In many cases, the dynamics of psychotherapeutic change processes is characterized by sudden and critical transitions. In theoretical terms, these transitions may be "phase transitions" of self-organizing nonlinear systems. Meanwhile, a variety of methods is available to identify phase transitions even in short time series. However, it is still an open question if different methods for timeseries analysis reveal convergent results indicating the moments of critical transitions and related precursors. Methods and Procedures: Seven concepts which are commonly used in nonlinear time series analysis were investigated in terms of their ability to identify changes in psychological time series: Recurrence Plots, Change Point Analysis, Dynamic Complexity, Permutation Entropy, Time Frequency Distributions, Instantaneous Frequency, and Synchronization Pattern Analysis, i.e., the dynamic inter-correlation of the system's variables. Phase transitions were simulated by shifting control parameters in the Hénon map dynamics, in a simulation model of psychotherapy processes (one by an external shift of the control parameter and one created by a simulated control parameter shift), and three sets of empirical time series generated by daily self-ratings of patients during the treatment. Results: The applied methods showed converging results indicating the moments of dynamic transitions within an acceptable tolerance. The convergence of change points was confirmed statistically by a comparison to random surrogates. In the three simulated dynamics with known phase transitions, these could be identified, and in the empirical cases, the methods converged indicating one and the same transition (possibly the phase transitions of the cases). Moreover, changes that did not manifest in a shift of mean or variance could be detected.

Introduction: Mentalization concerns the human ability to understand the actions of others (and oneself) in terms of intentional mental states. Theoretically, the notion has been described via the poles of automatic, non-verbal implicit mentalization as opposed to conscious and verbal explicit mentalization. In this article, we challenge this standard distinction by examining examples from psychotherapy. We argue that explicit mentalization can also be carried out via embodied non-verbal actions.Method: Four cases of real-life interaction from psychotherapy sessions are analyzed from the qualitative perspective of embodied cognition and multimodal interaction analysis. The analyses are based on video data transformed into transcriptions and anonymized drawings from a larger cognitive ethnography study conducted at a psychiatric hospital in Denmark.Results: The analyses demonstrate the gradual development from predominantly implicit mentalizing to predominantly explicit mentalizing. In the latter part of the examples, the mentalizing activity is initiated by the therapist on an embodied level but in an enlarged and complex manner indicating a higher level of awareness, imagination, and reflection. Thus, the standard assumption of explicit mentalization as contingent on verbal language is challenged, since it is demonstrated how processes of explicit mentalization can take place on an embodied level without the use of words.Conclusion: Based on real-life data, the study demonstrates that online processes of implicit and explicit mentalization are gradual and interwoven with embodied dynamics in real-life interaction. Thus, the analyses establish a window into how mentalization is carried out by psychotherapists through interaction, which testifies to the importance of embodied non-verbal behavior in psychotherapy. Further, informed by the notion of affordance-space, the study points to alternative ways of conceptualizing the intertwined nature of bodies and environment in relation to conveying more complex understandings of other people.

This article explores the nature and trajectory of a shared emotional experience in a psychotherapy interaction by combining insights from embodied cognition with the notion of intercorporeality along with the concept of re-enactment. The focus of the article is a detailed interactional analysis of the way the phenomenon of we-ness (or we experience) appears in a psychotherapy session. We-ness concerns the way two (or more) people share an experience by being aware and attentive to the way they participate together in the experience. It is argued that in social interaction, we-ness needs to be examined and understood as a profoundly temporal phenomenon that gradually evolves in the flow of interaction with different levels of intensity. It is built into and enabled by a skillful embodied coordination grounded in expressive movements and dependent on reciprocal patterns of action. Furthermore, it is suggested that the embodied enactment of we-experience may play a particular prominent role in psychotherapy. For the therapist, embodied communicative practices can work as an alternative resource to enhance the sensitive responsiveness in the interactive flow and thereby create an experience of being seen for the patient in a more direct manner than if only verbalized.

Introduction:Clinical dilemma management is an important part of daily decision-making processes in psychotherapy, and hence important for the quality of mental healthcare. However, the situated particularities of such dilemmas have been given little systematic attention -both in research and in practice, even though an improved understanding of the nature of clinical dilemmas is a central key to managing dilemmas successfully.Method: Eight cases of authentic clinical dilemma management in psychotherapy have been analysed from the perspective of interaction analysis and psychopathology. The article uses video data and narrative interviews from a larger cognitive ethnography study conducted at a psychiatric Hospital in Denmark. Results:The analysis demonstrates how clinical dilemma management in psychotherapy is particularly difficult due to the nature of a patient's psychopathology. Thus, it is often difficult to discern whether a given dilemma is intrinsically ethical, or if it is a manifestation of the patient's pathology. Two overall interaction patterns were identified: In the first pattern, the therapist fails to manage the clinical decision-making in accordance with the therapeutic goal, which strengthens the patient's psychopathological behaviour, for instance by giving in and do what the patient demands. In the second pattern, the therapist uses the situation as an opportunity to work with the patient's psychopathological behaviour in situated interaction. Conclusion:This article presents a model for integrating an understanding of patient pathology into clinical and ethical decision-making. It establishes a window into how psychotherapists manage clinical dilemmas (successfully or not) through interaction. This illustration might impact on how we address, evaluate and understand clinical and ethical dilemma management, which again can contribute to the reduction of moral distress amongst healthcare practitioners, as well as amongst patients.

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