perception when it is
not clear whether or not patient's perception is accurate.

 

Ex. You did not feel that your leg was moving.
Ex. You did not feel that you moved out of your body when
you were an adolescent.

Therapist attributes a pain perception or lack of pain perception
to the patient when there is no data to indicate that this attri-
bution is accurate. (Note: This category involves physical and
not psychological pain.)

 

 

 

553

554

555

556

557

558

559

107

Ex. You did not feel like nails were sticking in you when
you hurt youself.
Ex. You were not in constant pain as a child.

Therapist disagrees with patient's pain perception when it is
not clear whether or not patient's perception is accurate.

Ex. You were not in pain.
Ex. Yourleg didn't constantly hurt you when you were growing up.

Therapist attributes a perception of hotness or coldness or lack
of perception of hotness or coldness to the patient when there is
no data to indicate that th1s attr1bution is accurate.

Ex. You did not feel cold.
Ex. You did feel as if it were extremely cold outside when
you were a child.

Therapist disagrees with patient's perception of hotness or coldness
when it is not clear whether or not patient's perception is accurate.

Ex. You did not feel cold in that room.
Ex. You did not feel like you needed to put on a coat at
that time.

Therapist attributes sexual sensations or lack of sexual sensations
to the patient when there is no data to indicate that this
attribution is accurate.

 

Ex. You had sexual feelings most of the time when you were
a child.
Ex. You did not have sexual feelings when you were in school.

Therapist disagrees with patient's perception of his sexual
sensations when it is not clear whether or not patient's perception
is accurate.

 

Ex. You did not have sexual feelings.
Ex. You did not have sexual sensations when you were a child.

Therapist attributes a perception of time or lack of perception of
time to the patient when there is no data to indicate that this

attribution is accurate.

Ex. You felt as if everything were going very slowly when
you were a baby.
Ex. You did not feel that it was evening that day.

Therapist disagrees with patient's time perceptions when it is not
clear whether or not patient's perception is accurate.

 

Ex. You didn't feel that time stood still.
Ex. You felt that it was evening not morning.

 

108

560 Therapist attributes an overall body state or lack of such a state
to the patient when there is no data to indicate that this
attribution is accurate.

 

Ex. You did not feel as if your body was dying.
Ex. You did not feel as if you were perfectly well
physically when you were little.

561 Therapist disagrees with patient's oVerall body state or lack of
such a state when it is not clear whether or not patient's perception
is accurate.

Ex. You did not feel sick.
Ex. You felt as if your body broke into bits. You did not
feel like you had one body.

562 Therapist makes attributions about external or internal physical
reality, but the particular mode of sep§ation is not specified.
This category refers to modes of physical perception in general.
(Note: If specific behaviors are indicated the behavioral
category should only be used when none of the other physical
reality categories specifically apply.)

 

 

Ex. The woman was there.
Ex. The cat did not pass.

(These examples could refer to visual or auditory perception. The
mode of perception is not clearly specified.)

563 Therapist disagrees about external or internal physical reality,
but the particular mode of sensation is not specified. There is
no data to indicate whether or not the patients perception is
accurate.

 

Ex. The woman was there when you were in school. You do not
know what you are talking about.

Ex. The nurse was not in your room when you were in the
hospital as a child.

Patient Affect

564 Therapist states that patient felt fear or anxiety or did not feel
fear or anxiety when it is not clear whether or not the patient
felt these affects. The therapist does not present data.

Ex. You were frightened as a child.
Ex. Y0u were not anxious.

565 Therapist disagrees about patient's statement of fear or anxiety
or lack of fear or anxiety as a child or adolescent when it is not
clear whether or not patient felt anxious or afraid.

 

Ex. You were not afraid.
Ex. I know that you were afraid all the time no matter what
you say.

 

566

567

568

569

570

571

572

573

109

Therapist states that patient felt anger or did not feel
anger when it is not clear whether or not the patient felt angry.

Ex. You were angry at your brother.
Ex. You were not angry in school.

Therapist disagrees about patient's statement of anger or lack

of anger when it is not clear whether or not the patient felt
angry.

Ex. You were angry. I don't care what you say.
Ex. You were not angry at your mother.

Therapist states that the patient felt startled when it is not
clear whether or not this was the case.

Ex. You were startled that day by your father.
Ex. You didn't feel startled at that time.

Therapist disagrees about patient's statements of having been
or not been startled without providing justification.

Ex. I know that you were startled when your sister came in.
Ex. You didn't feel startled when you saw your mother twenty
years ago.

Therapist states that the patient felt surprised when it is not
clear whether or not this was the case.

Ex. You were surprised to see your brother.
Ex. You were not surprised that your father came.

Therapist disagrees about patient's statements of having been or
not having been surprised without providing justification.

Ex. I know that you were surprised to see him.
Ex. You were surprised then even if you think that you were
not.

Therapist states that patient felt distress-anguish when it is
not clear whether or not this was the case.

Ex. You were in constant anguish growing up.
Ex. You were not distressed at that time.

Therapist disagrees about patient's statement of having been or
not having been distressed without providing justification.

Ex. You were in distress as an adolescent.

574

575

576

577

578

579

580

581

582

110

Therapist states that the patient felt or did not feel disgust when
it is not clear whether or not the patient felt disgust.

Ex. You were disgusted with the teacher.
Ex. You didn't feel disgusted with your father.

Therapist disagrees with patient's statements of having been or
not having been disgusted without providing justification.

Ex. I know that you were disgusted with being there.
Ex. You were not disgusted.

Therapist states that the patient felt or did not feel envious
when it is not clear whether or not this was the case.

Ex. I know that you were envious of your mother.
Ex. You didn't envy her.

Therapist disagrees with patient's statements of having or not
having been envious without providing justification.

Ex. You were full of envy.
Ex. You didn't envy your father.

Therapist states that patient felt or did not feel jealousy when
it is not clear whether or not this was the case.

Ex. You were jealous of your friend's relationship to your
mother.
Ex. You never had feelings of jealousy.

Therapist disagrees with patient's statements of having or not having
been jealous without providing justification.

Ex. You were jealous. I know that you were feeling this.
Ex. You were not feeling jealous at that moment as a child.

Therapist states that patient felt or did not feel §pg_when it is
not clear whether or not this was the case.

Ex. You didn't feel sad. You had nothing to feel sad about.
Ex. I know that you felt sadness most of the time.

Therapist disagrees with patient's statements of having or not
having felt §pg_without providing justification.

Ex. You had been sad for a year at that time.

Therapist states that patient felt or did not feel shame when
it is not clear whether or not this was the case.

 

Ex. I know that you were ashamed to be with your brother.
Ex. You didn't feel shame. You just think that you did.

 

583

584

585

586

587

588

589

590

111

Therapist disagrees about patient's statements of having or not
having been ashamed. Therapist does not provide justification.

Ex. You felt same most of the time as a child.
Ex. You were ashamed at being a child even if you say you
were not.

Therapist states that patient felt or did not feel guilt when it
is not clear whether or not this was the case.

Ex. You felt guilty because you were a girl.
Ex. You probably think that you felt guilty. I know that
you didn't.

Therapist disagrees about patient's statements of having or not
having felt guilty. Therapist does not provide justification.

Ex. You didn't feel guilty. You felt nothing.
Ex. As a child you felt guilty about being born.

Therapist states that patient felt or did not feel happiness or
jgy. Therapist does not provide justification.

Ex. You were happy that you were leaving school.
Ex. You hadn't been happy for a long time as a child.

Therapist disagrees about patient's statement of having or not
having felt happiness. Therapist does not provide
justification.

Ex. You didn't feel joy at seeing her when you were little.
Ex. Don't tell me that you were happy. That was a lie.

Therapist states that the patient felt or did not feel excited
when it is not clear whether or not this was the case.

Ex. I know that you were excited about going to the game
when you were a child.
Ex. You weren't excited about anything.

Therapist disagrees with patient's statement of having or not
having felt excitement. Therapist does not provide justification.

Ex. You weren't excited. There was no reason to be.
Ex. You never got excited about anything.

Therapist states that patient felt or did not feel hatred when
it is not clear whether or not this was the case.

Ex. I know that you hated your mother when you were a child.
Ex. You didn't hate anybody.

 

591

592

593

594

595

596

597

(Note:

598

112

Therapist disagrees with patient's statement of having or not
having felt hatred. Therapist does not provide justification.

Ex. I know that you hated him. Don't tell me that you didn't.
Ex. You hated for a long time as a child.

Therapist states that patient felt or did not feel love when it
is not clear whether or not this was the case.

Ex. I know that you loved your brother.
Ex. You didn't love anyone. You didn't know how to love anyone.

Therapist disagrees with patient's statement of having or not
having felt love. Therapist does not provide data.

Ex. You didn't love your father.
Ex. You loved your mother even when you thought you didn't.

Therapist states that patient felt or did not feel positive affects
in general when it is not clear whether or not this was the case.

Ex. You felt good when you were little.
Ex. You didn't feel great all the time.

Therapist disagrees with patient's statement of having or not
having felt positive affects. Therapist does not provide data.

Ex. You didn't feel good. Why do you want me to think that
you did?
Ex. You felt wonderful.

Therapist states that the patient felt or did not feel negative
affects in general when it is not clear whether or not this was
the case.

Ex. You felt lousy when you were six years old.
Ex. You didn't feel terrible as an adolescent.

Therapist disagrees with patient's statement about having or not
having felt negative affects in general. Therapist does not
provide justification.

 

Ex. You felt rotten.
Ex. You didn't feel as bad as you think.

If an overall body state is indicated, code for body state. If
the general affect statements do not refer specifically to a
physical body state, code the general affect category.)

Therapist states that the patient felt or did not feel confusion or
craziness when it is not clear whether or not this is the case.

 

599

600

601

602

603

604

605

606

113

Therapist disagrees with patient's statement of having or not
having felt confused or crazy. Therapist does not provide
justification.

Ex. Certainly you felt confused when you were little. You
can't make me think that you didn't.
Ex. You were not feeling crazy at that time.

Therapist states that patient felt or did not feel emptiness
when it is not clear whether or not this is the case.

Ex. You went around feeling empty most of the time.
Ex. You didn't feel empty when you were in therapy as a child.

Therapist disagrees about patient's statements about having or
not having felt empty. Therapist does not provide justification.

Ex. You didn't feel empty when you were sixteen.
Ex. You felt empty when you didn't think that you did.

Therapist states that patient felt or did not feel loneliness
when it is not clear whether or not this was the case.

Ex. You felt lonely when you were in school.
Ex. You didn't typically have feelings of loneliness as
a child.

Therapist disagrees with patient's statement about having or not
having felt loneliness.

Ex. You didn't feel lonely when you were seven.
Ex. You felt lonely when your brother left you.

Therapist states that the patient felt or did not feel hope when
it is not clear whether or not this was the case.

Ex. You felt hope for the first time when you were five.
Ex. You didn't know what it was like to feel hope.

Therapist disagrees about patient's statements about having or not
having felt hope. Therapist does not provide justification.

Ex. I don't agree that you had hope. You didn't.
Ex. You had hope whether you think so or not.

Therapist states that patient felt or did not feel anything.
Therapist does not provide data.

Ex. You were never able to feel.
Ex. You thought that you felt. You felt nothing.

607

114
Therapist disagrees about patient's having or not having felt
anything. Therapist does not provide justification.

Ex. You did feel as a child.
Ex. You think that you felt. You did not.

Patient's Self Concept

 

608

609

610

611

612

613

(Note:

Therapist makes ositive statements about the patient as a person
during the patient's childhood or adolescence.

Ex. You were a strong child.
Ex. You were always a nice person.

Therapist disagrees with patient's statement of patient's positive
views of himself as a child or adolescent.

Ex. You were not a good little boy.
Ex. You were not a bright child.

Therapist makes negative statements about the patient as a person
during the patient's childhood or adolescence. Therapist does not
provide data for his views.

Ex. You were a crazy child.
Ex. You were bad.

Therapist disagrees with patient's statement of patient's negative

views of himself as a child or adolescent. Therapist does not

justify.

Ex. You were not crazy.
Ex. You were a nice child.

Therapist makes neutral statement about the patient as a person
during the patient's childhood or adolescence. Therapist does not
justify.

Ex. You were a busy child.
Ex. You were a scholar.

Therapist disagrees with patient's statement of patient's neutral

view of himself as a child or adolescent.

Ex. You were not a busy person.
Ex. You were not a business type.

The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is
not specified. Ex., "You were not a crazy person." The
therapist says that the person was not crazy. He does not go
on to specify something positive or negative. For example,

 

115

he does not go on to say that the patient was a healthy
person.)

(Note: The self concept category applies to enduring characteristics
over time. For example, if the therapist states that the
patient was crazy and an enduring characteristic is stated
or implied, the self concept category should be scored. If the
therapist states that the patient engaged in crazy behavior or
felt crazy, then the behavior or affect category is scored.)

Patient's Motives or Intentions Towards Self

614 Therapist states that patient wanted or had the intention of doing
such and such (positive intention) to himself as a child or
adolescent. Therapist does not provide adequate data for his
position.

Ex. You wanted to help yourself.
Ex. You wanted to do well in school.

615 Therapist disagrees with patient's statements about his positive
self motivation during childhood and adolescence. Therapist does
not provide data for his point.

Ex. You did not want to help yourself when you were little.
Ex. You wanted to hurt yourself.

616 Therapist states that patient wanted or had the intention of
doing such and such (negative intention) to himself as a child or
adolescent.

Ex. You wanted to hurt yourself.
Ex. You wanted to fail in school.

617 Therapist disagrees with patient's statements about his negative
self motivation during childhood and adolescence. Therapist does
not provide data for his point.

Ex. You didn't want to hurt yourself.
Ex. You wanted to help yourself when you were little.

618 Therapist states that patient wanted or had the intention of doing
such and such (neutral intention) to himself as a child or
adolescent.

Ex. You wanted to take a bath.
Ex. You wanted to gain some weight as an adolescent.

619 Therapist disagrees with patient's statements abOut his neutral
self motivation during childhood and adolescence.

Ex. You didn't want to wash your hair that day.
Ex. You didn't want to give yourself some water when you
were five.

 

116

Patient's Motives or Intentions Towards Family

620

621

622

623

624

625

Therapist states that patient wanted or had the intention of doing

such and such (positive intention) to his family as a child or
adolescent.

Ex. You wanted to help your father.
Ex. You wanted to understand your brother.

Therapist disagrees with patient's statements about his positive

motivation towards his family when the patient was a chi d or

adolescent. Therapist does not provide data for his point.

Ex. You didn't want to do nice things for your grandfather.
Ex. You wanted to kill your father.

Therapist states that patient wanted or had the intention of doing
such and such (negative intention) to his family when the patient
was a child or adolescent. Therapist does not provide data.

Ex. When you were a child you wanted your brother to do all
the work.
Ex. You wanted to make your younger sisters take care of you.

Therapist disagrees with patient's statements about his negative

motivation towards his family during childhood and adolescence.

Therapist does not provide data.

Ex. You did not want to hurt your mother.
Ex. You did not have the intention of being nasty to your
cousin when you were little.

Therapist states that patient wanted or had the intention of
doing such and such (neutral intention) to his family when the
patient was a child or adolescent. Therapist does not provide
data.

Ex. You wanted to go visit your grandparents.
Ex. You had the intention of seeing your mother when you
were a child.

Therapist disagrees with patient's statements about his neutral
motivation towards his famil during childhood and adolescence.
Therapist does not prov1de data.

Ex. You didn't want to take your mother to the store that
day.
Ex. You didn't want to go fishing with your uncle at that time.

 

117

Patient's Motives or Intentions Towards Others (aside from family)

626 Therapist states that patient wanted or had the intention of doing
such and such to others (positive intention). Therapist does not
provide data for his point.

 

Ex. You wanted to praise your friend.
Ex. When you were a child you were trying to be nice to your
teacher.

627 Therapist disagrees with patient's statements about his positive
motivations towards others during childhood and adolescence.

Ex. You didn't want to help your friend.
Ex. You didn't mean to help the woman across the street.

628 Therapist states that patient wanted or had the intention of doing
such and such to others (negative intentions) when the patient
was a child or adolescent. Therapist does not provide data.

 

Ex. You wanted to be nasty to the teacher.
Ex. You wanted to go to the house and hit the boy.

629 Therapist disagrees with patient's statements about his negative
motivation towards others.

 

Ex. You didn't want to be a pain to your father.
Ex. You didn't want to give the dog such a hard time.

630 Therapist states that patient wanted or had the intention of
doing such and such to others (neutral intention) when the patient
was a child or adolescent. Therapist does not provide data.

 

Ex. You wanted to see the grocer that day.
Ex. You wanted to give the dog a bath.

631 Therapist disagrees with patient's statements about his neutral
intentions towards others during childhood and adolescence.
Therapist does not provide data.

 

Ex. You did not want to go for a walk with the boy.
Ex. You did not want to see the grocer that day.

Patient's Motives or Intentions (recipient not specified)

 

632 Therapist states that patient wanted or had the intention of doing
such and such (positive intention) when the patient was a child or
adolescent. The recipient of the intention is not specified.
Therapist does not provide data.

 

Ex. You wanted to care.
Ex. You had the intention of being nice.

 

118

633 Therapist disagrees with patient's statements about his positive
intentions during childhood and adolescence. The recipient of the
intention is not specified. Therapist does not provide data.

Ex. You didn't want to care.
Ex. You didn't have the intention of being nice.

634 Therapist states that patient wanted or had the intention of doing
such and such during childhood and adolescence (negative intention)
The recipient of the intention is not specified. Therapist does
not provide data for his point.

Ex. You wanted to hurt.
Ex. You had the intention of being destructive.

635 Therapist disagrees with patient's statements about his negative
intentions during childhood or adolescence. Therapist does not
provide data for his point.

Ex. You didn't want to cause problems.
Ex. You didn't have the intention of being nasty.

636 Therapist states that patient wanted or had the intention of
doing such and such (neutral intention) during childhood or
adolescence. The recipient of the intention is not specified.
Therapist does not provide data for his point.

 

Ex. You had the desire to go to the play when you were a child.
Ex. You wanted to clean your toys.

637 Therapist disagrees with patient's statements about his neutral
intentions during childhood or adolescence. The recipient of the
intention is not specified. Therapist does not provide data for
his point.

Ex. You didn't have the desire to go to the play when you were
a child.
Ex. You didn't want to clean your toys.

(Note: In the intention categories others includes all living things,
objects, or concepts. Family includes nuclear and extended
family. Therapist refers to the therapist studied in this
project.)

(Note: Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist states
that the patient did not want to hurt his family, but does not
specify or imply that the patient wanted to help them the
neutral category should be coded. If the therapist implies or
states positive intent, the statement should be scored under
positive attribution. The same applies for negations of
positive intentions. This instruction only refers to attribution
categories. Disagreement categories are coded in the usual
manner.)

 

119

External Behavior Attribution in Self

638

639

640

641

642

643

Therapist states that patient behaved in a certain way (positive
behavior). Therapist does not provide data.

Ex. When you were little you took care of your fish.
Ex. You helped your mother.

Therapist disagrees with patient's statements that the patient
engaged in a specific behavior as a child or adolescent. Therapist
does not provide data for his point of view (positive behavior).

Ex. You didn't take care of your pets. You hurt them.
Ex. You didn't do the things that you were supposed to do at
your house.

Therapist states that patient behaved in a certain way as a child
or adolescent (negative behavior). Therapist does not provide
data.

Ex. You hit your brother.
Ex. You didn't do what your parents wanted.

Therapist disagrees with patient's statements that the patient
engaged in a specific behavior (negative behavior) as a child or
adolescent. Therapist does not provide data.

Ex. You didn't hit your brother.

Therapist states that patient behaved in a certain way as a child
or adolescent (neutral behavior). Therapist does not provide data.

Ex. You went to play.
Ex. You went for a walk with the other boy.

Therapist disagrees with patient's statements that the patient
engaged in a specific behavior as a child or adolescent (neutral
behavior). Therapist does not provide data.

Ex. I know that you didn't go to the store then.
Ex. You didn't take a bath when you were three.

Internal Behavior Attribution in Self

 

644

Therapist states that patient had certain feelings or thoughts as
a child or adolescent (positive internal behavior). Therapist does
not provide data.

 

Ex. You thought that you would go help your mother that day.
Ex. You felt certain about what you were doing.

 

645

646

647

648

649

(Note:

(Note:

120

Therapist disagrees with patient's statements about patient's
thoughts or feelings as a child or adolescent (positive internal
behavior). Therapist does not provide data.

Ex. You did not think that you were being cooperative.
Ex. You did not feel certain about what you were doing.

Therapist states that patient had certain thoughts or feelings
during childhood and adolescence (negative internal behavior).
Therapist does not provide data.

 

Ex. You doubted constantly.
Ex. You thought about hurting your mother.

Therapist disagrees with patient's statements about patient's
thoughts or feelings (negative internal behavior) during childhood
and adolescence. Therapist does not provide data.

 

Ex. No you didn't feel inferior when you were five.
Ex. You had no thoughts about hurting your family.

Therapist states that patient had certain thoughts or feelings
during childhood or adolescence (neutral internal behavior).
Therapist does not provide data.

 

Ex. You had the feeling that you should go to the movie.
Ex. You thought that you were talking to your mother at the
moment.

Therapist disagrees with patient's statements about patient's
thoughts or feelings (neutral internal behavior) during childhood
and adolescence. Therapist does not provide data.

 

Ex. You were not thinking about going to play right then.
Ex. You did not feel that you were about to move to another
house.

The behavior categories refer to events which are more complicated
than the physical reality categories in that in the behavior
categories specific modes of perception cannot be clearly
inferred. This category includes external events that occurred.
It also includes internal feelings or thoughts. If a feeling
refers to affects, the affect category should be coded. If
intention or motivation is mentioned, the motivation category
should be coded.)

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution
is implied or stated. For example, if the therapist indicates
that the patient did not feel inferior, but does not indicate
that he felt good, the neutral category should be coded. The
same applies to negations that concern negative material. This

 

121

instruction only applies to attribution categories. Disagree-
ment categories should be scored in the usual manner.)

Hypothetical Situations

 

650

651

652

653

654

655

Therapist states that patient could or could not have sensations
or perceptions as a child or adolescent. Therapist does not
provide data for his point. (See attached list of sensations and
code these.)

Ex. You could hear the plane.
Ex. It is possible that you could see the woman across the
street when you were little.

Therapist disagrees with patient's statements about the possibility
that the patient experienced or did not experience sensations or

perceptions.

Ex. I know that it was possible that you could have felt it if
a bug crawled on your feet.

Ex. You could not have felt that your body was dying when you
were little. How could you have felt that?

Therapist states that patient could or could not feel affects as a
child or adolescent. Therapist does not provide data. (See
affected lists of affects and code these.)

Ex. You couldn't have felt anger. It is not possible that
you would have been able to feel this.
Ex. You could have felt sadness.

Therapist disagrees with patient's statement about the possibility
of the patient having or not having felt affect.

Ex. You could not have felt empty.
Ex. It is not possible that you could have felt good.

Therapist states the possibility that the patient could have had
a positive self concept as a child or adolescent. Therapist does
not provide data for his point.

Ex. You could have been a nice person when you were little.
Ex. You could have been a good person.

Therapist disagrees with patient's statement about the possibility
of a positive self concept in the patient during childhood or
adolescence.

 

Ex. You couldn't have been a good person.
Ex. It is not possible that you could have been an intelligent
child.

 

122

656 Therapist states the possibility of a negative patient-self—
concept during childhood or adolescence. Therapist does not
provide adequate data for his point.

Ex. You could have been a totally incompetent child.
Ex. You could have been an extremely dumb child.

657 Therapist disagrees with patient's statements about the possibility
of a negative self concept in the patient during childhood or
adolescence. Therapist does not provide data.

Ex. It is not possible that you could have been dumb.
Ex. You could not have been incompetent.

658 Therapist states the possibility of a neutral patient—self-
concept during childhood or adolescence. Therap1st does not
provide adequate data for his point.

Ex. You could have been a scholar.
Ex. You could have been a business type.

659 Therapist disagrees with patient's statements about the possibility
of a neutral self concept in the patient during childhood or
adolescence.

 

Ex. You could not have been a business type at that time. I
don't know why you think that would have been possible.
Ex. You could not have been an athletic type as a child.

(Note: A negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient could not have been a dumb person, but
does not imply or state a positive emphasis, the statement
should be scored as neutral. The same applies to negations
of positive self-concept statements. These instructions apply
only to attributions. Disagreements are scored as usual.)

660 Therapist states that the patient could have had a positive intention
or motivation toward himself (patient) as a child. Therapist does
not provide data for his assertion.

Ex. You could have wanted to help yourself then.
Ex. You could have wanted to give yourself what you needed.

661 Therapist disagrees with patient's statement of the possibility
of a positive intention or motivation toward himself (patient) as
a child or adolescent.

Ex. You could not have wanted to make things good for yourself
at that time.

Ex. You could not have wanted to have given yourself what you
needed at that time.

 

662

663

664

665

666

667

123

Therapist states that the patient could have had a negative

intention or motivation toward himself (patient). Therapist

does not provide data for his assertion.

Ex. You could have wanted to kill yourself.
Ex. It is possible that you could have had the desire to be
nasty to yourself.

Therapist disagrees with patient's statement of the possibility
of a negative intention or motivation toward himself during
childhood or adolescence.

Ex. You could not have wanted to kill yourself.
Ex. It is not possible that you could have had the desire to
be nasty to yourself even though you tell me that you did.

Therapist states that the patient could have had a neutral intention
or motivation towards himself (patient) during childhood or
adolescence. Therapist does not provide data for his assertion.

Ex. You could have wanted to give yourself a bath at that time.
Ex. You could have wanted to get that dress for yourself that
year.

Therapist disagrees with patient's statement of the possibility of
a neutral intention or motivation toward himself during childhood
or adolescence. Therapist does not provide data for his assert1on.

Ex. You could not have wanted to give yourself a bath at that
time.

Ex. You could not have wanted to get that dress for yourself
that year.

Therapist states that the patient could have had a positive
intention or motivation towards his family. Therapist does not

provide data for his assertion.

Ex. You could have wanted to help your mother with her work.
Ex. You could have wanted to show affection to your family
when you were a child.

Therapist disagrees with patient's statement of the possibility
of a positive intention or motivation toward his family during
childhood or adolescence. Therapist does not provide data for
his assertion.

Ex. It is not possible that you would have wanted to do nice
things for your parents.

Ex. I know that you would not have wanted to care for your
sister.

 

668

669

670

671

672

673

674

124

Therapist states that the patient could have had negative
intentions or motivations towards his family. Therapist does not
provide data for his assertion.

Ex. You could have wanted to hit your mother.
Ex. You could have wanted to hate your family as much as possible.

Therapist disagrees with patient's statements of the possibility
of negative intentions or motivations towards his family during
childhood or adolescence.

Ex. You could not have wanted to hit your mother.
Ex. You could not have wanted to hate your family as much as
possible even though you think that you did.

Therapist states that the patient could have had neutral intentions
or motivations towards his family as a child or adolescent.
Therapist does not provide data for his assertion.

Ex. You could have wanted to take your mother to the store.
Ex. You could have wanted to take your sister to a movie.

Therapist disagrees with patient's statements of the possibility
of a neutral intention or motivation towards his family during
childhood or adolescence.

Ex. You could not have wanted to take your mother to the store.
Ex. You could not have wanted to take your sister to a movie.

Therapist states that the patient could have had ositive intentions
or motivations towards others during childhood or adolescence.
Therapist does not provide data for his assertion.

 

Ex. You could have wanted to be nice to your neighbor.
Ex. You could have wanted to give affection to your little friend.

Therapist disagrees with patient's statements of the possibility of
positive intentions or motivations towards others during childhood
or adolescence.

Ex. You could not have wanted to be nice to your neighbor.
Ex. You could not have wanted to give affection to your friend.

Therapist states that the patient could have had negative intentions
or motivations towards others during childhood or adolescence.
Therapist does not provide data for his assertions.

 

Ex. It is possible that you would have wanted to be nasty to
kick the dog.
Ex. It is possible that you would have wanted to be nasty to
the teacher.

 

675

676

677

678

679

680

681

125

Therapist disagrees with patient's statements of the possibility
of negative intentions or motivations towards othersduring childhood
or adolescence. Therapist does not provide data for his assertion.

 

Ex. You could not have wanted to hit your friend.
Ex. You could not have wanted to be hateful to the nurse.

Therapist states that the patient could have had neutral intentions
or motivations towards others during childhood or adolescence.
Therapist does not provide data for his assertion.

 

Ex. You could have wanted to take the cat and go across the
street.
Ex. You could have wanted to show the other girl the school.

Therapist disagrees with patient's statements of the possibility
of neutral intentions or motivations towards others during childhood
or adolescence. Therapist does not provide data for his assertion.

 

Ex. You could not have wanted to take the cat and go across
the street.

Ex. You could not have wanted to show the other girl the
school even though you tell me that you would have wanted to
have done this.

Therapist states that the patient could have had positive intentions
or motivations during childhood or adolescence. Therapist does
not provide data for his assertion. The recipient of these

intentions is not specified.

Ex. You could have wanted to care.
Ex. You could have wanted to be nice.

Therapist disagrees with patient's statements of the possibility
of positive intentions or motivations during childhood or
adolescence. The recipient of these intentions is not specified.
Therapist does not prov1de data for his assertion.

Ex. You could not have wanted to care.
Ex. You could not have wanted to do nice things.

Therapist states that the patient could have had negative intentions
or motivations during childhood or adolescence. The recipient of
these intentions is not specified. Therapist does not provide data
for his assertion.

Ex. You could have wanted to engaged in destructive behavior.
Ex. You could have wanted to go around hurting or destroying.

Therapist disagrees with patient's statements of the possibility
of negative intentions or motivations. The recipient of these

intentions is not specified.

 

682

683

(Note:

(Note:

684

685

686

126

Ex. You could not have wanted to engaged in destructive
behavior.
Ex. You could not have wanted to go around hurting or destroying.

Therapist states that the patient could have had neutral intentions
or motivations during childhood or adolescence. The recipient

of these intentions is not specified. Therapist does not provide
data for his assertion. .

Ex. You could have had the desire to go to the game.
Ex. You could have wanted to clean your room.

Therapist disagrees with patient's statements of the possibility
of neutral intentions during childhood or adolescence. The
recipient of these intentions is not specified. Therapist does
not provide data for his assertions.

Ex. You could not have had the desire to go to the game.
Ex. You could not have wanted to clean your room.

Family refers to patient's nuclear and extended family. Others
refers to all living things (but the family), objects, or
concepts.)

Negations should be scored as neutral intentions unless a
positive or negative aspect is also stated or implied. For
example, if the therapist states that the patient could not
have wanted to hurt his family, but does not state or imply a
positive intention, the neutral intention should be coded.)

Therapist states that the patient could have engaged in positive

external behaviors during childhood or adolescence. Therapist

does not provide data.

Ex. You could have cared for your pets adequately.
Ex. You could have done nice things for your brother.

Therapist disagrees with the patient's statement that the patient
could have behaved in a certain way (positive external behavior)
during childhood or adolescence. Therapist does not provide data.

 

Ex. You could not have cared for your pets adequately.
Ex. You could not have done nice things for your brother.

Therapist states that the patient could have engaged in negative

external behavior during childhood or adolescence. Therapist does

not provide data.

Ex. You could have hit your sister everyday.
Ex. You could have refused to give your brother food.

 

687

688

689

690

691

692

693

127

Therapist disagrees with the patient's statement that the patient
c0u1d have behaved in a certain way during childhood or adolescence
(peggtive external behavior). Therapist does not provide data

for his point.

 

Ex. You could not have been rude to your mother.
Ex. You could not have refused to talk to your friend.

Therapist states that the patient could have engaged in neutral

external behavior during childhood or adolescence. Therapist does

not provide data for his point.

Ex. You could have walked across the yard with your friend.
Ex. You could have taken your dog out for a walk.

Therapist disagrees with the patient's statement that the patient
could have behaved in a certain way during childhood or adolescence
(neutral external behavior).

 

Ex. You could not have gone over to the store.
Ex. You could not have had your hair cut.

Therapist states that the patient could have had certain thoughts
or feelings during childhood or adolescence (positive internal

behavior). Therapist does not provide data for his points.

Ex. You could have had thoughts of helping your mother.
Ex. You could have felt certain about what you are doing.

Therapist disagrees about the possibility of the patient having had
certain thoughts or feelings (positive internal behavior). Therapist
does not provide data for his points.

 

Ex. You could not have had thoughts of providing care for your
animals.

Ex. You could not have had thoughts of being nice to your
family.

Therapist states that the patient could have had certain thoughts
or feelings during childhood or adolescence (negative internal

behavior). Therapist does not provide data for h1s points.

Ex. You could have thought about hurting your father.
Ex. You could have had thoughts about hurting your grandfather.

Therapist disagrees about the possibility of the patient having had
certain thoughts or feelings during childhood or adolescence
(negative internal behavior). Therapist does not provide data for
his points.

 

Ex. You could not have had thoughts about hurting your
grandfather.
Ex. You could not have had thoughts about hurting your mother.

 

694

695

(Note:

(Note:

128

Therapist states that the patient could have had certain thoughts
or feelings during childhood or adolescence (neutral internal

behavior). Therapist does not provide data for his point.

Ex. You could have thought abOut working in the flowers.
Ex. You could have thought about studying your math.

Therapist disagrees about the possibility of the patient having
had certain thoughts or feelings (neutral internal behavior)
during childhood or adolescence. Therapist does not provide data
for his point.

 

Ex. You could not have thought about going to the play.
Ex. You could not have thought about reading the book.

Negations are coded under the neutral internal or external
behavior categories unlbss a positive or negative attribution

is implied or stated. For example, if the therapist

indicates that the patient could not have felt inferior but

does not indicate that the patient could have felt good, the
neutral category should be coded. The same applies to

negations that concern negative material. This instruction

only applies to attribution categories. Disagreement categories
should be scored in the usual manner.)

Since hypothetical situations are hypothetical it may be difficult
to judge whether or not mystification is occurring. Look at the
context of the session. Look at whether the therapist has data
to support his comments.)

 

129

Family Attributions
(nuclear and extended family)

Family Affect

696

697

698

699

700

701

702

703

Therapist states that patient's family felt or did not feel fear
or anxiety during the patient's childhood or adolescence. The
therapist does not present data for his position.

Ex. Your mother was frightened when you were a baby.
Therapist disagrees with patient's statement of fear or anxiet
lack of fear and anxiety in his family during the pat1ent 5
childhood or adolescence.

Ex. I know that your father was not anxious.

Therapist states that patient's family felt or did not feel anger
during the patient's childhood or adolescence. Therapist does not
provide data for his point.

Ex. Your cousin was not angry when you were small.

Therapist disagrees with patient' 5 statement ofa anger or lack of
anger in his family during the patient' 5 childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your mother had feelings of anger when you were four.
Therapist states that patient's family felt or did not feel
startled during the patient's childhood or adolescence when it
is not clear whether or not this was the case.

Ex. Your brother was not startled that time.

Therapist disagrees about patient's statement of a family member
being or not being startled during the patient's childhood or
adolescence. Therapist does not provide data for his position.

Ex. Your mother was not startled that night.

Therapist states that patient's family felt or did not feel
surprised during the patient's childhood or adolescence when it
is not clear whether or not this was the case.

Ex. Your grandfather was surprised to see you.

Therapist disagrees about patient's statement of surprise or lack
of surprise in his family during the patient's childhood or
adolescence. Therapist does not provide data for his position.

Ex. Your grandfather was not surprised.

 

704

705

706

707

708

709

710

711

712

130

Therapist states that patient's family felt or did not feel
distress-anguish during the patient's childhood or adolescence
when it is not clear whether or not this was the case.

Ex. Your mother was in constant anguish.

Therapist disagrees about patient's statement of distress—anguish
or lack of distress-anguish in his family during the patient's
childhood or adolescence. Therapist does not provide data for
his position.

Ex. Your mother was not in constant anguish when you were little.
Therapist states that patient's family felt or did not feel disgust
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your father was disgusted with you.

Therapist disagrees with patient's statement of disgust or lack of
disgust in his family during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your father was not disgusted.

Therapist states that patient's family felt or did not feel envious
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your mother was envious of your looks.

Therapist disagrees with patient's statement of his family having
been or not having been envious during his childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your sister was not envious.

Therapist states that patient's family felt or did not feel

jealous during the patient's childhood or adolescence. Therapist

does not provide data for his position.

Ex. Your cousin was jealous of you and your mother.

Therapist disagrees with patient's statement of his family having
or not having been jealous during the patient's childhood or
adolescence. Therapist does not provide data for his position.

Ex. Your cousin was jealous. Don't tell me that he was not.
Therapist states that patient's family felt or did not feel sadness
during his childhood or adolescence when it is not clear whether or
not this was the case.

Ex. Your aunt was not sad.

 

714

715

716

717

718

719

720

131

Therapist disagrees with patient's statement of sadness or lack
of sadness in his family during the patient's childhood or
adolescence. Therapist does not provide data for his position.

Ex. Your grandfather was sad.
Therapist states that patient's family felt or did not feel shame

during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

 

Ex. Your father felt shame about you.

Therapist disagrees with patient's statement of shame or lack of
shame in his family during the patient's childhood or adolescence.
Therapist does not provide data for his position.

 

Ex. Your family was ashamed. Don't tell me that they were not.

Therapist states that patient's family felt or did not feel guilt

during the patient's childhood or adolescence when it is not clear
whether or not this was the case. Therapist does not provide data
for his position.

Ex. Your family had not feelings of guilt.
Therapist disagrees with patient's statement of guilt or lack of
guilt in his family during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your grandmother did feel guilty.

Therapist states that patient's family felt or did not feel happiness

or joy during the patient's childhood or adolescence when it is not
clear whether or not this was the case. Therapist does not provide
data.

Ex. Your family felt happy that you were O.K.

Therapist disagrees with patient's statement of happiness or joy
or lack of happiness or joy in his family during the patient's
childhood or adolescence. Therapist does not provide data for
his position.

Ex. Your father was not happy. Don't try to think that he
was.

Therapist states that patient's family felt or did not feel excited
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your mother was excited that you were going home from the
hospital.

 

721

722

723

724

725

726

727

728

132

Therapist disagrees with patient's statement of excitement or
lack of excitement during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your mother was never excited. You are wrong.
Therapist states that patient's family felt or did not feel hatred

during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

 

Ex. Your mother hated you.

Therapist disagrees with patient's statement of hatred or lack of
hatred in his family during the patient's childhood or adolescence.
Therapist does not provide data for his position.

 

Ex. Your mother did not hate.

Therapist states that patient's family felt or did not feel love
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your family loved you.
Therapist disagrees with patient's statement of love or lack of

love in his family during the patient's childhood or adolescence.
Therapist does not provide data for his position.

 

Ex. Your father did not love anything.

Therapist states that patient's family felt or did not feel
positive affects in general during the patient's childhood or
adolescence when it is not clear whether or not this was the case.

 

Ex. Your father felt good about life.

Therapist disagrees with patient's statement of positive affects
in general or lack of positive affects in general during the
patient's childhood or adolescence. Therapist does not provide
data for his position.

Ex. Your father did not feel good about life.
Therapist states that patient's family felt or did not feel

negative affects in general during the patient's childhood or
adolescencewhen it was not clear whether or not this was the case.

 

Ex. Your brother felt bad for quite some time.

 

729

730

731

732

733

734

735

736

737

133

Therapist disagrees with patient's statement of negative affects

in general or lack of negative affects in general during the patient's
childhood or adolescence. Therapist does not provide data for his
position.

Ex. Your brother felt bad. Don't say that he didn't.
Therapist states that patient's family felt or did not feel

confusion or craziness during the patient's childhood or adolescence
when it is not clear whether or not this was the case.

 

Ex. Your family felt confused a lot.
Therapist disagrees with patient's statement of confusion or
craziness or lack of confusion or craziness during the patient's
childhood or adolescence. Therapist does not provide data for
his position.

Ex. Your mother was not confused that time.

Therapist states that patient's family felt or did not feel emptiness
when it is not clear whether or not this was the case.

Ex. Your cousin felt empty for several years when you were little.
Therapist disagrees with patient's statements of emptiness or lack
of emptiness during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. No one in your family felt empty.

Therapist states that patient's family felt or did not feel
loneliness during the patient's childhood or adolescence when it

is not clear whether or not this was the case.

Ex. Your father never felt lonely.
Therapist disagrees with patient's statements of loneliness or lack
of loneliness during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. Your mother always felt lonely. You know that.

Therapist states that patient's family felt or did not feel hope
when it was not clear whether or not this was the case.

Ex. Your father had hope. That was extremely important.
Therapist disagrees with patient's statement of hope or lack of
hope during the patient's childhood or adolescence. Therapist does
not provide data for his position.

Ex. Your father did have hope. There is no point in you
indicating otherwise.

 

738

739

134

Therapist states that patient's family felt or did not feel
anything during the patient's childhood or adolescence when it
is not clear whether or not this was the case.

Ex. Your sister was able to feel nothing.
Therapist disagrees with patient's statement of his family having
felt or not felt anything during his childhood or adolescence.
Therapist does not provide data.

Ex. Your whole family felt nothing.

Family Concept

740

741

742

743

744

745

Therapist makes positive statements about patient's family as
people during the patient's childhood or adolescence. Therapist
does not provide data for his views.

Ex. Your mother was a good woman.
Therapist disagrees with patient's statement of patient's views
of his family as people (positive views) during his childhood or
adolescence.

Ex. Your mother was not a good woman.

Therapist makes negative statements about patient's family as

people during the patient's childhood or adolescence w1t out

providing data for his view.
Ex. Your mother was a bitch.
Therapist disagrees with patient's statements of patient's views
of his family as people during the patient's childhood and
adolescence. Therapist does not provide data (negative views).
Ex. Your father was not the bad person that you say.
Therapist makes neutral statement about patient's family as people
during the patient's childhood or adolescence without providing
data for his view.
Ex. Your family was a busy family.
Therapist disagrees with patient's statement of patient's views of
his family as people during the patient's childhood or adolescence.
Therapist does not provide data (neutral views).

Ex. Your mother was not an artist.

 

135

(Note: The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is
not specified. Ex., “Your mother was not a crazy person.”
Therapist says that the mother was not crazy. He does not go
on to specify something positive or negative. For example,
he does not go on to say that the mother was healthy.)

(Note: The family concept category applies to enduring characteristics
over time. For example if the therapist states that the mother
was crazy and an enduring characteristic is stated or implied,
the family concept category should be scored. If the therapist
states that the mother engaged in crazy behavior or was feeling
crazy, then the behavior or affect category is scored.)

Family's Motives or Intentions

 

746 Therapist states that patient's family had the intention of doing
such and such to the patient (positive intention) during the
patient's childhood or adolescence.

Ex. Your mother wanted to understand you.

747 Therapist disagrees with patient's statement about his family's
intentions or motivations towards him (positive intentions) during
the patient's childhood or adolescence.

Ex. Your mother did not want to help you.

748 Therapist states that the patient's family had the intention of
doing such and such to the patient (negative intention) during
the patient's childhood or adolescence.

Ex. Your cousin wanted to have you do his work.

749 Therapist disagrees with patient's statements about his family's
intentions towards him (negative intention) during his childhood
or adolescence. Therapist does not provide data.

Ex. Your family did not want to hurt you. You just think that.

750 Therapist states that patient's family had the intention of doing
such and such to the patient (neutral intention) during the patient's
childhood or adolescence.

Ex. Your mother wanted to bring you your dress.

751 Therapist disagrees with patient's statements about his family's
intentions or motivations towards him (neutral intentions) during
the patient's childhood or adolescence.

Ex. Your mother did not want to bring you your dress.

 

752

753

754

755

756

757

(Note:

136

Therapist states that patient's family had the intention of doing

such and such (positive intention) during the patient's childhood

or adolescence. Recipient was anyone but the patient or recipient
may not be specified.

Ex. Your sister wanted to care.

Therapist disagrees with patient's statements about his family's
intentions or motivations during the patient's childhood or
adolescence (positive intention). Recipient is anyone but the
patient or recipient may not be specified. Therapist does not
provide data.

Ex. Your father did not want to care about your brother.

Therapist states that patient's family had the intention of doing
such and such (negative intention) during the patient's childhood
or adolescence. Recipient is anyone but the patient or recipient
may not be specified. Therapist does not provide data.

Ex. Your uncle wanted to be destructive.

Therapist disagrees with patient's statements about his family's
intentions or motivations during the patient's childhood or
adolescence (negative intention). Recipient is anyone but the
patient or recipient may not be specified. Therapist does not
provide data.

Ex. Your father did not have the impulse to be rude.

Therapist states that patient's family had the intention of doing
such and such (neutral intention) during the patient's childhood
or adolescence. Recipient is anyone but the patient or recipient
may not be specified.

Ex. Your brother wanted to see his friend.

Therapist disagrees with patient's statements about his family's
intentions or motivations (neutral intention) during the patient's
childhood or adolescence. Recipient is anyone but the patient or
recipient may not be specified.

Ex. Your brother did not want to go to the movie.

Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist stated
that the patient's family did not want to hurt the patient, but
did not specify or imply that the family wanted to help him,
the neutral category should be coded. If the therapist implies
or states positive intent, the statement should be scored under
positive attributions. The same applies for negations of
positive intentions. This instruction only refers to attribution
categories. Disagreement categories are scored in the usual
manner.)

 

137

External Behavior Attribution in Family

 

758

759

760

761

762

763

Therapist states that patient's family behaved in a certain way
during the patient's childhood or adolescence (positive behavior).
Therapist does not provide data for his points.

Ex. Your mother had been doing nice things.

Therapist disagrees with patient's statements that the patient's
family engaged in specific behavior during the patient's childhood
or adolescence. Therapist does not provide data for his point

of view (positive behavior).

Ex. Your father had not been taking care of you even though
you think that he had.

Therapist states that patient's family behaved in a certain way
(negative behavior) during the patient's childhood or adolescence.
Therapist does not provide data for his points.

Ex. Your mother hit your brother when he was little.

Therapist disagrees with patient's statements that the patient's
family engaged in specific behaviors during the patient's
childhood or adolescence (negative behavior). Therapist does
not provide data for his point of view.

Ex. Your mother did not talk nasty to you when you were little.

Therapist states that patient's family behaved in a certain way
(neutral behavior) during the patient's childhood or adolescence.
Therapist does not provide data for his points.

Ex. Your father went to work when you were three.

Therapist disagrees with patient's statements that the patient's
family engaged in specific behaviors during the patient's childhood
or adolescence. Therapist does not provide data for his point of
view (neutral behavior).

Ex. Your father did not go to work that day. Why do you tell
me that he did?

Internal Behavior Attribution in Family

764

 

Therapist states that patient's family had certain feelings or
thoughts during the patient's childhood or adolescence (positive
internal behavior). Therapist does not provide data for his
points.

Ex. Your mother felt that she cared for you.

 

765

766

767

768

769

(Note:

(Note:

138

Therapist disagrees with patient's statements about patient's
family's thoughts or feelings during the patient's childhood or
adolescence (positive internal behavior). Therapist does not
provide data for his points.

 

Ex. Your mother did not think about doing nice things for you.

Therapist states that patient's family had certain feelings or
thoughts (pegptive internal behavior) during the patient's
childhood or adolescence. Therapist does not provide data for
his points.

 

Ex. Your mother felt that she was no good.

Therapist disagrees with patient's statements about patient's

family's thoughts or feelings (negative internal behavior).

Therapist does not provide data for his po1nts.
Ex. Your mother did not feel that she was no good.

Therapist states that patient's family has certain feelings or
thoughts (neutral internal behavior) during the patient's
childhood or adolescence. Therapist does not provide data for
his points.

 

Ex. Your brother thought about his math.

Therapist disagrees with patient's statements about patient's
family's thoughts or feeling during the patient's childhood or
adolescence (neutral internal behavior). Therapist does not
provide data for his points.

 

Ex. Your sister had not been thinking about physics.

The behavior categories refer to events which are more complicated
than the physical reality categories in that in the behavior
categories specific modes of perception cannot be clearly
inferred. This category includes external events that have
occurred. It also includes internal feelings or thoughts. If
a feeling refers to affects, the affect category should be
coded. If intention or motivation is mentioned, the motivation
category should be coded.)

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution is
implied or stated. For example, if the therapist indicates that
the patient's family did not feel inferior, but does not indicate
that they felt good, the neutral category should be coded. The
same applies to negations that concern negative material. This
instruction only applies to attributions. Disagreement
categories should be scored in the usual manner.)

 

139

Hypothetical Situations

 

770

771

772

773

774

775

776

777

Therapist states that patient's family could or could not have
felt affects during the patient's childhood or adolescence.
Therapist does not provide data for his view. (See attached list
of affects and code these)

Ex. Your mother could not have been angry.
Therapist disagrees with patient's statements about the possibility
of the patient's family having felt or not having felt affects
during the patient's childhood or adolescence.

Ex. Your mother could not have felt empty.
Therapist states the possibility of a positive family concept during

the patient's childhood or adolescence. Therapist does not provide
data for his point.

 

Ex. Your father could have been a nice person.

Therapist disagrees with patient's statement of the possibility
of a positive family concept during the patient's childhood or
adolescence. Therapist does not provide data for his points.

 

Ex. Your mother could not have been a good person.

Therapist states the possibility of a negative family concept during
the patient's childhood or adolescence. Therapist does not provide
data for his points.

 

Ex. Your sister could have been a stupid woman.

Therapist disagrees with patient's statement of the possibility of
a negative family concept during the patient's childhood or
adolescence. Therapist does not provide data for his points.

 

Ex. Your sister could not have been a stupid woman.

Therapist states the possibility of a neutral family concept during
the patient's childhood or adolescence. Therapist does not provide
data for his points.

Ex. Your family could have been a busy family.
Therapist disagrees with patient's statement of the possibility of

a neutral family concept during the patient's childhood or
adolescence.

 

Ex. Your family could not have been a busy family.

 

(Note:

778

779

780

781

782

783

140

A negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient's brother could not have been a dumb
person, but does not imply or state a positive emphasis, the
statement should be scored as neutral. The same applies to
negations of positive family concept statements. These
instructions apply to attributions. Disagreements are scored
as usual.)

Therapist states that the patient's family could have had a positive
intention or motivation toward the patient during the patient's
childhood or adolescence. Therapist does not provide for his
assertion.

Ex. Your family could have wanted to help you.
Therapist disagrees with patient's statement of the possibility
that patient's family could have had a positive intention or
motivation toward the patient during the patient's childhood or
adolescence. Therapist does not provide data for his assertion.
Ex. Your family could not have wanted to help you.

Therapist states that the patient's family could have had a negative

intention or motivation toward the patient during the patient's

childhood or adolescence. Therapist does not provide data for
his assertion.

Ex. Your mother could have wanted to see you become crazy.
Therapist disagrees with patient's statement of the possibility that
patient's family could have had a negative intention toward the
patient during the patient's childhood or adolescence. Therapist
does not provide data for his assertion.

Ex. Your mother could not have wanted to see you become crazy.

Therapist states that the patient's family could have had a neutral
intention or motivation toward the patient during the patient 5

childhood or adolescence. Therapist does not provide data for his

assertion.

Ex. Your aunt could have wanted to take you over to visit some
friends.

Therapist disagrees with patient's statement of the possibility that
patient's family could have had a neutral intention or motivation
toward the patient during the patient's childhood or adolescence.
Therapist does not provide data for his assertion.

Ex. Your aunt could not have wanted to take you over to visit
some friends.

 

784

785

786

787

788

789

(Note:

141

Therapist states that the patient's family could have had a
positive intention or motivation during the patient's childhood
or adolescence. Recipient of the intention is anyone other than
the patient or recipient may not be specified. Therapist does

not provide data for his assertion.

Ex. Your family could have wanted to help your brother.
Therapist disagrees with patient's statement of the possibility that
patient's family could have had a ositive intention or motivation.
Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data
for his assertion.

 

Ex. Your family could not have wanted to help your brother.

Therapist states that patient's family could have had a negative
intention or motivation. Recipient of the intention is anyone

other than the patient or recipient may not be specified. Therapist
does not provide data for his assertion.

Ex. Your family could have wanted to be destructive.

Therapist disagrees with patient's statement of the possibility that
patient's family could have had a negative intention or motivation.
Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data

for his assertion.

 

Ex. Your family could not have wanted to be destructive.

Therapist states that the patient's family could have had a neutral

intention or motivation during the patient's childhood or adolescence.

Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data
for his assertion.

 

Ex. Your mother could have wanted to go visiting.

Therapist disagrees with patient's statement of the possibility that
patient's family could have had a neutral intention or motivation.
Recipient of the intention is anyone other than the patient or
recipient may not be specified. Therapist does not provide data

for his assertion.

 

Ex. Your mother could not have wanted to go visiting.

Negations should be scored as neutral intentions unless a positive
or negative aspect is also stated or implied. For example, if
the therapist states that the patient's family did not want to
hurt the patient, but does not state or imply a positive
intention, the neutral intention should be coded.)

 

790

791

792

793

794

795

796

797

142

Therapist states that the patient's family could have engaged in
positive external behavior during the patient's childhood or

 

adolescence. Therapist does not provide data.

Ex.

Your mother could have cared for her children adequately.

Therapist disagrees with the patient's statement that the patient's
family could have behaved in a certain way (positive external
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his statement.

Ex.

Your mother could not have cared for her children adequately.

Therapist states that the patient's family could have engaged in
negative external behavior during the patient's childhood or

 

adolescence. Therapist does not provide data.

Ex.
feel

Your brother could have gone around making other people
bad.

Therapist disagrees with patient's statement that the patient's
family could have behaved in a certain way (negative external
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his statement.

Ex.
bad.

Your brother could not have gone around making people feel
You just think that.

Therapist states that the patient's family could have engaged in
neutral external behavior during the patient's childhood or

 

adolescence. Therapist does not provide data for his statements.

Ex.

Your mother could have gone visiting.

Therapist disagrees with patient's statement that the patient's
family could have behaved in a certain way (neutral external
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his statements.

Ex.

Your mother could not have gone visiting.

Therapist states that the patient's family could have had certain
thoughts or feelings (positive internal behavior) during the patient's
childhood or adolescence. Therapist does not provide data.

Ex.

 

Your cousin could have thought nice things about you.

Therapist disagrees with patient's statement that the patient's
family could have had certain thoughts or feelings ( ositive
internal behavior) during the patient's childhood or adolescence.
Therapist does not provide data for his statement.

Ex.

Your cousin could not have thought nice things about you.

 

798

799

800

801

(Note:

(Note:

143

Therapist states that the patient's family could have had certain
thoughts or feelings (negative internal behavior) during the
patient's childhood or adolescence. Therapist does not provide data.

 

Ex. Your mother could have felt that she was not a good person.

Therapist disagrees with patient's statement that the patient's
family could have had certain thoughts or feelings (negative

internal behavior) during the patient's childhood or adolescence.

Therapist does not provide data for his statements.
Ex. Your mother could not have felt that she was a good person.

Therapist states that the patient's family could have had certain
thoughts or feelings during the patient's childhood or adolescence
(neutral internal behavior). Therapist does not provide data.

Ex. Your mother could have been thinking that she needed to go
to the store.

Therapist disagrees with patient's statement that the patient’s
family could have had certain thoughts or feelings during the
patient's childhood or adolescence (neutral internal behavior).
Therapist does not provide data for his statements.

Ex. Your mother could not have been thinking that she needed
to go to the store. Don't tell me that.

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution
is implied or stated. For example, if the therapist indicates
that the patient's mother could not have felt inferior but does
not indicate that she could have felt good, the neutral category
should be coded. The same applies to negations that concern
negative material. This instruction only applies to attribution
categories. Disagreement categories should be scored in the
usual manner.)

Since hypothetical situations are hypothetical, it may be
difficult to judge whether or not mystification is occurring.
Look at the context of the session. Look at whether the
therapist has data to support his comments.)

 

144

Attributions in Others Besides Patient's Family
(all living things {other than family}, objects, or concepts)

 

Affect in Others

802 Therapist states that a person felt or did not feel fear or anxiety
during the patient's childhood when it is not clear whether or not
this was the case. Therapist does not present data for his
position.

Ex. Your friend was frightened.

803 Therapist disagrees with patient's statement of fear or anxiety or
lack of fear or anxiety in others during the patient's childhood
or adolescence. Therapist does not present data for his position.

Ex. I know that your friend was not anxious.

804 Therapist states that a person felt or did not feel anger during the
patient's childhood or adolescence when it is not clear whether or
not this was the case. Therapist does not provide data for his
position.

Ex. The man across the street was not angry.

805 Therapist disagrees with patient's statement of anger or lack of
anger in others during the patient's childhood or adolescence.
Therapist does not provide data for his position.

Ex. The teacher had feelings of anger that year.

806 Therapist states that a person felt or did not feel startled
during the patient's childhood or adolescence when it is not
clear whether or not this was the case.

Ex. Your friend was not startled.

807 Therapist disagrees with patient's statement of another person
being or not being startled during the patient's childhood or
adolescence. Therapist does not present data for his position.

Ex. Your friend was not startled that night.

808 Therapist states that a person felt or did not feel surprised when
it is not clear whether or.not this was the case. Therapist does
not present data for his position.

Ex. The man was surprised to see you.
809 Therapist disagrees with patient's statement of another person

being or not being surprised during the patient's childhood or
adolescence.

 

810

811

812

813

814

815

816

817

145

Ex. The teacher was not surprised. You know that.

Therapist states that a person felt or did not feel distress-
anguish during the patient's childhood or adolescence when it is
not clear whether or not this was the case.

Ex. Your friend was not in constant anguish.

Therapist disagrees with patient's statement of another person
feeling or not feeling distress-anguish during the patient's
childhood or adolescence. Therapist does not provide data for
his position.

Ex. Your friend was in constant anguish. Don't tell me
that he was not.

Therapist states that a person felt or did not feel disgust during
the patient's childhood or adolescence when it is not clear whether
or not this was the case.

Ex. Your lover was disgusted with you.
Therapist disagrees with patient's statement of another person
feeling or not feeling disgust during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your lover was not disgusted with you.

Therapist states that a person felt or did not feel envious
when it is not clear whether or not this was the case.

Ex. When you were a child the scientist was envious of the
artist.

Therapist disagrees with patient's statement of another person
feeling or not feeling envious during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your friend was not envious. You just imagine that.
Therapist states that a person felt or did not feel jealous
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your friend was jealous of your friendship with your lover.
Therapist disagrees with patient's statement of another person
feeling or not feeling jealous during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your friend was jealous. Don't tell me that he was not.

 

818

819

820

821

822

823

824

825

826

146

Therapist states that a person felt or did not feel ppg during
the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. Your dog was sad.
Therapist disagrees with patient's statement of another person
feeling or not feeling §pd_during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your friend went through some sadness. Don't deny that.

Therapist states that a person felt or did not feel shame when
it is not clear whether or not this was the case.

 

Ex. The student felt shame because of the exam.

Therapist disagrees with patient's statement of another person
feeling or not feeling shame during the patient's childhood or
adolescence. Therapist does not provide data.

 

Ex. The patients were ashamed when you were little. Don't
tell me that they were not.

Therapist states that another person felt or did not feel guilt
during the patient's childhood or adolescence. Therapist does
not provide data.

Ex. The teacher had no feelings of guilt.
Therapist disagrees with patient's statement of another person
feeling or not feeling guilt during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your friend felt guilty.
Therapist states that another person felt or did not feel
happiness or joy during the patient's childhood or adolescence
when it is not clear whether or not this was the case.

Ex. The teacher felt happy that school was out.
Therapist disagrees with patient's statement of another person
feeling or not feeling happiness or joy during the patient's
childhood or adolescence. Therapist does not provide data.

Ex. Your friend was not happy. Don't try to think that he
was.

Therapist states that another person felt or did not feel excited
when it is not clear whether or not this was the case.

Ex. The nurse was excited when you went home from the hospital
as a child.

 

827

828

829

830

831

832

833

834

147

Therapist disagrees with patient's statement of another person
feeling or not feeling excitement during the patient's childhood
or adolescence. Therapist does not provide data.

Ex. Your friend was never excited.
Therapist states that another person felt or did not feel hatred

during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

 

Ex. The man hated for a long time.

Therapist disagrees with patient's statement of another person
feeling or not feeling hatred during the patient's childhood or
adolescence. Therapist does not provide data.

 

Ex. Your friend did not hate you.

Therapist states that another person felt or did not feel love
during the patient's childhood or adolescence when it is not clear
whether or not this was the case.

Ex. The woman felt love.
Therapist disagrees with patient's statements of another person

feeling or not feeling love during the patient's childhood or
adolescence. Therapist did not provide data.

 

Ex. The woman did not feel love.

Therapist states that another person felt or did not feel positive
affects in general when it is not clear whether or not this was
the case.

Ex. Your friend felt good about life.

Therapist disagrees with patient's statement of another person
feeling or not feeling positive affects in general during the
patient's childhood or adolescence. Therapist does not provide
data.

Ex. Your friend did feel good about life no matter what you
think.

Therapist states that another person felt or did not feel negative
affects in general during the patient's childhood or adolescence
when it is not clear whether or not this was the case.

Ex. The artist felt bad for quite some time.

 

835

836

837

838

839

840

841

842

843

148

Therapist disagrees with patient's statements of another person
feeling or not feeling negative affects in general during the
patient's childhood or adolescence. Therapist does not provide
data.

Ex. The potter never felt bad.
Therapist states that another person felt or did not feel

confusion or craziness during the patient's childhood or adolescence
when it is not clear whether or not this was the case.

 

Ex. The biologist felt confused a lot during that time.

Therapist disagrees with patient's statements of another person
feeling or not feeling confusion or craziness during the patient's
childhood or adolescence. Therapist does not provide data.

Ex. Your friend was not confused that year.

Therapist states that another person felt or did not feel
emptiness when it is not clear whether or not this was the case.

Ex. Your friend felt empty for several years when you were
a child.

Therapist disagrees with patient's statements of another person
feeling or not feeling empty during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Everyone that you knew during that time felt empty.

Therapist states that another person felt or did not feel lonely
during the patient's childhood or adolescence. Therapist does
not provide data.

Ex. The man never felt lonely then.

Therapist disagrees with patient's statements of another person
feeling or not feeling lonely during the patient's childhood or
adolescence. Therapist does not provide data.

Ex. Your friend always felt lonely at that time. You know
that.

Therapist states that another person felt or did not feel hope
during the patient's childhood or adolescence when it is not
clear whether or not this was the case.

Ex. The girl felt hope.
Therapist disagrees with patient's statements of another person

feeling or not feeling hope during the patient's childhood or
adolescence. Therapist does not provide data.

 

844

845

149

Ex. Your friend did not have hope. There is no point in
you indicating otherwise.

Therapist states that another person felt or did not feel anything
when it is not clear whether or not this was the case.

Ex. The man felt nothing when you were little.
Therapist disagrees with patient's statements of another person
feeling or not feeling anything during the patient's childhood or
adolescence. Therapist does not provide data for his views.

Ex. All of your friends felt nothing.

Person Concept

846

847

848

849

850

851

Therapist makes positive statements about others as people during
the patient' 5 childhood or adolescence. Therapist does not

provide data for his views.

Ex. Your friends were intelligent people.
Therapist disagrees with patient's statement of patient's views
of others as eo 1e during the patient' 5 childhood or adolescence
(positive views 5). Therapist does not provide data.

Ex. The woman was not a good person.

Therapist makes negative statements about others as people during
the patient's childhood or adolescence. Therapist does not provide

data.

Ex. Your friend was cruel.
Therapist disagrees with patient's statement of patient's views
of others as eo 1e during the patient' 5 childhood or adolescence
(n negative views s). Therapist does not provide data.

Ex. Your friend was not cruel.
Therapist makes neutral statements about others as people during
the patient's childhood or adolescence. Therapist does not provide
data.

Ex. The man was busy man.
Therapist disagrees with patient's statement of patient's views of
others as people (neutral views) during the patient's childhood or

adolescence. Therapist does not provide data.

Ex. The man was not a busy one.

 

(Note:

(Note:

150

The neutral category is used when it is not clear whether the
statement is positive or negative. It is also used when a
negation is stated, but a positive or negative attribute is not
specified. Ex., ”Your friend was not a crazy person.“ The
therapist says that the friend was not crazy. He does not go
on to specify something positive or negative. For example,
he does not go on to say that the friend was healthy.)

The person concept category applies to enduring characteristics
over time. For example, if the therapist states that the
friend was crazy and an enduring characteristic is stated or
implied, the person concept category should be scored. If the
therapist states that the friend engaged in crazy behavior or
felt crazy, then the behavior or affect category is scored.)

Other's Motives or Intentions Towards Patient

852

853

854

855

856

857

Therapist states that a person had the intention of doing such and

such to the patient (positive intention) during the patient's
childhood or adolescence. Therapist does not provide data.

Ex. The teacher wanted to understand you.

Therapist disagrees with patient's statement about a person's
intentions or motivations toward the atient during the patient's
childhood or adolescence (positive intention). Therapist does
not provide data.

Ex. Your friend did not want to help you.

Therapist states that a person had the intention of doing such and
such to the patient during the patient's childhood or adolescence
(negative intention). Therapist does not provide data.

Ex. Your friend wanted to have you do his work.

Therapist disagrees with patient's statements about a person's
intentions or motivations toward the patient during the patient's
childhood or adolescence (negative intentions). Therapist does not
provide data.

Ex. Your friend did not want to hurt you. You just think that.

Therapist states that a person has the intention of doing such and
such to the patient (neutral intention) during the patient's
childhood or adolescence. Therapist does not provide data.

Ex. The woman wanted to bring you your dress.

Therapist disagrees with patient's statements about a person's
intentions or motivations toward the patient (neutral intention)
during the patient's childhood or adolescence. Therapist does
not provide data.

 

 

151

858 Therapist states that a person had the intention of doing such
and such during the patient's childhood or adolescence (positive
intentions). Recipient is anyone other than the patient or
recipient may not be specified.

 

 

Ex. The man wanted to care.

859 Therapist disagrees with patient's statements about a person's
intentions or motivations during the patient's childhood or

adolescence (positive intentions). Recipient is anyone but the
patient or recipient may not be specified.

 

 

Ex. Your friend did not care about your mother.

860 Therapist states that a person had the intention of doing such
and such (ne ative intention) during the patient's childhood or
adolescence. Recipient 1S anyone but the patient or recipient
may not be specified.

 

 

Ex. The psychologist wanted to be destructive.

861 Therapist disagrees with patient' 5 statements about a person's
intentions or motivations (n negative intentions) during the patient' 5
childhood or adolescence. Recipient is anyone but the patient

or recipient may not be specified.

Ex. The psychologist did not want to be destructive. You
just think that.

 

862 Therapist states that a person had the intention of doing such and
such (neutral intention) during the patient's childhood or
adolescence. Recipient is anyone by the patient or recipient
may not be specified.

Ex. Your friend wanted to see the woman.

863 Therapist disagrees with patient's statements about a person's
intentions or motivations (neutral intention) during the patient's
childhood or adolescence. Recipient is anyone but the patient
or recipient may not be specified.

Ex. Your friend did not want to see the woman.

(Note: Negations should be included in the neutral category unless the
implication is otherwise. For example, if the therapist states
that a person did not want to hurt the patient, but did not
specify or imply that the person wanted to help him, the neutral
category should be coded. If the therapist implies or states
positive intent, the statement should be scored under positive
attributions. The same applies for negations of positive
intentions. This instruction only refers to attribution
categories. Disagreement categories are scored in the usual
manner.)

 

152

(Note: Others refers to any living thing, objects, or concepts. Even
if most of the examples have been of people, objects, and
concepts can be coded as well.)

External Behavior Attribution in Others

 

864 Therapist states that others behaved in a certain way (positive
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his points.

Ex. The world was nice to you at that time.

865 Therapist disagrees with patient's statements that others engaged
in specific behaviors during the patient's childhood or adolescence
(positive behavior). Therapist does not provide data for his points.

Ex. The hospital had not been taking care of you when you were
little.

866 Therapist states that others behaved in a certain way (negative
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his point.

Ex. Your friend hit the boy at school.

867 Therapist disagrees with patient's statements that others engaged
in specific behaviors (negative behavior) during the patient's
childhood or adolescence. Therapist does not provide data for
his points.

Ex. Your friend did not hit the boy.

868 Therapist states that others behaved in a certain way (neutral
behavior) during the patient's childhood or adolescence. Therapist
does not provide data for his points.

Ex. The boy went out to play.

869 Therapist disagrees with patient's statements that others engaged
in specific behaviors (neutral behaviors) during the patient's
childhood or adolescence. Therapist does not provide data for his
points.

Ex. The woman did not go get the red dress.

Internal Behavior Attribution in Others

 

870 Therapist states that others had certain thoughts or feelings
(positive internal behavior) during the patient's childhood or
adolescence. Therapist does not provide data for his points.

 

Ex. The doctor felt that she had cured you.

 

871

872

873

874

875

(Note:

(Note:

153

Therapist disagrees with patient's statements about other's
thoughts or feelings (positive internal behavior) during the
patient's childhood or adolescence. Therapist does not provide
data for his points.

 

Ex. Your friend did not think about doing nice things for
you.

Therapist states that others had certain thoughts or feelings
(negative internal behavior) during the patient's childhood or
adolescence. Therapist does not provide data.

 

Ex. The boy felt that he was no good.

Therapist disagrees with patient's statements about other's
thoughts or feelings (negative internal behaviors) during the
patient's childhood or adolescence. Therapist does not provide
data for his points.

 

Ex. The boy did not feel that he was no good.

Therapist states that others had certain thoughts or feelings
(neutral internal behavior) during the patient's childhood or

 

adolescence. Therapist does not provide data for his points.
Ex. Your friend thought about his math.

Therapist disagrees with patient's statements about other's
thoughts or feelings during the patient's childhood or adolescence
(neutral internal behavior). Therapist does not provide data for
his points.

 

Ex. The student had not been thinking about physics.

The behavior categories refer to events which are more complicated
than the physical reality categories in that in the behavior
categories specific modes of perception cannot be clearly
inferred. This category includes external events that occurred.
It also includes internal feelings or thoughts. If a feeling
refers to affects, the affect category should be coded. If
intention or motivation is mentioned, the motivation category
should be coded.)

Negations are coded under the neutral internal or external
behavior categories unless a positive or negative attribution is
implied or stated. For example, if the therapist indicates
that a person did not feel inferior, but does not indicate
that he felt good, the neutral category should be coded.

The same applies to negations that concern negative material.
This instruction only applies to attribution. Disagreement
categories should be scored in the usual manner.)

 

154

Hypothetical Situations

 

876

877

878

879

880

881

882

883

(Note:

Therapist states that others could or could not have felt affects
during the patient's childhood or adolescence. Therapist does not
provide data for his view. (See attached list of affects and code
these

Ex. The woman could have been angry.
Therapist disagrees with patient's statement about the possibility
of others feeling or not feeling affect during the patient's
childhood or adolescence.

Ex. The man could not have felt empty.

Therapist states the possibility of a positive person concepp.
Therapist does not provide data for his point.

 

Ex. The woman could have been an intelligent person.

Therapist disagrees with patient's statement of the possibility
of a positive person concept.

 

Ex. The hospital could not have been a good place at that time.

Therapist states the possibility of a negative person concept.
Therapist does not provide data for his point.

 

Ex. Your friend could have been a stupid boy.

Therapist disagrees with the patient's statement of the possibility
of a negative person concept.

 

Ex. Your friend could not have been a stupid boy.

Therapist states the possibility of a neutral person concept.
Therapist does not provide data for his point.

 

Ex. Your friend could have been a busy person.

Therapist disagrees with patient's statement of the possibility
of a neutral person concept. Therapist does not provide data for
his point.

Ex. Your friend could not have been a busy person.

A negation is scored as neutral unless a positive or negative
aspect is stated or implied. For example, if the therapist
states that the patient's friend could not have been a dumb
person, but does not imply or state a positive emphasis, the
statement should be scored as neutral. The same applies to
negations of positive person-concept statements. These
instructions apply only to attributions. Disagreements are
scored as usual.)

884

885

886

887

888

889

890

891

155

Therapist states that a person c0u1d have had a positive intention
or motivation toward the patient during the patient's childhood
or adolescence. Therapist does not provide data for his assertion.

Ex. The world could have wanted to help you.

Therapist disagrees with patient's statement of the possibility
that a person could have had a positive intention or motivation
toward the patient. Therapist does not provide data for his
assertion.

Ex. The world could not have wanted to help you.

Therapist states that a person could have had ne ative intentions
or motivations toward the patient during the patient's ch1|dhood
or adolescence. Therapist does not provide data.

Ex. People could have wanted to see you become crazy.
Therapist disagrees with patient's statement of the possibility
that a person could have had a negative intention or motivation
toward the patient during the patient's childhood or adolescence.
Therapist does not provide data.

Ex. People could not have wanted to see you remain crazy.
Therapist states that a person could have had neutral intentions
or motivations toward the patient during the patient's childhood
or adolescence. Therapist does not provide data.

Ex. Your friend could have wanted to talk to you that time.
Therapist disagrees with patient's statement of the possibility
that a person could have had neutral intentions or motivations
toward the patient during the patient's childhood or adolescence.
Therapist does not provide data for his assertion.

Ex. That man could not have wanted to take you over to visit
some friends.

Therapist states that a person could have had positive intentions
or motivations during the patient's childhood or adolescence.

Recipient of the intention is not specified or is anyone other than

the patient. Therapist does not provide data.
Ex. The social worker could have wanted to help the girl.

Therapist disagrees with patient's statement of the possibility
that a person could have had ositive intentions or motivations
during the patient's childhood. Therap1st does not provide data.
Recipient of the intentions is anyone other than the patient or
recipient may not be specified.

 

 

 

892

894

895

(Note:

896

897

156

Ex. The hospital could not have wanted to help the girl.

Therapist states that a person could have had negative intentions
or motivations during the patient's childhood or adolescence.

Recipient of the intention is not specified or is anyone other
than the patient. Therapist does not provide data.

Ex. The hospital could have wanted to be destructive.

Therapist disagrees with patient's statement of the possibility
that a person could have had negative intentions or motivations.
Recipient of the intention is anyone other than the patient or
recipient mgy not be specified. Therapist does not provide data.

 

Ex. The hospital could not have wanted to be destructive when
you were a child.

Therapist states that a person could have had neutral intentions
or motivations during the patient's childhood or adolescence.
Recipient of the intentions is not specified or is anyone other
than the patient. Therapist does not provide data.

Ex. Your friend could have wanted to go visiting.

Therapist disagrees with patient's statement of the possibility
that a person could have had neutral intentions or motivations
during the patient's childhood or adolescence. Recipient of the
intention is anyone other then the patient or recipient may pp:
be specified. Therapist does not provide data.

 

Ex. Your friend could not have wanted to go visiting.

Negations should be scored as neutral intentions unless a
positive or negative aspect is also stated or implied. For
example, if the therapist states that a person could not have
wanted to hurt the patient, but does not state or imply a '
positive intention, the neutral category should be coded.)

Therapist states that a person could have engaged in positive
external behavior during the patient's childhood or adolescence.
Therapist does not provide data.

Ex. The woman could have cared for her children adequately.

Therapist disagrees with the patient's statement that a person
could have behaved in a certain way (positive external behavior)
during childhood or adolescence. Therapist does not provide
data for his statement.

 

Ex. The woman could not have cared for her children adequately.

 

898

899

900

901

902

903

904

905

157

Therapist states that a person could have engaged in negative

external behavior during the patient's childhood or adolescence.

Therapist does not provide data.

Ex. Your friend could have gone around making people feel
bad.

Therapist disagrees with the patient's statement that a person
could have behaved in a certain way (pegptive external behavior)
during the patient's childhood or adolescence. Therapist does
not provide data for his statement.

Ex. The doctor could not have gone around making people feel
bad.

Therapist states that a person could have engaged in neutral

external behavior during the patient's childhood or adolescence.

Therapist does not provide data.
Ex. The man could have gone visiting.

Therapist disagrees with the patient's statement that a person
could have behaved in a certain way (neutral external behavior)
during the patient's childhood or adolescence. Therap1st does
not provide data.

Ex. The man could not have gone visiting.
Therapist states that a person could have had certain thoughts or

feelings (positive internal behavior) during the patient's
childhood or adolescence. Therapist does not provide data.

 

Ex. Society could have thought nice things about you.

Therapist disagrees with the patient's statement that a person
could have had certain thoughts or feelings (positive internal
behavior) during the patient's childhood or adolescence. Therapist
does not provide data.

Ex. Society could not have thought nice things about you.

Therapist states that a person could have had certain thoughts or

feelings (negative internal behavior) during the patient's childhood
or adolescence. Therapist does not provide data.

Ex. Your friend could not have felt that she was a good person.

Therapist disagrees with the patient's statement that a person
could have had certain thoughts or feelings (negative internal
behavior) during the patient's childhood or adolescence. Therapist
does not provide data.

Ex. The boy could have felt that he was O.K. You don't know
what you are talking about.

 

906

907

(Note:

(Note:

(Note:

(Note:

158

Therapist states that a person could have had certain thoughts or
feelings (neutral internal behavior) during the patient's
childhood or adolescence. Therapist does not provide data.

 

Ex. The woman could have thought that she needed to go to the
store.

Therapist disagrees with the patient's statement that a person
could have had certain thoughts or feelings (neutral internal
behavior) during the patient's childhood or adolescence.

Therapist does not provide data.

Ex. The woman could not have thought that she needed to go
to the store.

Negations are coded under neutral internal or external behavior
categories unless a positive or negative attribution is implied
or stated. For example, if the therapist indicates that a
person could not have felt inferior but does not indicate that
he could have felt good, the neutral category should be coded.
The same applies to negations that concern negative material.
This instruction only applies to attribution categories.
Disagreement categories should be scored in the usual manner.)

Since hypothetical situations are hypothetical, it may be
difficult to judge whether or not mystification is occurring.
Look at the context of the session. Look at whether the
therapist has data to support his comments.)

The thought or feeling (internal behavior) category does not
apply to specific affects. If specific affects are stated
the material should be coded under the affect category.)

Person refers to any living thing, object, or concept. The
word person has been used here to simplify the language.)

 

 

REFERENCES

 

REFERENCES

Bateson, 6., Jackson, D.D , Haley, J., & Weakland, J. (1956). Toward
a theory of schizophrenia. Behavioral Science, 13 251-264.

Boszormenyi—Nagy, 1- (1965). A theory of relationships: Experience
and transaction. In I. Borszormenyi-Nagy & J.L. Framo (Eds.),
Intensive family therapy: Theoretical and practical aspects.
New York: Harper and Row.

Fairbairn, W.R.D. (1952). Psychoanalytic studies of the personality.
London: Routledge and Kegan Paul.

 

Guntrip, H. (1969). Schizoid phenomena, object relations and the self.
New York: International Universities Press.

 

Karon, B.P. & VandenBos, G.R. (1981). Psychotherapy of schizophrenia:
The treatment of choice. New York: Jason Aronson.

 

Klein, M. (1975). Notes on some schizoid mechanisms (1946). In
Envyand gratitude and other works 1946-1963. New York: Dell
Publishing Company.

Laing, R.D. (1959). The divided self: An existential study in sanity
and madness. Middlesex, England: Penguin Books.

 

Laing, R.D. (1961). Self and others. New York: Penguin Books.

Laing, R.D. (1965). Mystification, confusion, and conflict. In I.
Boszormenyi—Nagy & J.L. Framo (Eds.), Intensive family therapy:
Theoretical and practical aspects. New York: Harper and Row.

 

Laing, R.D. (1969). The politics of the family and other essays.
New York: Vintage Books.

 

Laing, R.D. (1970). Knots. New York: Vintage Books.

Laing, R.D. & Esterson, A. (1964). Sanity, madness, and the family:
Families of schizophrenics. Middlesex, England: Penguin Books.

 

Lidz, T. (1973). The origin and treatment of schizophrenic disorders.
New York: Basic Books.

 

Lidz, 1., Fleck, S., & Cornelison, A.R. (1965). Schizophrenia and
the family. New York: International Universities Press.

159

 

160

Meyer, R.G., & Karon, B.P. (1967). The schizophrenogenic mother
concept and the TAT. Psychiatry, 39) 173—179.

Mitchell, K.M. (1968). An analysis of the schizophrenogenic mother
concept by means of the Thematic Apperception Test. Journal of

Abnormal Psychology, 733 571-574.

Mitchell, K.M. (1969). Concept of ”Pathogenesis" in parents of
schizophrenic and normal children. Journal of Abnormal Psychology,
74, 423-424.

 

Nichols, N. (1970). The relationship between degree of maternal
atho enicit and severit of e 0 im airment in schizo hrenic
offspring. Unpublished doctoral dissertat1on, University of
Michigan.

 

Searles, H.F. (1965). Collected papers on schizophrenia and related
subjects. New York: International Universities Press.

 

Singer, M.T., & Wynne, L.C. (1963). Differentiating characteristics
of parents of childhood schizophrenics, childhood neurotics, and
young adult schizophrenics. American Journal of Psychiatry, 129,
234-243.

 

Singer, M.T., & Wynne, L.C. (1965). Thought disorder and family
relations of schizophrenics. III. Methodology using projective
techniques. Archives of General Psychiatry, 12, 187-200.

 

Singer, M.T., & Wynne, L.C. (1963). Thought disorder and family
relations of schizophrenics. IV. Results and implications.
Archives of General Psychiatry, 12) 201-212.

 

Skynner, A.C. (1976). Systems of family and marital psychotherapy.
New York: Brunner/Mazell.

 

VandenBos, G.R., & Karon, B.P. (1971). Pathogenesis: A new therapist
personality dimension related to therapeutic effectiveness. Journal
of Personality Assessment, pp, 252-260.

 

Wynne, L.C., & Singer, M.T. (1963). Thought disorder and family
relations of schizophrenics. I. A research strategy. Archives
of General Psychiatry, 9, 191—198.

 

Wynne, L.C., & Singer, M.T. (1963). Thought disorder and family
relations of schizophrenics. II. A classification of forms of
thinking. Archives of General Psychiatry, 9, 199—206.

 

 

 

 

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