. J- V V V V . . V V . V . Q ~ V .V V V V V V V. .V . V V _ .V. o. V V V V . V V a V l. V. V V V . .V .V. V Vouifzu 0—0. V V V . . . . V. V V . v V V . V V V .V .. V. . . V V . . V V . V . V . .VV » . V . V V . .4 .V . V V. .V n V . V V V V . V. V - . V I .V n V -. V n A V . . V. V .. . V V V V . . V . . V V V . . V . V V V V V . V V . o . 1 VV. V V V V. V V V. VV . V V V V V V V. V V o . V A V o . V .o V. V V . .. V . V V V V V .V V. . . . V V VVV V . V . V V . . V V V V . p u . V V V V . V . V V V V . V V . V V V V V V. . . . ._ V t a V V V n . V V . V V V. . V V V. V .V V V . V . Q A V V V. V V V I V. V . o . V V o v V . . V. V. .V I . V V . V V! V .. . .5 a V V . V V. V .V t. .V V V .- . V . . .oV A V V V V V . V . V V V V . V . . V V V . V. V V V . V .V V % . . V. . V. V V V 0 V V V. V V . V . V . .V . . V V . V. .V . 9 V V w . V .V V V . V... V V V V . . . V V . . .V .V . V . . . W V V V n V V. . . . A V . .V V V. V V V. V V V V . .V V . V . .V V V V K V 1. VV . V . . V . 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V . V V V V V V V I. O V V V v V. A V V- V V V V. V o 0 V V. V V o . V . V V V V V V. r V. V . V V V . . V 9V V V a V V.V . V . .V. V . V V V .0. V V _ V V . V V V V . V V V V V V V o . V V. t V . V V O V V V n V V o V . . . V.. V; . V V . . V V V . r . . V V V V V V V. V .V r n V. V V V V v V . V. . V . V. 0 V V V V . V V V V V V V V. _. . V 3 . V V.. . V V 0 ‘ V . n V V. v n V V. . V. . V V .u r . V . _ I _ . . V. . . .V V V M V O u . 0. V. V . V V V V 4 V V . V v . . U l o _ . .. .V V V . .2 V . V V V V V V. V V V . V V V . V .D V VVV'. V V V V V V . A V- V V. .u V V.. V V. V V .V . V V V o .0 V V . V V V . V V V V .V . V . . . . . V V «V V V I no 0. V v 1- A. . . V V . V V V. V . V- V V V V .V a . V V . V V V. V . V . N V . V V V - . V . V .V U . . . . . . . V I . . . V . .. .V V J .V . V V . V V V V V . . n V . V a V .. V I n - n V - V o m . ' V V V . V 0 V V V n l g V. I o . V . V V V V. V V C n n . . V. V V a . V V . V V V I I V N V I O s . V ' V. V . g V V V . V V i . . M o o . V V . V . V . . r O V, 5 W I V I m a u c . I o o V . . . o I o — V . w — V . a V V . v . V. . V. V V . ‘ V V .V V V _ .V V V, .VI .V_ V V V V. .V V .V V V V V n a V . . . .V o . . V IO. .. V V . V . V V VI .26 ..u .. o. .3 .y . V V V V .3. V V V V V n V V V V . I . V V . V 0 n . V . V V .V-L V o . .V x . . V —. n V .9 v V . V . . V t I... V V .‘0V V V-L. V aou V V .V. . 0;: V v‘... . 2 V V ; V s V V V V . . V . V . U .V V V I c 5.: V V .0 V ..V .V. r. V v V. IVA. .V v. . . . VvVO . a V a. V. . V V V . . V V V V . .4.Mv. V 3. z I V lV/Fl. .o. V.v VD... .V V IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 3 1293 00069l ABSTRACT PERSPECTIVES ON PSYCHOTHERAPY: DRIVE CONTENT AND EXPERIENCING BY Alison Jones The relationship between drive content and experiencing level in therapy was investigated by rating selected TAT cards for drive content and by rating tape segments taken from the second therapy sessions. The subjects used were college students seeking psychotherapy at MSU's counseling center. The major focus of the study centered upon determining whether drives as they were expressed on a projective measure manifested themselves in therapy as part of the client's ability to experience or focus within the therapy setting. It was expected that the clients level of affective expression and ego control measures should have a direct bearing on what takes place in therapy. As such it was assumed that there would be a relationship between drives as expressed on a projective measure and the extent to which there is inward focus in therapy. In ascertaining the accuracy of these propositions the following hypotheses were presented and tested: Alison Jones 1. Experiencing is negatively related to extreme levels of drive content (high or low) and positively related to moderate levels of drive content. 2a. A positive relationship was hypothesized between experiencing and expressing drives in a socially unacceptable manner. 2b. A negative relationship was hypothesized between experiencing and expressing drives in a socially unacceptable manner. 3. A relationship was hypothesized between integration of drive and content and experiencing. None of the hypotheses were supported statistically. When the hypotheses were not confirmed other factors were explored. It was found that when level of client disturbance (as measured by the MMPI) was taken into account, Experiencing in therapy did relate positively to drive content ratings. Also, when gender differences were taken into account, the ratings for male subjects showed a positive correlation between experiencing level and direct socialized drive content. The same was not found for female clients. This research suggests that gender differences and levels of disturbance need to be taken into account when formulating hypotheses regarding therapeutic processes. lin,lu{ ll PERSPECTIVES ON PSYCHOTHERAPY: DRIVE CONTENT AND EXPERIENCING BY Alison Jones A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Psychology 1975 To Packie, Schnevitie and Babekins ii .- iltrl‘fnl‘ [[[rl II‘. [.11. . III-1‘. Ill ll! Ill lll‘\ if-O[([r[..[ ‘l . I III I ‘ n 3 ACKNOWLEDGMENTS I wish to express my deepest appreciation to Dr. Norman Abeles, my committee chairman, for his ready availability, invaluable guidance and encouragement throughout all phases of this research. I would also like to thank Dr. Bertran Karon and Dr. Dozier Thornton for their assistance and participation on my committee. iii i 5 ; lilllId.‘ I’I ‘I III. .Il’u. II" Ili- ‘%IJE Elli. . “Films 7- . . L[.[ [f III .. -‘l'w .’. I, III! .r, .lvlu Ill .II. V\. .3 \ .\ . . TABLE OF CONTENTS INTRODUCTION 0 O O O O O O O 0 Client Variables . . . . Instruments . . . . . . . HYPOTHESES . . . . . . . . . . METHOD 0 O O O O O O O O O O 0 subjects 0 O O O O O O . Instruments . . . . . . . Rater Selection, Training RESULTS 0 O O C O O O O O O 0 Reliability of Measures . Hypotheses . . ... . . . DISCUSSION . . . . . . . . . . BIBLIOGRAPHY . . ... . . . . . APPENDICES . . . . . . . . . . and Procedure A. Data for Exp. Scale and Drive Content B. A Manual for Rating Drive Content in the Thematic Apperception Test . . . iv Page 21 22 22 22 28 30 30 32 42 47 51 51 52 Hand—1191!. 3.2!. . 4‘, iv LN.» ‘Isl. . .y .m% H w LIST OF TABLES Table Page 1. Interrater reliability on Exp. Scale . . . . . . 3O 2. Interrater Agreement for Total Drive Content, Drive Level and Drive Integration Ratings (M = 30) O O O O O O O O O O O O O O O O O O O 31 3. Drive Content and Exp. Level for High MMPI Scorers (i.e., those with 3 T scores above 70) and Low MMPI Scorers (i.e., those with fewer than 3 T scores above 70). . . . . . . . . . . 39 4. Drive Content and Exp. Level for Males and Females O O O O O I O C O O I O O O O O O O 0 4O I, ' I. \l .l ‘l .IA l.l.lrl {[Illll. ,[ I .1 (III. .III. (I lll‘l‘n'll'lfl [‘[rll INTRODUCTION 'What goes on in a psychotherapeutic session is in- fluenced by many factors. Client variables, therapist variables, type of therapy, experience level of the therapist, among others, all contribute to the therapeutic interaction and outcome. The variables that affect the therapeutic process have far reaching consequences for research and practice in this area. If it can be stated with certainty that some variables affect the therapeutic session in parti- cular ways, then it can be predicted and determined with reasonable accuracy which persons would benefit most from what kinds of therapists and types of therapies. In this study an attempt was made to examine certain client measures and see how these factors influence processes in therapy. More specifically, drive content as it was expressed in the T.A.T. and measured using Pine%5(l960) scoring system was related to "experiencing" level (1969) in therapy. Since the level of affective expression a client brings into the therapy session should have a direct bearing on what takes place there, it was expected that there would be a relationship between drives as expressed on a projective measure and the extent to which there was inward focus in therapy. .{IIII [.(l Simply stated it is suggested that client dynamics strongly influence what occurs in psychotherapy. Furthermore, by knowing the relationship between client dynamics and inward focus in therapy it ought to be possible to determine which therapies are best for specific clients. Client Variables Many studies have dealt with the effects of client variables on the process of therapy. Since what takes place in a therapeutic session is influenced not only by the therapist's personality and skills but also by what the client contributes to the interaction, it is necessary to examine some of the client variables that could have a pronounced effect on the therapeutic process. The client factors influencing the therapeutic process include such variables as adequacy of general personality functioning, motivation, intelligence, age, sex, affect, self-awareness, insight, and sensitivity. A look at some of the studies done relating these variables to process in therapy will help clarify some of the intervening variables in a therapeutic interaction. Considering first the adequacy of general personality functining and prognosis in psychotherapy, many of the studies reviewed suggest that the healthier the patient is to begin with the better is the outcome in therapy. Harris and Christiansen (1946) studied to see which personality correlates were associated with different responses to Ill" \[r‘I ‘[ \[ri .ll‘flq‘lfl l,a.|l-Illul.l’.[l[ [III [fi'll psychotherapy. Using the MMPI, Rorschach, and the Wechsler- Bellevue Adult Intelligence scale to predict responses to psychotherapy in their sample of physically ill patients, they found that those responding poorly to therapy were the ones with psychotic trends in their personality and conversely, those with ego-strength and mental health did better. Hamburg, Bibring, Fisher, Stanton, Wallerstein, Weinstock and Haggard (1967) report the results of questionnaires sent to 1,000 psychoanalysts quizzed about their patients. The questionnaire results suggest that fewer of those classified as having serious illnesses were judged improved as compared to those with less serious diagnoses. They found that with male schizophrenics fewer improvements (than would be expected by chance) occurred whereas for both males and females high in anxiety reactions, more of both sexes were reported as improved. In relating the client variable of motivation and/or expectation in therapy to therapeutic prognosis several studies are relevant. Cartwright and Lerner (1963) report a study with twenty-eight patients in client-centered counseling using pre and post-test measures. The results they obtained suggest that a patient's need to change at the start of therapy is directly related to his level of improve- ment. Goldstein (1960) reports that clients who have positive expectations about therapy change more. Along the same lines, Brady, Reznikoff and Zeller (1960) report that a good deal - 1.47.3 35.5“ .3 5. a“ is ..{Ia Lulu: .4 . ....r In ’ l ‘l ‘..[.[[[[[ .l‘[[[ lllll..l[.l[[{ll [~ll" I of theoretical information exists, supporting the notion of the importance of the patients prognostic expectancies on improvement. Studies relating the client variable of intelligence to prognosis in therapy suggest that patients with a higher level of intelligence (as measured by a standard intelligence test) do better in therapy. A study by Barron (1953) on twenty-three adult psychoneurotics after six months of psychotherapy. to assess certain personality and intelligence test correlates of change, suggests that intelligence is positively associated with change in psychotherapy. Rosenberg (1954) also reports that the most favorable prognosis in therapy is found with patients with superior intellectual ability, who can produCe associations easily and who are not rigid in their thinking. As the population to be used in the proposed investigation consists of college students, the level of intelligence can be expected to be above average and this variable should not be expected to vary significantly with the subjects. The variable of affect has direct bearing on the present study, as it seems to be a particular mode of expression of drive content. Studies relating measures of affect with outcome in therapy suggest that certain affects are positively correlated with favorable prognosis in therapy (Luborsky, 1971). In a review of the literature on factors influencing the outcome of psychotherapy (Luborsky, 1971), five out of nine studies in which initial anxiety level was assessed found positive relationships existing between high anxiety and improvement. He also reported that depression is a good prognostic indicator for change, whereas flattened affect suggests poor outcome. The same reviewer further states that although anxiety and depression are the best indicators for change, nearly any affect is more indicative of health, than no affect at all. Kirtner and Cartwright (1958) worked with the hypothesis that the length of therapy with respect to outcome is related to the personality struc- ture of the client at the start of therapy. Their results suggest that the short term success groups in therapy have a higher level of personality integration, are more Open to their impulse life and are less confused about their sex- role identity than are the other groups. In other words, they seem to express more affect than the long term success group, short term or long term failure group. Gallagher (1954) attempted to distinguish between the most successful therapy cases (as measured by using a multiple criteria scale for success in psychotherapy deve10ped by Tucker) by using pre-therapy test measures. Administering the MMPI, Rorschach and the Mooney Problem Checklist to seventy-six students who had come to the counseling center at Penn State University, he obtained results that supported his hypothesis, that success in the client-centered therapy situation is positively related to the amount of overt stress present and is negatively related to the amount of verbal productivity shown in the tests given before therapy. Another study by Luborsky (1962) investigating patient variables connected with change in long term therapy, resulted in the finding that the variable of "anxiety level" was correlated significantly with the measure of change on a health-sickness rating. Similarly, Gottschalk, Mayerson and Gottlieb (1967) found that patients who rated high on an anxiety scale (Psychiatric Morbidity Scale) did better in therapy than those ranking low on this measure. Closely related to affect, some studies done relating self-awareness, insight and sensitivity to prognosis in therapy suggest that clients with these characteristics do better in therapy. .For example, Zolik and Hollon (1960) using three groups of patients (those having brief psychother- apy, those requiring long term psychotherapy and those refusing therapy), measured and compared them on sixteen dimensions. Their results suggest that patients in short term psychotherapy are less defensive, have more insight, fewer pathological symptoms and the lowest level of self- esteem. Patients refusing recommended psychotherapy are most defensive, least anxious, have the highest levels of self- esteem, and the most pathology. Long term patients fall in between these two groups on these dimensions. Ii: ESE. ......HlnnfiimJJ £13.. Instruments The Exp. Scale is an instrument designed to measure a person‘s level of experiencing or self-involvement in therapy. Experiencing refers to a person's ability to focus upon his feelings and emotions. In the manual the Exp. Scale (1970), experiencing is defined as being "the quality of an individuals experiencing of himself and the extent to which his ongoing, bodily, felt flow of experiencing is the basic datum of his awareness and communications about himself, and the extent to which this inner datum is integral to action and thought" (p. 1). According to Gendlin, experiencing is seen as a ". . . preconceptual, bodily sense of being in interaction with the environment, a guts-level sense or felt meaning of things. This includes the feeling of having experience and the continuous stream of sensations, impression, somatic events, feelings, reflexive awareness, and cognitive meanings that make up one's phenomenological field" (p. 4). .Rogers (1958, 1959) assigned a crucial role to experiencing in therapy. Only when a person can get in touch with his feelings and integrate them into his core-self can he become a self-actualized, fully functioning personality. Through his influence the Exp. Scale evolved from a client- centered framework where the therapeutic process involved having the patient get in touch with his feelings and express them Openly. The Exp. Scale has also been used as a research tool in studying the dynamics of the psychotherapeutic relationship. For example, in a study by Schoeninger (1965) the Exp. Scale was used to determine the effects of training (of c1ients)in.experiencing and the effects of therapist self- disclosure on therapy sessions. The study used two conditions of therapist behavior both self-disclosure and non self-disclosure (i.e., the clients appraisal of this) combined with both the presence and the absence of pre- therapy training in Exp. The pretherapy training for the 32 subjects included MMPI testing, questions about their expectations, a recorded discussion of their personal problems, and for half of the subjects, training in rating on the Exp. Scale. After three sixty minute therapy sessions, the subjects rated their therapists on several variables. The results showed that the clients Exp. level was closely related to their personality characteristics and expectations but was not influenced by pretraining. Still further, Exp. levels were not 7 related to therapists behavior (i.e., self-disclosure or non-disclosure) but rather were correlated with the therapist qualities as they were perceived by their clients. Auerbach and Luborsky (1968) used the Exp. Scale in an attempt to understand certain process variables involved in therapy, including those factors that facilitate or inhibit change. An attempt was also made to determine the constituents alumni... {lien} . 1., [[llfl‘f‘ [.[l‘ [Il‘[[..llI1l' ll[(\.[[€l| sultry?” . . .r .‘r nah": ... .....fléq of a "good" therapy hour. The researchers obtained therapy tapes from fifteen experienced therapists. Each therapist provided tapes from two of his patients. Using as their sample two successive sessions from the early part of therapy, two professional and one non-professional judge separately rated the sessions on twelve therapist and thirteen patient variables relating to change in psychotherapy. The results suggest mostly satisfactory reliabilities, with much variation ranging from .76 to -.l3. Lower reliabilities were obtained for the professional and non—professional judges than for the two professional judges. With respect to the constituents of a "good" therapy hour, Exp. did not differentiate between "good" and "less good" hours. With respect to more recent studies using the Exp. Scale, Kiesler (1969) relates Exp. level scores to Eysenck's personality dimensions of neuroticism, and extroversion- introversion. His basic hypothesis is that Eysenck's personality dimensions will be related to Exp. level, as measured in a quasi-therapy situation. The quasi-therapy situation consists of having the subjects interview themselves about their problems, values and personality charactersitics as they speak into a tape recorder in a room alone. The subjects were 88 students in psychology undergraduate classes, and 68 undergraduate and graduate students applying for counseling at the university counseling center. Samples of their self-interviews were obtained and rated for Exp. 10 level by a group of judges. The results suggest that the variables of sex and client versus non-client status interacted significantly with Eysenck's personality dimensions. None of Eysenck's dimensions alone, however, were related to Exp. level. Again using the Exp. Scale, Gruver (1971) attempted to determine whether individual process measures involving short samples of tape recorded interactions between therapist and client which are rated on Exp. Scale are a valid and reliable indicator of success in psychotherapy. His procedure involved using tape recorded samples of three groups of interactions of 18 college students. The first set of samples came from an interview setting with therapist and client while the other two came from group therapy types of settings. The three samples were rated in Exp. The correlation between Exp. level of the three samples as well as the relationship of experience level to different psychological tests (Gough Adjective Checklist and a modified semantic differential self-description measure) was determined. Results showed no significant linear relationship between Exp. level of random samples of group interactions and Exp. level of dyadic interaction samples. Neither was there a significant rela- tionship between Exp. level at the termination of therapy sessions and the paper and pencil psychological measures. They also found that individual Exp. level was relatively stable over fifteen weeks while group Exp. level gradually increased over the fifteen week time span. 11 The Pine scoring manual (1960) presents a system for rating drive content in the T.A.T. The manual provides a system for scoring the extent to which drive content is integrated within the T.A.T. stories. Effective integration of drive content is reflective of functional adaptation and is a measure of ego control. Weak integration of drive content reflects lack of impulse control and a weakening of ego strength. The manual describes three major types of ratings of drive content. The first of these, total drive content, refers to the total number of derivatives of both sexual and aggressive drives which appear in the manifest content of the T.A.T. stories. Drive content is rated only if it appears explicitly in the story. Speculations about implied motives and symbolic expressions of drives are ignored in the scoring system. Drive content is also not rated if it appears in response to an explicit inquiry question. The second type of rating refers to the degree of inte- gration of drive content in the stories. The extent to which drive content is integrated within a T.A.T. protocol is indicative of the appropriateness of drive expression and the strength of ego control. In relating a story, drive content which is used to develop the main theme of the story is labeled thematic and that which is used to enrich the story, incidental. These two types of ratings are interpreted as being task appr0priate and indicative of an appropriate use of drive content. Drive content which LEI! A I‘l‘ll“ ll'l’ ‘1‘ kl! .I II 12 is labeled non-appropriate refers to side comments, verbal slips involving drive derivatives and other unrelated expres- sions of drive. Non-appropriate ratings suggest that non- adaptive regression and ego-alien drive expression has occurred. The third type of rating refers to the directness of expression of drive content in the T.A.T. stories. The present manual depicts three levels of expression of drive content. Level 1 or direct-unsocialized, refers to those expressions of drive content where sexual or aggressive impulses are expressed in unconventional and primitive ways. Rape, incest, robbery, murder, prostitution are included here. Drive content rated as level 1 is indicative of a breakdown in ego functioning and an inability to regress adaptively. The second level of drive expression, direct-socialized ratings, refers to expressions of drive content where impulses are expressed in conventional, socialized ways. Kissing, anger without physical violence, childbirth, inter- course between marriage partners are included here. High scores on level 2 are indicative of adaptive regression as well as ego control and strength as here the ego is playing an active role in defining the form which the drive takes. The third level of drive expression, disguised-indirect ratings, refers to the fact that the drive itself is not expressed but indirect references to it permit the inference that a certain drive concerns the person. Mention of words 13 as boyfriend, girlfriend, husband, saloons, illnesses, soldier, etc. are rated here. High scores on the disguised- indirect dimension are indicative of strong ego controls with very little regression. Aside from the levels of drive ratings, three additional points on drive level ratings are noted. First, the negation of drive expression is rated the same as the positive expres- sion of drive. Second, thoughts and wishes are rated the same as actions in most instances. And third, the context of the story must always be considered in rating drive content. For example, kissing which is ordinarily rated level 2, if seen in the context of the seduction of a married person, would be considered as level 1. In another study by Pine, (1959) the relationship between various drive content scores on the T.A.T. and the literary creativity of the stories was examined. The results indicate that productions of higher literary quality had more drive content than did stories of lower literary quality. The results also show a positive correlation between con- trolled drive expression and the quality of production. Pine showed that literary quality was positively related to the- matic ratings and negatively related to non-appropriate ratings. These findings were in the hypothesized direction. Reliability Studies in this area suggest that the Pine scoring system has adequate reliability. Stories told in response to l4 eight T.A.T. cards were rated independently by two raters. The two raters practiced rating together but for the actual ratings, worked independently. Discrepancies between the raters, were resolved through discussion and final ratings were achieved. An agreement between the raters was considered when both of them rated the same unit of content or when they both agreed that a story should receive no ratings. Of 637 rated units of drive content, the raters agreed in 414 instances. This gave them a consensus 69% of thetime which, although not perfect, is a good deal more than would be expected by chance alone. Validity The validation studies done on Pine's system lend support to the scoring system outlined above. To carry out these studies, Pine obtained Q-sort ratings on 14 male under- draduates by giving gs a Rorschach, and a Weschler-Bellevue test in addition to having them write an autobiographical statement as well as having them be interviewed by a trained clinical psychologist. He had two raters, at first separately and then jointly use these materials to rate gs on six Q-sorts. (Affects and Inner States, Thought Processes, Motives, Defenses, Interpersonal Behavior, Identity, and Self-Attitudes.) Correlations between the scores on the T.A.T. stories and the Q-sorts measures were then obtained to determine some measure of the validity of the T.A.T. scores . Eflirvwx..a.hvvluu MAE. u I . I ll} [flit [[[u’l luff-[Ill ,l. ‘a‘ ‘I. ‘ll 15 Pine reported the following results based on the corre- lation between the scores: §s with high drive presence tend towards emotionality, expressiveness and flux. An expressive quality characterizes thinking, communication and relation- ships. At times, the expressiveness has a distinctly positive and adaptive character including spontaneous affect, insight- fulness and meaningful relationships. At times this tends toward an excessive fluidity both in emotional control and in identity. In marked contrast, individuals with low drive presence appear to reflect a pattern of inhibition, over- control and rigidity. These gs seem to be out of touch with the inner resources of personality: thinking is blocked and control operations seem both excessive and shaky. There is also a blocking of the resources for expressive contact with the world outside: both emotionality and relationships are minimal (Ibid., p. 41-42). §s with well integrated drive content present an over- all picture of smooth functioning. Their thinking is effi- cient and proceeds without disruption by anxiety. Expressive needs find their outlet through relatively controlled channels, and a basis for steady and adequate personality functioning appears well established. (Coupled with this is some tendency towards experiencing conflicts internally and psychologically.) §s with poorly integrated use of drive material appear to be characterized by anxiety and disruption. The personality appears to be under constant stress, having an affective life that is frequently unpleasant, 16 characterized by anxiety rather than more controlled and positive feelings (Ibid., p. 43). gs who modulate the use of drives and express them in direct—socialized ways are characterized by having a balanced ‘relationship between expressive and control processes. This is reflected in a relatively free intellectual and esthetic expressive style, a flexible identity, equal peer relation- ships, and adequate controls over impulses. ‘Ss who used unmodulated or direct unsocialized drive expression show a tendency towards impulsive discharge and mechanisms of adjust- ment to this. The tendencies toward discharge are indicated in competitive social relationships, loose thinking, a fear of loss of control and the absence of a tendency to discharge impulses in internalized ways, such as fantasy. Also, there is a weakening of the inner resources for control either through intellect or through other defenses (Ibid., p. 43-44). M.M.P.I. The MMPI is an often used personality test designed to assess major personality attributes which influence a person's functioning and adjustment. In general, the MMPI is a good instrument to use in measuring personality varia- bles as well as variation, as it is sensitive to change within an individual. In the present study the MMPI is being used to control for the level of disturbance within the population being sampled. There is evidence that .(b 17 individuals with high MMPI T scores function differently than individuals who do not have high T scores, therefore it is important to control for this variable. Many studies have been done using the MMPI with college students. Here we will focus on those which have dealt with using the MMPI to establish changes in college students in therapy. Gallagher (1963) investigated changes in the MMPI profiles of students undergoing client-centered therapy. The subjects were Penn State College students who had sought help in the school's psychological clinic. Interview sessions were taped and transcribed, and the MMPI was administered before and after therapy. The basic hypothesis tested was that personality changes taking place in therapy should be reflected by the MMPI. The forty-one subjects used in the study were counseled by advanced graduate students in clinical psychology. The results of the tests suggest a significant change in the direction of decreases of T scores on the MMPI from pre to post therapy test measures on six of the scales, with the greatest change being found in the feeling or mood scales and the smallest in the character and behavior disorder scales. The changes in the maladjustment ratings on the MMPI correlated positively with measures of self-rating of success in therapy. Kaufmann .(1963) investigated changes in the MMPI as a function of psychiatric therapy, using students coming for help to the health center at the University of Wisconsin. Tests 18 (including the MMPI) were administered at the start of therapy. At the end of therapy those patients who were rated by their therapists as being improved, were given a retest. The control group used in the study consisted of students drawn from psychology classes at the University but who were not undergoing treatment. The results suggest that the patient group had higher mean scores on most of the MMPI scales (all but the K scale and the MF scale for women). The D, Pa and Sc scales were the most sensitive in distinguishing between the patient and control groups as well as being the most easily modified through therapy. Danet (1965) attempted to determine if predictions could be made by experienced and non-experienced therapists using MMPI profiles of college students, on who would request counseling and who would not. A sample of 70 freshmen enter- ing the University of Minnesota who had taken the MMPI were used as subjects. Thirty-four clinicians with different ranges of experience, and seven inexperienced graduate students attempted to judge which of these students would request personal counseling within two years of their matri- culation into the university. The results obtained suggest that experienced clinicians are no more successful in predicting psychological disturbance on the basis of MMPI profiles than are non-experienced clinicians. All three groups (experienced, non-experienced and graduate students) on the average, did better than expected by chance in l9 predicting emotional disturbance on the basis of these scores. Further, Cooke and Kiesler (1967) studied to see whether the MMPI, can distinguish between students who apply for therapy at a university counseling center and those who do not. Based on results of tests administered to incoming college freshmen, their findings show that males and females seeking therapy had significantly higher mean scores on the MMPI than those not seeking therapy. Jansen and Robb (1970) in a study used the MMPI to determine if there were significant differences between college students who did and didn't use the school's counseling facilities. The MMPI scores of students who had been counseled for over two years were compared with those who had never been counseled. The results obtained suggest that the MMPI scores of students who were being counseled differed significantly from those not seeking help. Males in therapy had significantly higher mean standard scores than their non-counseled counterparts on all except three MMPI scales. Counseled women had significantly higher MMPI scores on all except four scales. In general, the students in therapy had higher profiles across all of the MMPI scales than did students not in therapy. Greenfield and Fey (1956) used the MMPI to determine differences between college students who undergo therapy and those who do not. The MMPI was routinely administered to all incoming male freshmen at the University of Wisconsin and a post hoc 20 examination of the scores of those seeking treatment and those not was made. The hypotheses being tested for, i.e., that promptness of referral is related positively to the amount of anxiety, degree of internalization, amount of discomfort and severity of pathology, were not supported. The variables tested for did not seem to be significantly related to the number of months that intervened between the time of taking the test and seeking help at the clinic. HYPOTHESES 1. It was hypothesized that experiencing is negatively related to extreme levels of drive content (high or low) and positively related to moderate levels of drive content. It is assumed here that when drive content is excessive, experience in therapy is less likely to occur because the individual's efforts and energies are consumed in expressing the drive content so that inward reflectiveness (experiencing) is interfered with. When drive content is low, on the other hand, there is insufficient psychic activity to permit a great deal of experiencing. Only when there is a modicum of drive content, does experiencing manifest itself. 2. A positive relationship was hypothesized between experiencing and direct socialized drive content. a. A negative relationship was hypothesized between experiencing and direct-unsocialized drive content. Pine (1960) suggests that direct socialized ratings refer to expressions of drive content where impulses are expressed in conventional, socialized ways. As such a greater degree of ego control is believed to be present which would permit more focusing to occur and hence higher levels of experiencing. 3. A relationship was hypothesized between integration of drive content and experiencing. 21 METHOD Subjects Clients The subjects for the present study consisted of under- graduate students at Michigan State University who sought psychological help at the university counseling center during the 1968-1969 school year. Students participating in research at the counseling center were administered psycholo- gical tests at the start, after selected sessions, and at the completion of therapy. Tape recordings were also made of their therapy sessions which formed the tape library from which the samples were drawn. Twenty-nine subjects were used in the study. Instruments T.A.T. The instruments used to obtain the experimental variables were the TAT and the Exp. Scale. The MMPI was also used to estimate the degree of pathology in each client. In the present study, TAT cards 1, 2, 4 and 13MF were examined and rated for drive content using Pine's method of scoring. Card one was chosen because it is a relatively non-threaten- ing stimulus which touches upon certain childhood feelings and memories and further serves as a warm-up card for the rest of the sequence. The other cards were selected because, 22 (mitt; {Illllulhli HI' l‘l.( 23 according to Eron (1949) they possess a good deal of "stimulus pull" for producing stories with aggressive and sexual content, which is what is being sought in the present study. The cards are, however, sufficiently unstructured to allow the person to determine the extent and mode of expression of these drives. Scoring Procedure. Pine's drive content manual with its various ratings, as well as validity and reliability studies were discussed in a previous section so that they will only briefly be reviewed here. TAT protocols were scored by reading the transcripts and underlining each specific unit of drive content. Following this, drive units in each proto- col were rated for level of drive expression (direct-social- ized, direct-unsocialized or disguised-indirect) and the degree of drive integration (thematic, incidental or non- apprOpriate). For example, direct-socialized drive is depicted in the statement "after eating his dinner he sat down next to his wife and kissed her." Direct-unsocialized drive can be seen in the statement "He murdered his father." Indirect-disguised drive is illustrated in "when he returned from the war he found his girlfriend married to someone else." In each of these phrases a rating of thematic drive integra- . tion would be given to the extent that they played a central role in the context of the story. For example, if the story concerned the anger and rage that lead a son to kill his father, then the phrase "he murdered his father" would be rated as thematic. Similarly, to the extent that 24 each phrase is not essential to the content of the story, a rating of incidental would be administered. For example if the phrase "After eating his dinner" were unimportant in terms of events or context of the story, or were given tangentially to enrich the story, it would be given a rating of incidental. And again a rating of non-appropriate would be given to those expressions which have little to do with telling the story. Rated here would be such things as exclamations ("Oh boy, what a sexy picturel"), slips of the tongue, the failure to include certain items on the card in a story, which were previously mentioned and misperceiving certain items or people in the TAT cards. Scoring Reliability. The TAT protocols were rated by two persons independently. Pine (1960) in his study, found a satisfactory level of interrater reliability. He found between 80 and 90 percent agreement between the two raters on all of the drive content scores (TDC, DU, DS, ID, "thematic" and "non-appropriate"), except for "incidental" use of drive where he obtained only 65 percent interrater agreement. Dietzel (1970) obtained interrater reliability for Total Drive Content, Drive Level, and Drive Integration ratings of 84.4%, 95.5%, and 15.7% respectively. Exp. Scale The Exp. Scale was used to measure the degree of inward reflection taking place within therapy sessions. The Exp. Scale distinguishes between seven stages 25 of experiencing, ranging on a continuum from those who experience very little to those who are fully functioning persons experiencing themselves completely. Stage one, the lowest level of experiencing refers to the discussion of events in a detached and impersonal manner within the therapy context. At this stage, the person says very little about his own perSonal feelings or attitudes but merely describes events in a distant emotionless manner. At the second stage, there is some acknowledgement of connection between external events recounted and personal involvement but emotional expression is negligible and the person seems unable to own having certain feelings that he expresses. At stage three, it is evident that the client is involved in the story and events that he is recounting. He attempts self descriptions of himself but his insight is limited to descriptions of his feelings in terms of his behavior. At the fourth stage, the client has insight into his feelings and reactions and can express them verbally. He is mainly concerned with describing his feelings and his personal experiences, and does so in a manner which is flexible and associative rather than rigid and obsessive. In stage five, the client makes use of his integrated feelings to explore new dimensions of his personality. This stage can be differentiated from stage four in the sense that the client now not only has insight into his feelings but uses this information to question and to probe further into his psyche. At stage 26 six, the client makes use of his newly gained insight and explorative knowledge to work on and resolve personally sig- nificant issues. He is able to express his feelings in a vivid and integrative manner, and in this way further adds to his growth and development. Dithe seventh and final stage of the scale the client has fully integrated his feelings and knowledge about himself into a composite, self-actualized picture. Scoring Procedure. Segments from therapy tapes in the early stages of therapy were rated. Tapes from sessions early in therapy are being used to avoid bias which would be introduced by therapist interaction and personality effects which would become more pronounced as therapy progressed. The segments were chosen from the middle of the therapy tapes as according to Abeles and Karl (1969) this is the segment in which the greatest number of hostility (i.e., one measure of drive content) statements occur. They further state that in working with Freudian variables more effective results will be obtained through sampling specific segments of the hour, instead of sampling randomly. The segments were five minutes long as this is the length considered adequate to provide enough material for identifying high levels of experiencing without becoming too complex or drawn out. Two kinds of ratings were used--modal and peak. The modal rating refers to the overall or average scale level of a particular segment or unit. The peak rating is the 27 score given to the highest Exp. Scale level obtained in the particular unit being rated. Peak ratings can be of any length, or located anywhere within a unit being rated. Scoring Reliability. Interrater reliability studies using the Exp. Scale, using the means of the judges ratings, show correlations ranging from modes of .76 to .91 and peaks of .75 to .92. These ratings are taken from therapy sessions with schizophrenics, and neurotics, interviews with normals and interview sessions rated with the therapists voice removed. Ryan (1966) did a study using 22 neurotics sampling 96 tape segments each of eight minutes duration. He found a modal correlation of .76 and a peak correlation of .77 between the four judges rating the tapes. Interrater reliability was further tested in a study by Kiesler (1969) in which he had two groups of judges, four experienced clinicians and four clinically naive undergraduate students rate, independently, 42 tape recorded segments from psycho- therapy sessions with three groups--schizophrenics, psycho- neurotics and normals. The results indicate no difference between the ratings of the two groups of judges. Interrater reliabilities, means and standard deviations of the naive and experienced judges were comparable. These findings suggest that clinical experience is unimportant for learning and rating the Exp. Scale. More recently, in a thesis done at M.S.U., Schaffer (1973) using similar data to that used 28 in the present study, found interrater reliability modal correlations of .92 and a peak of .88. MMPI The MMPI is being used in the present study to determine and control for the level of disturbance in the present subject population. According to D. A. Rogers (1972) "the MMPI is probably the instrument of choice for screening or assessing emotional upset in a research population." He further expresses his feeling that the test is best used as an aid in assessing a patient's personality and degree of emotional upset. He states "in this role it is one of the more powerful aids available." In this study the cutoff point for distinguishing between pathological and non- pathological was three T scores above 70. Rater Selection, Training and Procedure The raters to be used in the present study were selected from the undergraduate population at M.S.U. Two raters were used for each instrument as this number is suffi- cient for obtaining interrater reliability and more than two persons requires more of an investment in terms of training, fees, etc. The raters for the TAT were trained by studying Pine's (1960) Scoring Manual. They then practiced rating on protocols not being used in the present study. After sufficient practicing, Ebel's (1951) formula for interrater reliability was applied and when adequate reliability had been obtained, the scorers rated the test protocols of the 29 subject pool. With respect to the Exp. Scale, raters were trained using the sixteen hour training program as elaborated in the Exp. Scale Manual. Tape segments were then trans- cribed, coded and rated. Following this a list was made of the mode and peak ratings and then a statistical analysis was made of the data. RESULTS Reliability of Measures Two raters were used to establish interrater reliabi- lity for the Exp. scale and for the rating of TAT protocols. When high interrater agreement and proficiency was obtained, the sample tapes and TAT protocols were rated. Three tape segments for each of 29 subjects were given both modal and peak ratings by the two judges. The modal rating refers to the overall, average Exp. level of a segment whereas peak rating refers to the highest Exp. level reached in a parti- cular segment. Using a correlational analysis, interrater reliability for the mode and peak were established. The results are listed in Table 1. Table l. Interrater reliability on Exp. scale Means S.D. Pearson r Ratings of modes Rater A 2.32 .95 .80 Rater B 2.19 1.0 Ratings of peaks Rater A 2.90 .99 .68 Rater B 3.01 1.17 30 31 The four TAT protocols (cards 1, 2, 4, 13MF) for each of the 29 subjects were scored by two raters for drive content as well as degree of socialization of drive and degree of drive integration. The results for this are listed in Table 2. Table 2. Interrater Agreement for Total Drive Content, Drive Level and Drive Integration Ratings (m = 30) . . Number Number Percent Drive Ratings of unitsa of unitsp Agreed Total Drive Content 209 179 85.6 Direct-Unsocialized 77 66 85.7 Direct-Socialized 61 46 75.4 Disguised-Indirect 44 33 75 Totals for Levels 182 145 79 Thematic 169 162 95.5 Incidental 8 1 12.5 NonapprOpriate 0 0 100 Total for Integration 177 163 92 aNumber of units where there was drive present initially. bBased on the degree to which both raters agreed on rating. COf the 179 agreements there were 39 unrated stories, i.e., the raters agreed that 14 stories did not have ratable drive content. Hypotheses Overall Drive Content and Experiencing Hypothesis 1. Experiencing is negatively related to extreme levels of drive content (high or low) and positively related to moderate levels of drive content. As the first scatter plot seems to indicate there is no statistically significant relationship bewteen Exp. and Total Drive Content. The hypothesis that individuals who are high or low in drive content will be lower in Exp. levels does not seem to be supported. As an inverted U shaped relation— ship was predicted here, Etaz, a curvilinear correlation coefficient, was used to analyze the data. An Eta2 correla- tion of .293 (p # .05) was obtained relating TDC with modal ratings and one of .329 (p f .05) was obtained relating TDC with peak ratings. Neither of these are statistically significant. Experiencing and Direct Socialized Drive Content Hypothesis 2. There will be a positive relationship between experiencing and direct socialized drive content. As scatter plot two illustrates, no positive relation- ship is found to exist between Exp. level and direct socialized drive content. Statistically the correlation between modal Exp. level and direct socialized drive content is .30 (p # .05) and that between peak Exp. level and direct Illlilllllllf‘lllilllll‘llllll 33 Scatter Plot 1. Overall Drive Content and Exp. Mode EXP 0 MODE ‘0 0 co . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 TDC Peak .... O. 0:1 0:2 l 2 3 4 S 6 7 8 9 10 11 12 13 14 TDC Scatter Plot 2. EXP. MODE N L: 1 Q 1‘ A v 34 Direct-Socialized Drive Content and Exp. Mode 10 20 30 40 50 60 EXP. PEAK mmq .5 ....u 70 80 9O DS/TDC X 100 Peak 10 20 30 40 50 60 70 80 90 DS/TDC x 100 35 socialized drive content is .23 (p ¢ .05). Conversely, the correlation between modal Exp. level and direct—unsocialized drive is -.25 (p # .05) and between peak ratings and direct- unsocialized drive is -.l93 (p # .05) (Scatter Plot 3). Integration of Drive Content and Experiencing Hypothesis 3. A relationship is hypothesized between integration of drive content and experiencing. Scatter plot four suggests no statistically significant relationship between integration of drive content and experiencing. The correlation between modal Exp. level and thematic drive content is -.188 (p # .05) and that between peak Exp. level and thematic drive content is -.33 (p # .05). It should be noted that the peak thematic correlation approaches statistical significance (p = .05). A complicating factor is that the variability on the thematic ratings is quite limited, a factor which influences the overall relationship. MMPI Differences As suggested earlier an analysis dealing with the relationship between degree of disturbance and the experi- mental variables was performed. This was done to control for the degree of psychological disturbance as measured by the MMPI. Correlations were computed for the scores of those subjects with a high degree of disturbance (i.e., 3'rscores 36 Scatter Plot 3. Direct-Unsocialized Drive Content and Exp. Mode EXP. MODE 10 20 30 40 50 60 70 80 90 DU/TDC x 100 Peak EXP. PEAK bu [ALL 0 Q o o O O 00". ‘° 0 10 20 30 40 50 60 70 80 90 DU/TDC x 100 37 Scatter Plot 4. Thematic Drive Content and Exp. Mode EXP. MODE 7—1 6— F 5—- 4 , T o 3 ° ° "’ o . . ’ :4 .=1 2— .0 .=5 9'1 0:2. 1 pt;— 0 THEMATIC Scatter Plot 4 (continued) Peak EXP. PEAK THEMATIC 10 39 above 70 on the MMPI) and the experimental variables. A separate analysis for the scores of subjects with a low degree of disturbance (i.e., those with fewer than 3 T scores above 70 on the MMPI) and the experimental variables was performed. The results are listed in Table 3. Table 3. Drive Content and Exp. Level for High MMPI Scorers (i.e., those with 3 T scores above 70) and Low MMPI Scorers (i.e., those with fewer than 3 T scores above 70). High MMPI 4 Low MMPI Sta- Mode Peak Mode Peak tistic Overall Drive Content .346 .374 .406 .399 eta2 Direct-Socialized .214 .124 .235 -.386 Direct—Unsocialized -.450 -.325 -.l40 -.479 Thematic -.479 -.666* -.358 -.320 *significant at .01 level For the high disturbance group of gs there was a statistically significant inverse relationship between peak ratings of Exp. and thematic expression of drive content on the TAT. Thus, subjects in this group who scored high on peak ratings of experiencing scored low on thematic drive content . Gender Differences In addition to the hypotheses stated above, it was decided to examine how the gender of the §s might have “___‘.\I I ill 40 interacted with the experimental variables. For these purposes statistical analyses were performed separately for males and females on all of the variables tested previously. The results are listed in Table 4. Table 4. Drive Content and Exp. Level for Males and Females Males Females Sta- Mode Peak Mode Peak tistic Overall Drive Content .731 .701 .354 .577 eta2 Direct-Socialized .718* .642 .158 .090 Direct-Unsocialized -.592 -.500 -.103 .006 Thematic -.291 -.349 -.342 -.423 *significant at .05 level As Table 4 indicates, a significant correlation is found between modal rating of experiencing and direct social- ized drive content for males. With the present sample, it seems that for males the higher the Exp. level (modal rating) the more drives will be expressed in a socially acceptable manner. Although statistical significance was not obtained in correlating peak and direct socialized drive content ratings for males, the correlation approaches significance (p = .05) and indicates a trend in the expected direction. Although the significance obtained seems suggestive of a relationship, it should be noted that the correlation is due 41 in part to the unusually high score of one subject. When this particular subject is omitted, the correlation between modal level of experiencing and direct-socialized drive content drops markedly. The correlation between modal experiencing ratings and direct-unsocialized drive content, and peak experiencing ratings and direct-unsocialized drive content, although not statistically significant represents a trend in the hypothe- sized direction. With the present sample of males it might be suggested that to some extent those with higher Exp. levels manifest lower levels of direct-unsocialized drive content. Using an eta2 coefficient the correlations between modal experiencing ratings vs. total drive content and peak experiencing ratings vs. total drive content for males, although high are not statistically significant. This is because of the small number of males participating in this investigation. With respect to females it does not appear that any of the correlations are statistically significant nor is there a trend in the hypothesized direction. DISCUSSION Hypothesis 1 The first hypothesis predicted a bell shaped relation- ship. It was predicted that subjects expressing extreme levels of drive content should have lower Exp. levels than those with intermediate levels of drive expression. This relationship was expected because it was assumed that high drive content inhibits experiencing because the individual's energies are consumed in expressing the drive. Therefore, there is interference with inward reflectiveness (experienc- ing). Low drive content, on the other hand, does not elicit sufficient psychic activity to permit a great deal of experiencing. It was expected that moderate amounts of drive content permit Optimal levels of experiencing. Results did not confirm these expectations. Several factors might have contributed to this. First it might be speculated that the therapists influenced the Exp. level. This is consonant with Gendlings notion that focusing or experiencing is basically an emotional problem-solving skill that can be taught to everyone. However, it is difficult to see how the therapists could have influenced the Exp. level as early therapy segments were sampled, but the thought is intriguing. Additionally, it might be speculated that the sample was too small. This probably contributed to limited variability which 42 43 may have masked a statistically significant relationship that might exist between amount of drive presence and Exp. level. Hypothesis 2 The second hypothesis predicted that subject who expressed drive content in socially acceptable ways would have higher levels of experiencing than those expressing drive content in an unsocialized manner. The Obtained results, although in the predicted direction, did not support the hypothesis. It does not seem that the expression of drives affects a persons experiencing. More generally, if this is true then experiencing is independent Of certain personality functions, suggesting perhaps a more qualitative difference between socialized (cognitive) versus affective (experiential) factors in personality. It can be speculated that perhaps one reason statistical significance was not Obtained here is based upon the nature Of the population sampled. Dietzel (1970) in using a "normal" college population to study the relationship between thematic drive expression and self-esteem found that direct-socialized drive content was expressed more frequently than was direct- unsocialized drive content. In the present study, however, using a subject population of college students seeking coun- seling, a greater proportion Of direct-unsocialized drive content as compared to direct-socialized drive content was Obtained. Thus for this research population, drives were 44 more generally expressed in a socially unacceptable manner. It seems plausible to suggest that through having a popula- tion which more Often expresses drives in a socially unaccept- able manner, greater variability in Exp. level was Obtained and hence there was less predictability from one scale to (another. As a corrollary to the above hypothesis it was predicted that subjects with large amounts of direct-unsocialized drive content would have lower experiencing levels. The correlation between these variables although in the predicted direction was not significant. This suggests that there is no relationship between expressing the feeling that things aneout of control on a paper and pencil measure (TAT) and the expression of this feeling in therapy (low Exp. level). Hypothesis 3 The third hypothesis predicted that there would be a relationship between the way drives are integrated and Exp. level. The results are not suggestive Of a relationship between these variables. Most likely this was simply a function Of limited variability though, interestingly enough, the correlation between peak ratings Of experiencing and integration Of drive content approached significance. Level of Disturbance The above results are complicated by the fact that the hypothesis testing did not attempt to control for degree Of 45 disturbance. When this factor was taken into account however, differences occurred. We take note of the fact that if level of disturbance is uncontrolled, drive content and experiencing are unrelated. However as amount of disturbance is controlled, experiencing (peak ratings) correlated (at a statistically significant level) with low thematic content. For subjects with high degrees Of disturbance, it seems that those who are in touch with and in control of their feelings (high Exp. level) do not express them in a direct fashion on a paper and pencil measure. It might be noted that a negative relationship was Obtained between peak experiencing and thematic drive content in spite Of the fact that variability Of thematic drive content was limited. Suppose there had been more var— iability in thematic content? What is suggested here is that homogeneous populations may tend to mask relationships be- tween these experimental variables. Gender Differences In addition tO looking at degree Of psychological disturbance, results were examined in the content of gender differences. ' For males a positive correlation was found between modal Exp. level and direct socialized drive content, indicating support for the hypothesis that males who are in— wardly reflective and in touch with their feelings express their drives in a socially acceptable manner. Peak Exp. 46 ratings approached significance but were not statistically significant. No such relationship was found for females. This suggests that statistically significant results might have been masked by not taking gender differences into account. It must be noted, however, that for the males significance was caused by a subject with an extreme score. When a correlation between direct-socialized drive content and modal Exp. level was run omitting this subject the correlation dropped considerably and was no longer statistically significant. Additionally the small number of male subjects used made looking at the results from a statistical point Of View difficult. In summary, while no support was found for the hypo- theses, the study does suggest with qualifications, that degree of psychological disturbance as well as subjects gender may influence the relationship between Exp. and drive content. BIBLIOGRAPHY Doll ‘u' ill-l ‘ll.| III III .1 I. 1'! (I‘ll Ill I'll I'll! II I l BIBLIOGRAPHY Auerbach, A. H. and Luborsky, A. Accuracy Of judgements of psychotherapy and the nature Of the "Good Hour." Research in Psychotherapy, 1968, 1, 155-168. Barron, F. 'Some test correlates of response to psychotherapy. JOurnal of Consulting Psychology, 1953, 11, 235-241. Brady, J. P., Reznikoff, M. and Zeller, W. 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The patient's personality and psychotherapeutic change. In H. H. Strupp and L. Luborsky (Eds.) Research in PsyghotherapYa Vol. 2, Washington, D. C., APA, 1962. Pine, F. Thematic drive content and creativity. Journal of Personality, 1959, 11, 136-151. Pine, F. A manual for rating drive content in the TAT. Journal of Projective Techniques, 1960, 11, 32-45. Rogers, D. A. The MMPI. In 0. K. Buros (Ed.) The Seventh Mental Measurements Yearbook. Highland Park, New Jersey: Gryphon Press, 1972. Rogers, C. R. A process conception of psychotherapy. American Psychologist, 1958, 11, 142-149. Rogers, C. R. A tentative scale for the measurement of pro- cess in psychotherapy. In E. A. Rubinstein and M. B. Parloff (Eds.) Research in Psychotherapy, Vol. 1, Washington: American Psychological Assn., 1959, 96-107. Rosenberg, S. The relationship Of certain personality factors to prognosis in psychotherapy. Journal Of Clinical Psychology, 1954, 10, 341-345. Ryan, R. P. The role of the experiencing variable in the psychotherapeutic process. (Doctoral dissertation, University of Illinois), Ann Arbor Mich.: University Microfilms, 1966, no. 66-7805. 50 Schaffer, N. Attraction_§nd Distress: Antecedents of client experiencing in psychotherapy. Unpublished masters thesis, Michigan State University, 1973. Schoeninger, D. W. Client experiencing as a function of therapist self-disclosure and pre-therapy training in experiencing. (Doctoral dissertation, Universit of Wisconsin), Ann Arbor, Michigan: University Microfilms, 1965, no. 65-14, 929. Zolik, E. S. and Hollon, T. H. Factors characteristic Of patients responsive to brief psychotherapy. American Psychologist, 1960, 15, 387 (Abstract). APPENDICES APPENDIX A DATA FOR EXP. SCALE AND DRIVE CONTENT ”Qt-”Wu '1‘ an. 1.0: t. 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This includes aggressive and libidinal drives and partial drives (oral, anal, phallic, genital, exhibitionistic, voyeuristic, sadistic, masochistic, homosexual, narcissistic) (cf., Freud, 1905). The term "drive content" refers to observable ideational derivatives of the inferred aggressive and libidinal drives. These derivatives appear in the TAT story content. Drive content is rated only if it is stated explicitly in the story; thus, for example, implied motives and symbo- lic expressions Of drives are not rated. The decision to rate only the manifest story content was made for two reasons: first, in the belief that individual differences would bexerased somewhat in speculations about more universally present drives which are latent (in the story) and unconscious (in the person); second, in an attempt to relate the ratings closely to the psychology of ego func- tioning. The manual is not intended tO be an all-purpose one; both its usefulness and its limitations are tied to its commitments to psychoanalytic theory (reflected here in the selection Of aggressive and libidina1\drives for rating) and its more specific commitment to psychoanalytic ego psychology (reflected here in the emphasis on control Operations with regard to expressed drive content). Drive content is rated if it appears at any point in S's response to a TAT card except in response to a direct inquiry question. Thus, "how did he feel?" - "angry" would not be rated although responses to inquiries such as "tell me more" or "how did it all turn out" are rated. Drive content is rated without regard to its extent; passing mention or full thematic development Of, say, an aggressive incident would each be rated. On the other hand, drive content which is too far removed from aggressive or libidinal connections is not rated (for example, friendship, achievement motives, gazing at scenery): it was found necessary to establish some such *Journal of Projective Techniques, 1960, 11, 32-45. 52 53 cutting point, albeit an arbitrary one, in order to avoid a tendency to rate almost everything S says. The ratings of drive level, described below, represent an attempt to cope with this entire issue. Finally, affective experi- ences which are directly linked to particular drives (anger, love) are rated, although affective states in general are not (shame, guilt, sadness, elation, etc). These and all other ratings are illustrated below. Integration of drive content S's task on the TAT is to tell a story about a picture. To the degree that drive content is given in accord with this task requirement, some ego control is indicated. The degree to which drive content is inte- grated intO S's response to a card (the response ordinarily being a story, but on occasion an essay-like production or an elaborated description) was taken to be an index of appropriateness of drive expression and adequacy Of ego control. Of the appropriately used drive content, two types were distinguished. Drive content which is part of the central theme or character portrayal Of the story is rated thematic, in contrast to drive content which is incidental to the main theme (but still part of the story). Drive content can be rated thematic even if it is given only briefly; its links to the main story rather than its extent is at issue here. Even if the rater feels a story could get along without an item Of drive content, if S gave it as part Of the central story theme it is rated thematic. Incidental drive content, while integrated into the story, is generally expendable even in S's pre- sentation Of the material. For example, drive content is generally incidental when it is given in analogy which is intended tangentially to enrich the story. In contrast to both thematic and incidental ratings, a rating of nonapprOpriate is given to those expressions of drive which are not in accord with the TAT task (telling a story about a picture) or which were not intended by 8. These include: 1. Exclamations and side comments before, during, or after the story (for example, "Wow, this is a sexy one" or "That murder last week gives me an idea for this story"). 2. Drive content given in card descriptions when it does not then get included in the story (for example, mention of the gun on card 38M followed by a story about fatigue rather than, say, suicide). 3. Misperceptions or doubts about the identity Of persons or Objects when drive content is involved (for example, calling the violin on card 1 a machine gun or misperceiving the sex of a character; the figure on 38M and the lower figure on 18GF were unrated whether seen as male or female). 4. Verbal slips where drive content is evident in the slip itself (including the sexual ambiguity suggested by 54 use of wrong-sex pronouns- "he" instead of "she" for example). Slips that are made in a broader drive content context are rated separately while the story context gets its own rating. Directness of expression of drive content. TAT stories vary in the degree to which their expressed drive content is primitive, value-violating, and direct on the one hand, or socialized, value-syntonic, and/or disguised on the other. The present manual dis- tinguished three levels of expression Of drive content, the levels partially modelled after Holt and Havel's (1959) distinction between two levels Of drive content in Rorschach responses. 2 Level I (direct-unsocialized) includes those expressions of drive content where libidinal or aggressive impulses are directly expressed in a way contrary to conventional social values. Murder, robbery, rape, prosti- tution, homosexuality, alcoholism, and extramarital sexual relationships, for example, are all rated here. In addition to the criterion "violation of conventional values," a second criterion is applied for aggression derivatives, i.e., physical expression. Anger is rated level I only when it involves physical violence. In all cases, it is only the unsocialized and direct drive expression in the manifest story content which gets rated. Level II (direct-socialized) includes those expres- sions Of drive content where libidinal or aggressive impulses are expressed directly but in socialized ways. Anger expressed without physical violence, arguments among family members, sexual rivalries and jealousies, kissing, eating, social drinking, intercourse between marriage part- ners, and childbirth are all rated here. Level III (indirect-disguised; weak) actually includes two kinds Of drive content. The first, indirect and disguised drive expression, includes those instances that are associated with (Often relatively strong) drives, but where the underlying impulse is neither explicitly thought nor acted upon in the story. Mention of police, soldiers, rulers, restaurants, saloons, illness, accidents, natural or accidental deaths are all included here. All Of these permit the inference that a particular drive is an issue for the person but, although some reflection of the drive appears in the manifest story, the drive itself is not expressed. If the context alters this, e.g., "he ate in a restaurant" or "the soldier fought," level II or I would be rated. The second type of content rated level III includes drive expressions which are weak and highly derived. For example, social expressions of aggression derivatives such as strikes and militant unions are rated here as are highly formalized drive expressions such as familial affection. An arbitrary cutoff point must be 55 established here so that material which is too weak does not get rated. Reference to surgeons, microscopes, struggles to get ahead in life are not rated although inferences can readily be made to impulses from which they derive. Three additional points on drive level ratings: (1) Negation of drive expression is rated identically with positive expression. "He wanted to kiss her but he didn't" is rated level II. (Such negated expressions are Often given in such a manner as to make them "incidental"; for example, "let's see . . . it's not that he wanted to kiss her, I'd say he just liked her.") (2) Thoughts and wishes are rated equally with actions in most cases. "He wanted to kill him" is rated level I whether or not the act is carried out. On occasion, such content is given as a way of communicating intensity rather than true intent: in those instances a more controlled level may be rated. (3) Context is always considered in rating drive level. For example, kissing as part of an attempted seduction of a married person is level I rather than II. Similarly, criminal execution and war are the two major examples of killing that may be rated level II rather than level I; for war stories, the level II rating is given when the emphasis is on patriotism, duty, and the normal course of events in war rather than on aggressive acts and violations of rules of warfare. Units Of analysis Drive material may be rated many times in any one story, and considerations of the extent of the expressed content were independent Of the rating unit. Several rules were established to guide raters in selecting the unit to be rated in each instance: (1) Expressions of derivatives of different drives are rated as separate instances Of drive expression. For example, "he was angry but a couple of drinks helped him to settle down" would be rated once for the aggressive content and once for the oral content. (2) Expressions of drive with differing degrees of inte- gration into the story (thematic, incidental, or non- - appropriate) are always rated separately, even if the drive expressed is identical. Thus, an incidental and a thematic aggressive phrase would receive two ratings. (3) In contrast, a new level of an already expressed drive would not get a separate rating. "He went into a bar (level III) and got dead drunk" (level I) would be rated only once, the rating of the more extreme content. This stepwise expression of drive material appears so Often and generally with such an inevitability in the sequence that to rate them independently would artificially raise the total number of ratings given. (4) Within the same general type of drive content and the same degree of integration separate ratings are given if new behavior sequences are described or if the expressed impulse has a new aim. .iI‘IIII-l 56 Some illustrative stories and ratings Four illustrative TAT stories are given below. Stories particularly rich in rating issues were selected. In each, certain material is lettered and italicized; comments on the lettered material are given immediately following each story, using the letters for cross reference. Ratings are given in parentheses. The first symbol indicates the drive level (I, II, or III); the second symbol indicates the degree Of integration ("T" for thematic, "In" for incidental, and "N" for nonapprOpriate). 1. (Card 3BM) (a) Well, I take it that is a pistol on the floor. This young man is in a Balkan country. He was young and (b) inclined to melancholy. (c) 153 Germans had overrun the country. His father had been captured and killed by the Germans. His fortune was lost and all his friends died. Oh. I forgot to say he was Jewish. He's been making feverish attempts (d) to release his father, but without success. Now he has returned from an exploit where he went to German headquarters, (e) shot the man who was there, and ran through the streets to his home. He knows what will happen when he's caught, so he (f) puts a bullet through his own head. (9) I guess that's a pistol. It certainly isn't a very realistic rgpresenta- tion of one though. a. (Not rated) Although this is card description, it is later used in the story. Had the gun been mentioned and then omitted from the story it would have been rated III-N (level III because it is associated with an aggressive impulse which, however, would not have been expressed in the story). As is, the rating is included with (f), below. b. (Not rated) Affects are rated only if drive content is specifically stated. c. (I-T) All of this is rated as one unit. The emphasis on the atrocities of war requires the level I rating. It is all central to the story theme. d. (I-N) The phrase "release his father" contradicts the earlier "his father had been captured and killed." There is a slip here somewhere, and since it involves the killing of the father, it is rated level I, nonapprOpriate. e. (I-T) Though still aggression, this is a new behavior sequence (in relation to the actions of the German invaders) and is rated separately. Although one may sympathize with the actions of the hero, the murder in a revenge context is best rated as level I. f. (I-T) This aggression too is sufficiently different from the former instances to be rated separately. Suicide is level 1. Although the suicide is only briefly mentioned, it is still a part of the central theme of the story and is rated thematic. Inl‘ I All. All! Li‘l.‘ ‘ . 57 g. (I-N) This is a nonapprOpriate extraneous comment; it has nothing to do with the story. Since context is considered in rating drive level, and since the gun has already been established in the story as a murder and suicide weapon, the reference to the gun here is level I rather than level III. 2. (Card 10) (a) A soldier going Off to fight in the war, and the woman with whom he is supposedly (b) 15 love is crying and kisses him goodbyg. Much later, he returns to France and finds that his young lady has (c) married someone else in order to keep herself in (d) food and clothing. And he does nothing probably. Looks for (e) food and clothing for himself. NO action. Well, of course the marriage- I could clear that. He could find her, and she, not having married for love, (f) could give herself to him as well as to the person she married. a. (II-T) In the context of duty, war is rated level II. b. (II-T) This is a direct expression Of a libidinal impulse in a socialized way and in line with the main story theme. c. (III-T) The later references to marriage in the story add nothing new to this first reference and are included in this rating. Marriage, when given in such a stylized way, is rated level III since only a very watered down expressioncfi'drive comes through into the story. d. (II—T) Oral (food) content is different from the earlier rated libidinal content (kissing and marriage) and is rated as a separate unit. The reference to food provides motivation for the marriage under wartime condi- tions and, as such, is essential to the main theme Of the given story. It is a direct expression of an oral need. e. (II-In) Once again the reference tO food is a direct oral expression in a socialized way. Here, however, it seems to be presented by S as a momentary pause in the story, before 8 gets on with the main theme; as such it is rated incidental. Incidental presentation by S in the story, rather than the rater's decision that a story could do without an item Of drive content, is what requires an item of drive content to be rated inci- dental. Although the "food" content here is identical with the previously rated item, it is rated as a separate unit because it is a different degree of integration (incidental rather than thematic) and because it is a new behavior sequence carried out by another person; either of these reasons alone would be sufficient to require a separate rating for this unit. f. (I-T) Using the conventional values of society as the yardstick for deciding between level I and level II ratings, this is unsocialized-drive expression and is rated level I. 58 3. (Card 13MF) This boy had (a) time to kill and stopped in a (b) bar for a few drinks. He kept (c) noticing a gir1_who was not pretty but whose dress showed off her body well. She came up to him after a while and suggested they go to her apartment. She was (d) not what might be considered an actual prostitute but she was lonely and wanted to do something to change her mood. After they had (e) three or four drinks at her place, she suddenly suggested (f) they go to bed together. The boy was naive and was taken aback, but felt his (9) manly pride required him to do so- so he did. As he's leaving the room now, he feels that sexual relations are not all that they are made out to be and that he can take it or leave it. But what he doesn't realize is that (h) sex should never be an end in itself but only a means to an end with someone you love. a. (Not rated) FiguratiVe expressions like this one are not rated. b. (II-T) This is an instance where two similar instances of drive content are rated as one unit even though they would individually be rated at different levels (bar as level III and drinks as level II). The two form a consistent unit and are rated at the level of the strongest expression. c. (II-T) Although "noticing" alone would be considered too distant from voyeuristic impulses to be rated, the total context provides a ratable voyeuristic- exhibitionistic theme. The expression is direct, socialized, and thematic. d. (I-In) The denial here makes this incidental to the main theme. Although prostitution is negated, it is still level I. e. (II-T) This is a new behavior sequence and is rated separately from the earlier oral content. The drinking here is still sufficiently socialized to get a level II rating. f. (I-T) This rating includes the various references to intercourse in the story. Premarital intercourse, certainly in this non-love context, is rated level I. g. (III-T) This is a thematic and highly derived expression of narcissistic libido. h. (II-In) This is extraneous comment, but it manages to retain enough of a link to the story (as a "moral" of sorts) so that it cannot be rated nonapprOpriate. Hence, the incidental rating. 4. (Card 4) (a) These people resemble Clark Gable and Gene Tierney. The curtains give the impression this takes place in a house, but (b) the pin-up picture in the back seems to negate this. SO I conclude that it's (c) in a bar or a roadside stand or someplace like that, and (d) this waitress is trying to prevent this truck driver from leaving. He's (e) not too well liked by the other drivers on the route, so one of them started a rumor 59 that his (f) girlfriend here was cheating on him. The eyes of the girl make it clear that she'll convince him of the falseness of the rumors. (How does he feel?) He has a tinge Of doubt, but he believes (9) him . . . her . . . basically, but he has doubt. The doubt makes him have a not very convincing (h) fit of anger but then they forget it. a. (Not rated) Although this is relevant commen- tary, it has no drive content and is not rated. b. (II-In) This is card description which gets into the story only peripherally, through providing a kind of atmosphere and backdrop; as such it is incidental. The voyeuristic implications of the pin-up picture seem direct enough to require a level II rating. c. (III-In) All of this oral content is level III; no one is actually eating. Although this is part of the story, the way in which S presents it ("it could be X or Y or Z") indicates that it is incidental even to S himself. d. (III-T) "Waitress" is rated separately from "bar or restaurant" since it is given as part of the main story theme and is thus a new level of integration. e. (II-T) The rating is level II. In Spite of the euphemistic and negative mode of expression, this is still a direct expression of hostility. f. (II-T) Applying conventional standards of morality: since the first man and the woman are unmarried, and since intercourse is not explicit here, the reference to "cheating" seems better described as level II than level I. ‘g. (III-N) This slip, involving a sexual confusion, gets rated although a slip in which the drive content is not evident in the slip itself would not be rated. The him-her ambiguity does not involve any direct drive. expression and is rated level III. h. (II-T) Although this is part Of the inquiry, it is rated because it was not evoked directly by an inquiry question. (If the sequence had been, "how does he feel?," "angry," there would be no rating.) No physical violence is made explicit in the story, so the "fit of anger" remains level II. HICHIGRN STATE UNIV. LIBRQRIES 31293000693493