The transmissions in the interpersonal communication in psychotherapy is very complex as both parties are simultaneous senders and recipients of non-verbal and verbal messages. To learn more about these transmissions, it is important in psychotherapy research to link the non-verbal communication to the verbal content and to explore the communication patterns that arise over time. Non-verbal communication is multimodal and includes, for example, body/head position and movements, facial expressions, eye movements or emotional prosody. These non-verbal signals also form part of the complex interactional synchronization patterns that include reflections of emotional expression. First results will be presented of an interdisciplinary project, in which the fields of psychology and data science are brought together. The aim of the study is to analyze all sessions of video-recorded psychodynamic psychotherapy with the help of AI-based methods such as machine learning and time series analyses to investigate what is transmitted non-verbally and which nonverbal interactive behavioral patterns develop between patient and therapist.

Empirical studies until now have not been rigged for documenting the personal changes taking place in trainees when learning to work in the transference by conducting therapy and receiving supervision. The aim of this pilot study is to explore how we can start investigating such a complex learning task. The research question is: During the corresponding therapy and supervision processes, how does a psychology student in a professional-oriented psychology study programme learn to contain and intervene in the transference here-and-now in the therapy relationship with the help of supervision? This qualitative, single-case study is part of the ongoing Nordic Psychotherapy Training Study (NORTRAS). Relevant data from video recordings of therapy and supervision sessions and research interviews are selected and triangulated in the data analysis. In the results, a transformative learning process is described where the therapist during the process became able to formulate in words emotions that initially were communicated through anxieties, projections, somatizations, and avoidance responses and to start talking with the patient about these feelings. The supervisor supported the process by her containment and psychoanalytic listening and knowledge, and by offering suggestions for interventions.

The interpretation of dreams holds a special place in psychoanalytic psychotherapy. While Sigmund Freud regarded dreams as attempts at wish fulfillment-containing unconscious meanings hidden in their latent content - more recent psychoanalytic theories emphasize the clinical significance of the manifest dream. This text presents three such contemporary approaches in greater detail and explores their clinical implications. First is Erik Homburger Erikson's model of dream analysis, which systematically examines the manifest content of dreams. Second is Ernest Hartmann's emotionally focused approach, which centers on how dreams process affect. Finally, Ulrich Moser and Ilka von Zeppelin's model of dream generation is introduced, in which dreams are understood as simulations of micro-worlds.

How do we learn working in the transference? In this chapter, we present empirical studies investigating aspects of the learning process necessary for dealing with transference phenomena, with a specific aim to identify possible intrapsychic changes in the trainees. None of the training studies especially highlight learning to work in the transference but rather address psychoanalytic (and psychodynamic) competence in general. The results in the training-outcome studies indicate that therapists’ personalities are not easily changed. The training-process studies show that trainees typically have transference- and defensive reactions toward their supervisors and that such reactions are difficult to handle while complex and challenging learning processes are going on. In sum, there is only fragmented empirical research on the change process taking place in trainees during learning to work in the transference. Further empirical research is not only needed to investigate the learning process in more detail but also for further developing the psychoanalytic therapeutic tradition. Better studies are also required in order to test main assumptions and to substantiate the relevance of working in the transference. Finally, we present an ongoing sub-study within the Nordic Psychotherapy Training Study with the aim to meet some of these needs.

Dear Readers,

I am excited to introduce the latest issue of the Scandinavian Psychoanalytic Review, a special issue on the topic of Transmissions, which was the overall theme of the latest Nordic Psychoanalytic Congress in Oslo, held from August 8–11, 2024.

The editors of SPR invited all presenters to publish their congress presentations in a special issue of the Scandinavian Psychoanalytic Review. As most of the presenters accepted our invitation, we are now able to present this special issue in two parts. The next issue of SPR will contain an additional eight articles on the topic of transformation.

The text investigates a specific aspect of dreams and dreaming, which is best described with reference to the Freudian concept of ‘the Uncanny’. By combining psychoanalytical knowledge with concepts developed within the frame of empirical dream research, the dream generation model by Moser and v. Zeppelin is applied in order to discuss aspects of Dream-work. Dream-processes are described as oscillating between two areas – a familiar and an unfamiliar world. The approach to unfamiliar material in a dream implies the potential of uncanniness. Thus, every dream contains potentially uncanny material. Clinical implications for dream interpretations are discussed. 

Refugees from sexual and gender minorities (SGMs) face particular hardships, which demand adaptive responses. This pilot study explored SGM refugees’ experiences of resilience within the context of hardship from pre- to post-migration. Eleven semi-structured interviews with SGM refugees who had migrated to Sweden were analysed using thematic analysis. Four themes were identified: (1) Concealing Identity in Response to Pervasive Oppression, (2) Living in Suspension, (3) External Sources of Support and (4) Strength from Within. Respondents reported utilising limited external resources and employing considerable internal resources in order to navigate and survive in the face of hardships that carried over and shifted across time. A more nuanced understanding of the connections between resilience and hardship is needed to inform post-migration reception practices and service provision in order to facilitate resilience in SGM refugees.

The ability to recognize and work with patients’ emotions is considered an important part of most psychotherapy approaches. Surprisingly, there is little systematic research on psychotherapists' ability to recognize other people’s emotional expressions. In this study, we compared trainee psychotherapists’ non-verbal emotion recognition accuracy to a control group of undergraduate students at two time points: at the beginning and at the end of one and a half years of theoretical and practical psychotherapy training. Emotion recognition accuracy (ERA) was assessed using two standardized computer tasks, one for recognition of dynamic multimodal (facial, bodily, vocal) expressions and one for recognition of facial micro expressions. Initially, 154 participants enrolled in the study, 72 also took part in the follow-up. The trainee psychotherapists were moderately better at recognizing multimodal expressions, and slightly better at recognizing facial micro expressions, than the control group at the first test occasion. However, mixed multilevel modeling indicated that the ERA change trajectories for the two groups differed significantly. While the control group improved in their ability to recognize multimodal emotional expressions from pretest to follow-up, the trainee psychotherapists did not. Both groups improved their micro expression recognition accuracy, but the slope for the control group was significantly steeper than the trainee psychotherapists’. These results suggest that psychotherapy education and clinical training do not always contribute to improved emotion recognition accuracy beyond what could be expected due to time or other factors. Possible reasons for that finding as well as implications for the psychotherapy education are discussed.  

Introduction: Psychotherapists’ emotional and empathic competencies have a positive influence on psychotherapy outcome and alliance. However, it is doubtful whether psychotherapy education in itself leads to improvements in trainee psychotherapists’ emotion recognition accuracy (ERA), which is an essential part of these competencies.

Methods: In a randomized, controlled, double-blind study (N = 68), we trained trainee psychotherapists (57% psychodynamic therapy and 43% cognitive behavioral therapy) to detect non-verbal emotional expressions in others using standardized computerized trainings – one for multimodal emotion recognition accuracy and one for micro expression recognition accuracy – and compared their results to an active control group one week after the training (n = 60) and at the one-year follow up (n = 55). The participants trained once weekly during a three-week period. As outcome measures, we used a multimodal emotion recognition accuracy task, a micro expression recognition accuracy task and an emotion recognition accuracy task for verbal and non-verbal (combined) emotional expressions in medical settings.

Results: The results of mixed multilevel analyses suggest that the multimodal emotion recognition accuracy training led to significantly steeper increases than the other two conditions from pretest to the posttest one week after the last training session. When comparing the pretest to follow-up differences in slopes, the superiority of the multimodal training group was still detectable in the unimodal audio modality and the unimodal video modality (in comparison to the control training group), but not when considering the multimodal audio-video modality or the total score of the multimodal emotion recognition accuracy measure. The micro expression training group showed a significantly steeper change trajectory from pretest to posttest compared to the control training group, but not compared to the multimodal training group. However, the effect vanished again until the one-year follow-up. There were no differences in change trajectories for the outcome measure about emotion recognition accuracy in medical settings.

Discussion: We conclude that trainee psychotherapists’ emotion recognition accuracy can be effectively trained, especially multimodal emotion recognition accuracy, and suggest that the changes in unimodal emotion recognition accuracy (audio-only and video-only) are long-lasting. Implications of these findings for the psychotherapy education are discussed.