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Several years ago, Shedler and Westen began to report on their development of the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen and Shedler 1999), a dynamically informed Q-sort measure in which the clinician rank orders statements about a patient on a scale ranging from “very descriptive” to “inapplicable or not descriptive.” After completing preliminary studies with the SWAP-200, we began a longitudinal study. Participating analysts describe the index patient as analysis begins and every six months until the analysis ends. As analysis progressed, scores on a sexual conflict scale increased dramatically for some patients, perhaps showing the intensification of conflicts characteristic of the mid-phase of psychoanalysis as core conflicts are more exposed and become accessible to psychoanalytic work with hysteria related to sexual conflicts and obsessiveness related to hostile conflicts (see, e.g., Freud 1926).
We are concerned here with the SWAP-200 scores for histrionic and obsessive personality disorder in the first month or two of psychoanalysis and scores for sexual conflicts (e.g., “Appears to associate sexual activity with danger [e.g., injury, punishment, contamination, etc.], whether consciously or unconsciously”) and hostility (e.g., “Tends to be critical of others”) at the beginning of analysis and 6, 12, 18, and 24 months into it.
We correlated the scores of 7 male and 8 female patients on histrionic and obsessive personality disorder scales at the beginning of analysis