Anaclitic and Introjective Personality Distinctions among Psychotherapy Outpatients: Examining Clinical Change across Baseline and Therapy Phases
Date of Award
Doctor of Philosophy
Michael R. Nash
Robert G. Wahler, Robert E. Levey, John W. Lounsbury
S. J. Blatt and colleagues (e.g., Blatt, 1995; Blatt & Blass, 1996; Blatt & Shichman, 1983) have theorized that individuals develop and function along two basic lines— that of interpersonal relatedness and that of self-definition. These two modes, while moderately-oscillatory across the lifespan, suggest two respective, relatively-fixed, personality configurations—the anaclitic and the introjective. It is suggested that psychopathology arises when investment in the themes of one’s preferred personality configuration become enduringly over-emphasized. Individuals with anaclitic psychopathologies tend to be plagued by feelings of helplessness and weakness, and they tend to have fears of being abandoned; they generally have a depleted sense of self. Individuals with introjective psychopathologies tend to be plagued by feelings of guilt, self-criticism, and inadequacy; they generally have a distorted sense of self. Some individuals struggle with both types of feelings and problems. Previous research, conducted mostly among seriously disturbed inpatients in long-term therapy, with only a few measurements over time, suggests differential responses to treatment as a function of these anaclitic—introjective distinctions. Uniquely, the present study employs a form of hierarchical modeling, using continuously collected outcome measurements, to examine therapeutic course and outcome in relatively short-term psychotherapy among outpatients. More specifically, it tests a number of hypotheses examining the role of personality configuration in clinical change during baseline as well as therapy phases. Results indicate that duration-of therapy, and therapeutic alliance levels did not differ significantly as a function of personality configuration; pre-treatment level of symptomotology did not differ between anaclitic and mixed-type patients, and was lower among introjective patients—who as a group reported a symptomotology-level that was subclinical. In the sample as a whole, significant symptom improvement occurred during baseline-phase—most of which was driven by clear improvement in the anaclitic and mixed-type groups, while attenuated some by the lack of improvement in the introjective group. During therapy-phase, patients as a whole, and by group, did not report any meaningful change in symptomotology. Several possible explanations for this no-therapy-effect phenomenon, as well as study-limitations, are discussed.
Kemmerer, David Dix, "Anaclitic and Introjective Personality Distinctions among Psychotherapy Outpatients: Examining Clinical Change across Baseline and Therapy Phases. " PhD diss., University of Tennessee, 2006.