Psychosomatic Medicine 19:99-104 (1957)
© 1957 American Psychosomatic Society

Physiological Correlates of Tension and Antagonism During Psychotherapy

A Study of "Interpersonal Physiology"

¹ Department of Psychiatry, Harvard Medical School, and the Boston Psychopathic Hospital, Dr. H. C. Solomon, Director

During psychotherapeutic interviews continuous and synchronous recordings were made of social interaction (Bales' method) and physiological activity. Selected categories of interaction of the patient were correlated with heart rate and lability of patient and therapist, and with skin temperature level and lability of patient. The results indicated that:

The higher the number of "tension" scores for patient during a given interview, the higher the patient's heart rate. The higher the number of "tension release" scores for the patient the lower the patient's heart rate. In general, the patient's heart was most stable in the instances when the rate was fast and least stable when it was slow.

The higher the number of "tension" scores for patient during a given interview, the higher the therapist's heart rate during that interview and the lower his heart lability. There was a tendency for the therapist's heart rate and lability to follow a pattern similar to that of the patient.

For "antagonism" the patient and therapist tended to manifest opposite trends in cardiac functioning; the patient's heart rate would slow down whereas therapist's would speed up.

(These relationships suggest a positive "physiological identification" of therapist with patient when the latter is expressing "tension" or "tension release" but a negative one when he is expressing direct "antagonism.")

The patient appears to express "tension" more through his heart rate than skin temperature and "antagonism" through his skin temperature rather than heart rate. Thus the different "emotions" noted in this subject during psychotherapy tend to be expressed through different peripheral physiological pathways.

The correlation between social behavior and autonomic physiology found in this investigation apply only to psychotherapy involving a specific patient and therapist. While they do not allow broad generalizations to other psychotherapeutic diads, they offer heuristic guidelines^* for more extensive investigations in this area.