A Comment on “A Psychophysiologic Perspective on Affect and Psychotherapy” by Herbert S. Gross, M.D. and Kenneth Fligsten, M.D.

In their ground-breaking paper, Gross and Fligsten (this issue) continue a long-standing psychoanalytic tradition of exploring the linkage between mind and body. Freud (1895) initiated this adventure in his “Project for a Scientific Psychology,” in which he attempted an explanation of mental phenomena in neurophysiological terms. Since then, numerous psychoanalytic investigators have examined the connection between mental and physical phenomena. Over the past 50 years, a number of psychophysiologists, including some psychoanalysts, have studied the physiological changes that occur during dyadic and group interactions. These investigations have focused on a number of physiological modalities including muscle tension, heart rate, blood pressure, skin temperature, electrodermal activity, gastrointestinal motility, respiratory function, and certain hormonal responses. In general, there appears to be a close association between physiological activity and specific clinical events during interviews as well as psychotherapy. For example, affective arousal is clearly associated with voluntary and autonomic nervous system perturbation, while affective tranquility is correlated with voluntary and autonomic nervous system quiescence. Simultaneous physiological monitoring of both interviewer and subject (therapist and patient) reveals that psychological rapport between them is correlated with mutually decreased autonomic nervous system arousal; conversely, when their relationship is antagonistic, there is mutually increased autonomic nervous system activity. Physiological responses alone do not convey psychological meaning; they must always be interpreted in the context of the clinical material. For example, while tachycardia may occur with anxiety in one subject, it may be correlated with anger in someone else. Each individual has a hierarchy of idiosyncratic physiological responses associated with specific affects. Thus, while anxiety may be primarily associated with tachycard