Inter-Brain Synchronization During Sandplay Therapy: Individual Analyses.

Interactions between the client (Cl) and therapist (Th) evolve therapeutic relationships in psychotherapy. An interpersonal link or therapeutic space is implicitly developed, wherein certain important elements are expressed and shared. However, neural basis of psychotherapy, especially of non-verbal modalities, have scarcely been explored. Therefore, we examined the neural backgrounds of such therapeutic alliances during sandplay, a powerful art/play therapy technique. Real-time and simultaneous measurement of hemodynamics was conducted in the prefrontal cortex (PFC) of Cl-Th pairs participating in sandplay and subsequent interview sessions through multichannel near-infrared spectroscopy. As sandplay is highly individualized, and no two sessions and products (sandtrays) are the same, we expected variation in interactive patterns in the Cl-Th pairs. Nevertheless, we observed a statistically significant correlation between the spatio-temporal patterns in signals produced by the homologous regions of the brains. During the sandplay condition, significant correlations were obtained in the lateral PFC and frontopolar (FP) regions in the real Cl-Th pairs. Furthermore, a significant correlation was observed in the FP region for the interview condition. The correlations found in our study were explained as a "remote" synchronization (i.e., unconnected peripheral oscillators synchronizing through a hub maintaining free desynchronized dynamics) between two subjects in a pair, possibly representing the neural foundation of empathy, which arises commonly in sandplay therapy (ST).

Alexithymia and sociocultural factors in a Japanese sample: a study with the Rorschach.

We reexamined the Japanese version of the 20-item Toronto Alexithymia Scale, a self-report sc ale for measuring alexithymic characteristics, by comparing the scores on three factors and the total scores with variables of the Rorschach in a sample of 40 (originally 48) Japanese college students. Based on prior studies, our aims were to further validate the 20-item Toronto Alexithymia Scale by comparing its scores with those on a projective technique. We also investigated whether sociocultural factors, such as repression of hostility. are associated with scores on the 20-item Toronto Alexithymia Scale (especially Factor 3). None of the seven Rorschach Alexithymia Variables were significantly related to the factors and total scores of the 20-item Toronto Alexithymia Scale. However, scores for Factor 1 (difficulty identifying feelings) of the 20-item Toronto Alexithymia Scale correlated positively with scores on Sum C' (reserved responses to emotional stimuli) and Adj es (stimulus demand), suggesting that individuals who score high for Factor 1 experience gloomy, depressive feelings but in constricted ways. Scores for Factor 3 (externally oriented thinking) correlated positively with the D scores (stress tolerance) and negatively with m (situational stress) responses, suggesting that Factor 3 may reflect a psychological defense that enhances stress tolerance. There was a nonsignificant negative correlation between Factor 1 and Factor 3 scores, but, unlike our hypothesis. Factor 3 was neither related to AG (aggression) nor S (space responses reflecting oppositional tendency), indices of aggression or hostility in the Rorschach Comprehensive System. It may be that the 20-item Toronto Alexithymia Scale and the Rorschach measure quite different aspects of personality, but further research is necessary.

Psychosocial predictors of relapse among diabetes patients: a 2-year follow-up after inpatient diabetes education.

In a 2-year follow-up study of diabetes patients (N=309) who received 2 weeks of inpatient diabetes education, the authors investigate the relationship of several demographic, clinical, and psychosocial factors with relapse, defined as the worsening of glycemic control. The patients with no improvement in glycemic control after diabetes education were more likely to have higher scores on the depression subscale of the Profile of Mood States, compared to the patients with improvement. Kaplan-Meier survival analyses showed that patients who had no prior diabetes education, whose meals were prepared by their spouses, and who had less social support were more likely to relapse and relapsed within a significantly shorter period of time than those who had prior diabetes education, cooked for themselves, and had more social support.