Exploring the Language of Body Boundaries in Person-Centred Psychotherapy1

Introduction

This article aims to explore whether the clarification of internalised familial and social values would stimulate changes in patients’ body boundary finiteness. Such changes in the expression of one's body boundary awareness would indicate the presence of a dynamic and temporal personality state rather than a stable personality trait.

Fisher and Cleveland (1958), the exposure and internalisation of familial, stable and secure values and behavioural expectations are assumed to represent the most important influence in the formation of bodily boundaries (Fisher & Cleveland, 1958). Although exposure to a stable and secure family environment is typically perceived to be a fortunate occurrence, Rogerian person-centred theory (1951, 1961) states that the internalisation of values that are incongruent with the true self contribute to the development of psychological disturbances. Given the theoretical relationship between body boundary formation and Rogerian person-centred theory, patients should experience changes in their body boundary finiteness within an empathic psychotherapeutic process. Such changes in body boundary finiteness would represent some empirical support

related to the effectiveness of psychotherapy to bring about changes in the body boundary awareness as well as indicating how body boundary awareness is embodied in the language patients’ use within the psychotherapeutic context. Out of this context, this study might helpful to practitioners of body psychotherapy to further their understanding of the intra- and inter-psychotic functions associated to the of the body boundary personality.

Fisher and Cleveland's Body Boundary Concept

Fisher and Cleveland (, 1958) observed that individuals vary in the appraisal of their body boundaries to the extent that “there is considerable variation in the firmness or definiteness persons ascribe to their body boundaries. At one extreme is the individual who views his body as clearly and sharply bounded, with a high degree of differentiation from non-self objects and the opposite pole is the person who regards his body as lacking demarcation or differentiation” (Fisher, 1970, p. 155). Fisher and Cleveland reasoned that individuals would project their phenomenological experience of their own body boundaries onto their environment. Therefore, individuals with more definite body boundaries would show a greater tendency to direct their visual attention to the protective and enclosing features in their environment, as opposed to individuals with less definite body boundaries.

In a series of empirical studies using projective tests, including the Rorschach inkblot test (Rorschach, 1921), Fisher and Cleveland developed a manual scoring system that measured the frequency of words that related to the definiteness and permeability of an individual's body boundaries. Barrier imagery emphasised the protective and enclosing features of the boundaries of a definite structure and surface, whereas penetration imagery related to the fragility and permeability of definite boundaries. Based on this scoring system, a high frequency of barrier imagery corresponded to a High Barrier personality, whereas a low frequency of barrier imagery indicated a Low Barrier personality. Examples of Barrier responses were “a striped zebra”, “a woman wearing a high-necked dress”, “a tower with stone walls”, “a man smoking a pipe”, and “a pregnant woman”, and examples of Penetration responses included “a man climbing though a window”, “an amputated arm”, “an open mouth” and “a bleeding leg”.

Most importantly, Fisher and Cleveland (1958) suggested that an individual's degree of body boundary finiteness is correlated to the social values and behavioural expectations learned from the interactions in family environments. For example, mothers of High Barrier personalities scored lower on maladjustment and rigidity scales than mothers of Low Barrier personalities. Based on this result, Fisher and Cleveland (1958, pp. 259-260) interpreted that individuals with definite body boundaries would have mothers that provided a secure model and strong values as well as the ability to maintain stable and intimate relationships, whereas individuals with less definite body boundaries would grow up in family atmospheres characterised by instability, insecurity and tension. Although High Barrier personalities might be construed as a favourable personality trait compared to the Low Barrier personality, it has to be noted that Fisher and Cleveland's observation of High Barrier patients with rheumatoid arthritis showed reservations in expressing negative emotions, such as anger and frustrations. The focus on enclosing peripheries and the rigid appearance of bodily stiffness might, on a psychosomatic level,

reflect a defensive function by containing and controlling these negative emotions that are perceived as unacceptable, overwhelming or threatening. The body functions, then, as an enclosing container “whose walls would prevent the outbreak of these impulses” (p. 55). If also not explicitly stated by Fisher and Cleveland (1958), the extreme development of high and low body boundaries might be perceived to result in defensive forms of affect regulation, whereas body boundaries in the middle range on the High-Low Barrier personality continuum might represent more functional forms of regulating emotions.

These findings are also consistent with psychodynamic theories that perceive early socialization experiences to represent one of the strongest influences on the formation of a coherent self and bodily schema (Ogden, 1989; Bick, 1968, Winnicott, 1971). Thus, individuals with coherent self and bodily schemas are assumed to communicate their internal mood states to their social environment, whereas the inhibition to express one's internal experiences is assumed to indicate dissociation from one's emotions and thoughts (Bollas, 1987). Based on the Freudian theory (1923) that perceives a relationship between the body and the unconscious, Cariola (2015) identified that autobiographical memories of High Barrier personalities used more words associated to primordial mental activity, such as group references, somatosensory processes, and spatial references. In contrast, Low Barrier personalities showed increased use of semantic content related to conceptual thought, such as self-reference, as well as affective and cognitive processes. Primordial mental activity and conceptual thought represent similar concepts to the Freudian (1900) modes of cognitive functioning that differentiates between the primary and secondary processes. The primary process is concrete, irrational, unrelated to spatio-temporal constraints, and free from social and moral conventions. It is also the principal awareness of young children, and it has also been associated with the cognitive functioning of ASC, including dream, meditative, mystical and drug-induced hallucinatory states. In contrast, the secondary process is abstract, related to the principles of grammar and logic, time and space, social and moral conventions, and it is the cognitive functioning of older children and adults.

Rogerian Person-Centred Psychotherapy

The Rogerian approach to therapy generally refers to the theories and clinical practice of Carl Rogers (1902-1987), the founder of the person-centred psychotherapy. According to the person-centred approach, a supportive and loving family environment in which children experience their parents’ unconditional positive regard represents the basis of the development of a positive congruent self and self-worth. Yet, to obtain his/her basic needs to obtain parental approval, the child also “internalizes” his/her parents’ conditional values of what constitutes acceptable and love-worthy behaviour, no matter how bizarre and irrational. These internalised parental values may fail to reflect the person's authentic emotional experiences, action tendencies and values, and eventually, the child will start to distort and deny any experiences of the true self that are perceived as incongruent would fail to win parental approval. Consequently, the discrepancies between the conditional parental values and the individual's experiences result in a split between the experiencing phenomenological self and the true self. A person who is preoccupied in fulfilling a great variety of internalised values that are incongruent with the true self tends to engage in rigid attitudes and maintain behaviours and values that

further reinforce a negative self-concept to the extent that such a person might even become completely cut off from their own inner resources and their own values and are governed by a secondary and treacherous valuing process which is based on the internalisation of other people's judgments and evaluations” (Thorne, 2003, p. 138). The person-centred theory states that the discrepancy between the phenomenological self and true self represents the basis for the development of psychopathological disorders.

Rogers' Core Conditions

Person-centred psychotherapy employs a non-directive approach emphasising the therapists’ use of reflection as a means to summarise what the clients expressed about their feelings and thoughts so that patients’ phenomenological experiences are fully acknowledged by the therapist. Most importantly, Rogers (1961) stressed the notion of the psychotherapeutic climate as a pre-requisite for a deep understanding by the therapists of their clients and for the desired psychotherapeutic changes to occur. Through the psychotherapeutic processes that depend substantially on three core conditions — 1) the therapist's congruence or genuineness, 2) unconditional positive regard, 3) empathic understanding — patients will be supported to gradually assume more courage to trust their intuitions, values, needs and desires. This growth enables patients to find their phenomenological self and develop a stable and healthy self-concept, in addition to recognising their personal worth that is independent of external approval.

Allport's Transient States

Allport (1961; Allport & Odbert, 1936) suggests that some units of personality (e.g., states and activities) are temporary and related to external events. He further stated that the expression of personality traits is dynamic and largely influenced by the motive to regulate tensions related to basic biological necessities, (e.g., hunger, sleep and feelings of security). As adults, these basic needs become more complex and abstract, but the need to reduce tensions remains activated; for example in social relationships, when individuals will engage in behaviour to gain approval from their social environment in order to maintain a positive self-image. Such a relationship between social approval and personality development, as proposed by Allport (1961), also represents a central rationale in Fisher and Cleveland's (1958) theory of the body boundary formation. For example, a series of empirical studies have shown that individuals with more finite body boundaries will also have more defined concepts of parental figures and will “have parents who stood for certain definite values and ways of doing things” (p. 249). Parents will not only be representative of definite values, but, more importantly, their social interactions will inevitably influence their children's internalisation of these social values and the development of associated socialisation processes. These internalisations are perceived to represent the primary foundation of the development of an individual's body boundary structure and self-concept.

Hypotheses

Given that previous research demonstrated that High Barrier personalities use semantic content associated with primordial mental activity in the written narration of everyday and dream memories (Cariola, 2015b), the first hypothesis (H1) predicted that barrier

imagery would correlate positively with semantic content associated with primordial thought, such as group references (i.e., first-person plural pronouns and inclusion words), perceptual process (i.e., seeing, hearing and feeling), and spatial references (i.e., relativity, space and motion), bodily processes (i.e., body, health, sexual and ingestion) and references related to personal concerns (i.e., work, achievement, leisure, home, money, religion and death). Barrier imagery would be negatively correlated with semantic content related to conceptual thought, such as self-reference (i.e., first-person singular pronouns), verb forms (i.e., common verbs, auxiliary verbs, present tense, past tense and future tense), affective processes (i.e., positive emotions and negative emotions) and cognitive mechanisms (i.e., insight, causation, discrepancy, tentativeness, certainty, inhibition and exclusion words) in the combined spoken psychotherapy transcripts. Correlations of semantic content consistent with the research hypotheses would then demonstrate external validity in which an association between barrier imagery and primordial mental activity can be generalised to naturally occurring language behaviour and to experimentally derived autobiographical memories.

Additionally, psychological theory proposes early socialisation experiences and internalisation of social and behavioural values, or the lack thereof, influence the development of the body boundary formation (Fisher & Cleveland, 1958; Rogers, 1961). Considering that person-centred therapy aims to support patients to trust and become consciously aware of their organismic experiences and values, the second hypothesis (H2) predicted that progressive psychotherapy sessions would be correlated positively with barrier imagery in Low Barrier patients but correlate negatively with barrier imagery in High Barrier patients. In this sense, this study it based on the assumption that the expression of the true self as well as the formation of the body boundary lies in the middle range rather than the extreme ends on the True-False Self and High-Low Barrier personality continuums.

Method

Data

Patients' verbal behaviour in psychotherapy transcripts were sourced from the online ‘Counselling and Psychotherapy Transcripts’ database provided the data for this study. According to the accompanying ‘Counselling and Psychotherapy Transcripts’ handbook , the psychotherapy transcripts were provided by practicing therapists who adhered to the American Psychological Association's Ethics Guidelines, and were selected by an editorial board of distinguished practitioners and academics. The transcript database of the Rogerian person-centred approach to psychotherapy, however, is the most comprehensive because it offers a range of transcripts of individual therapies based on twenty consecutive sessions, with the twentieth session representing the final session. In contrast, the transcripts of the other psychotherapeutic modalities were often provided with only a few consecutive sessions. Out of this context, the transcripts selected for the purpose of this study were based on patients that attended twenty psychotherapeutic sessions.

The psychotherapy transcripts used in this study were based on 12 patients (7 men and 5 women) who attended 20 consecutive once-weekly Rogerian person-centred

psychotherapy sessions. The demographic information of the patients, including age range, sexual orientation and marital status, can be seen in Table 1.

The 12 person-centred psychotherapy transcripts had a total text length of 1,699,534 words with a mean of 3,836.42 words per psychotherapy transcript (SD = 3,057.79). The therapists’ verbal behaviour had a total text length of 358,137 words, with a mean of 1,577.70 words per psychotherapy session transcript (SD = 678.36). The patients’ verbal behaviour had a total text length of 1,341,397 words with a mean of 6,210.17 words per psychotherapy session transcript (SD = 2,773.22).

Measures and Analysis

The Body Type Dictionary (BTD) (Wilson, 2006) is computer-assisted dictionary that calculates the frequency of semantic items categorised as barrier imagery and penetration imagery, based on Fisher and Cleveland's (, 1958) scoring system of body boundary awareness (Cariola, 2014a, b). In total, the BTD contains 551 words for barrier imagery, 231 words for penetration imagery, and 70 exception words that prevent the erroneous matching of ambiguous word stems that are assigned to 12 semantic categories (Wilson, 2008).

The Linguistic Word Count Inquiry text analysis program (LIWC) (Pennebaker, Booth, & Francis, 2007) calculates the frequencies of predefined types of semantic content. The LIWC is based on approximately 4,500 words and word stems that are assigned to 80 semantic categories. The LIWC dictionary is hierarchically organised so that one word can be ascribed to different main categories and sub-categories. The semantic categories are based on the following categories: ‘Function Words, ‘Psychological Processes’’ and ‘Personal Concerns’. Each of these categories has sub-categories. For example, as noted by Tausczik and Pennebaker (2010, pp. 27-28), the ‘function words’ category includes to the ‘articles’ sub-category, which is made up of three words (i.e., a, an, the). Grammatically based categories are based on the classification of semantic items that relate to objective grammatical conventions; however, the semantic content of other categories, such as ‘emotions’, is made of semantic items that rely on the researchers’ subjective judgment.

For the computerised content analysis, the BTD and LIWC were applied to the texts using the PROTAN content analysis software program, which measures occurrences of category-based lexical content in texts (Hogenraad et al., 2003). The PROTAN computes the frequency rate, which indicates how many total lexical items match the dictionary

categories (Wilson, 2008). The frequency rate used in this study for both linguistic and grammatical variables was based on the following formula:

To obtain a better understanding of the quantitative derived results, samples of patient's verbal behaviour were selected to demonstrate the use of semantic content within the psychotherapeutic settings and to how the semantic content aligned to existing psychotherapeutic theories and constructs.

Statistical Analysis

Initial descriptive statistics regarding the frequencies of barrier imagery revealed that the psychotherapy transcripts had a mean 1.72 of and a median of 1.69 (SD = .66). By drawing on the methodology applied by Fisher and Cleveland (1958), the median value of 1.69 for the barrier imagery frequency of the first psychotherapy session was used to divide the psychotherapy transcripts into two patient groups that used high and low frequencies of barrier imagery at the beginning of their therapy. Therefore, psychotherapy beginnings with barrier scores less than the median value (< 1.69) were categorised as ‘Low Barrier patients’, whereas Barrier scores greater than the median value (> 1.69) were categorised as ‘High Barrier patients’.

After the psychotherapy transcripts were divided into two equal parts, the descriptive statistics showed that the Low Barrier patients (N = 6) had a mean of 1.54 (SD = .49) and that the High Barrier patients (N = 6) had a mean of 1.84 (SD = .57) for the barrier frequencies in the psychotherapy transcripts. As a result of this median division, 6 of the 12 patients were classified as High barrier patients and 6 were classified as Low Barrier patients. The High Barrier patients were 3 men aged 11 to 30 years and 3 women aged 21 to 40 years. The Low Barrier patients were 4 men aged 21 to 30 years and 2 women aged 21 to 40 years.

A Spearman rank correlation coefficient (Spearman, 1904) was used to explore the strengths of association between barrier imagery and the semantic content of the LIWC in the patients’ overall verbal behaviour. The test was also used to explore the strengths of associations between the progression of sessions and barrier imagery in the psychotherapy transcripts of Low and High Barrier patients.

Results

Consistent with the first hypothesis (H1), the results demonstrated that barrier imagery correlated positively with semantic content associated with primordial mental activity (Tables 2 and 3).

Group references, such as first-person plural pronouns (e.g., we, us, and our), and inclusion words (e.g., and, with, and include) showed a weak positive association with barrier imagery. The use of collective group references resonates with a lack of self-other differentiation and over-inclusive thinking. In this sense, self-expectations and internal experiences are over-generalised in relation to others, such as the patients’ therapist and partners, which can be observed in the following phrases: [Patient 3]“Are we supposed to sit here and just tell anything that comes to my mind?” or “Well we were both more or less elated because we both want to get this problem resolved, so we are quite hopeful.”

Particularly, the weak negative correlation between barrier imagery and first-person singular pronouns (e.g., I, me, and mine) implies a reduced self-focus. By drawing on person-centred psychotherapy (Rogers, 1961), a reduced self-focus would be indicative of a blocked interpersonal communication, or so-called defence mechanism of denial, in which patients are unaware of their feelings. In this sense, conversations maintain a superficial tone, referred to as phatic conversations (Malinowski, 1972), and contain a restricted level of self-disclosure by focusing on objects and, in relation to the psychotherapeutic context, problems that are non-immediate and external to the self (Rogers, 1961). In contrast, an increased self-focus emphasises internal mental processes that relate to affective and cognitive states and changes, whereas an increase usage of group-references and non-immediate others associated with barrier imagery relate to

interpersonal material processes (Halliday, 1985). Consistent with this view, there was a weak positive association between barrier imagery and third-person singular pronouns (e.g., she, her, and him), indicating an increased non-immediate, or extended, other-focus related to the patients’ exploration of their personal relationships. A high prevalence of third-person singular pronouns might also represent a staging strategy to regulate their discomfort of being the focus in the conversational situation (McCarthy, 1991) as well as to justify their feelings and concerns. This strategy indicates reduced personal responsibility and dissociation from statement ownership (Hancock et al., 2008) within the psychotherapeutic context, which can be observed in the following example: [Patient 6]

Person-centred psychotherapy assumes that psychological disturbances are acquired through the process of familial and social introjects that are incongruent with the values and experiences of the phenomenological self. This process precedes the embodiment of these values within the body boundary (Fisher & Cleveland, 1958). Therefore, a weak positive association between barrier imagery and family-related references (e.g., daughter, husband, and aunt) highlights the inflated focus on family related themes, as demonstrated in the following patient's statement: [Patient 11] “Because I was already invited by Jodie's mother over to dinner. See, it was almost like - and I sat down and thought about, tried to think about that, too. And, I was thinking…because I felt this before, that my mother might have rejected me, like my mother did not really care. You know I think I told you that last week.”

Barrier imagery correlated moderately positively with home references (e.g., apartment, kitchen, and house), which mirrors a focus on the immediate and intimate social environment and indicates an emphasis of container-schematic precepts — e.g., [Patient 110] “And, I guess what happened was, some kids had rung this old lady's doorbell, so she had come up from the basement to answer the door, and her husband had seen the kids running away from the door, and so he knew who they were and so he told her, and she came over and told my neighbour. And, the neighbour got all mad, and she was sitting there yelling at two of her own kids and one of the people across the street's kids, and she screamed at him about, oh, maybe she sent him home.”

A weak to moderate positive correlation between barrier imagery and references to personal concerns, including work (e.g., job, majors, and Xerox) and money (e.g., audit,

cash, and owe) relates to a materialistic and achievement orientated focus, e.g., [Patient 124] “I - although I enjoy sort of basking in the accomplishments - well, based on when I go back home. Like, I have spoken quite a few times to my - well, the old high school keeps inviting me back. I was the first graduate in class,” and in relation to monetary references, “So, I remember I went out and I bought her something from K.M. Hightower's…like I spent like a whole part-time pay check, which is like 15 bucks. It's, well…but I mean it was still a substantial amount for just like a small housewarming gift for somebody who is not even a relative or really that close.” This materialistic and goal-orientated focus could possibly relate to being socially positively evaluated by others based on superficial values rather than on personal inter-personal qualities. Conversely, a weak positive correlation between barrier imagery and leisure words (e.g., cook, chat, and movie) is consistent with the creative expression and unstructured behaviour associated with primordial mental activity — e.g., [Patient 2] “So, I read his psychology book. However, he does not because I do not do it that much. I am not interested in that much, you know. I like to read, but I like to read novels historical novels, and he does not.”

As expected, barrier imagery was weakly to moderately negatively associated with affective processes (e.g., happy, cried, and abandon), including positive emotion (e.g., love, nice, and sweet) and anxiety words (e.g., worried, fearful, and nervous) that are related to the reduced conscious awareness of both positive and anxiety-related emotional experiences and the communication to the therapist. Although a heightened primordial mental activity typically relates to reduced affective processes, barrier imagery showed a significant weak positive correlation with anger words (e.g., hate, kill, and annoyed) and swear words (e.g., damn, piss, and fuck), which indicate an emphasis of anger-related experiences associated with a body boundary finiteness within the psychotherapeutic context. These anger emotions can be directed towards the self in the form of references related to self-harming, e.g., [Patient 6] “And, you know, it was like really stupid, but it was like about the third night within the last week that I woke up and wanted to cut myself, which is just really. Like I before that had gone through a fantastically long time,” or the feeling of anger in relation to others, e.g., [Patient 27] “Well, I think to be worried about that is, it makes sense to me because I just I feel like if you are angry and you are angry while somebody is saying something to you, you ought to be able to tell them you are angry or express it or say something or do something.”

According to Rayner (1995, pp. 101-102), aggression involves the actual or simulated activation of muscular movements associated with primordial mental activity to bring about a negation and separation as well as a reaction of perceived threats and a self-preservation function. Considering that high barrier individuals introjected their parental social and behavioural values, such as the socially unacceptable expression of rage and anger (Fisher & Cleveland, 1958), the expression of anger within the therapeutic context would facilitate an essential cathexis to explore interpersonally distressing experiences that result in a gradual resistance to maladaptive parental and social introjects (Freud, 1905; Fenichel, 1945). A resistance may be then perceived as an adaptive manifestation of the patient embodying an agent of change (Coghlan, 1993; Nevis, 1987) in which the patient would resist the learned masochistic submission to parental demands as a means to avoid interpersonal rejection, as well as the harsh criticism of the internalised sadistic parental super-ego (Freud, 1923).

Given that the inhibited expression of anger-related emotions has been associated with the stiffening of the body musculature in High Barrier personalities (Fisher & Cleveland, 1958), the positive correlation between barrier imagery and aggression words might represent a psychotherapeutic feature of the previously repressed anger and the loosening of the conditioned punishment-reward behaviour to avoid socially rejecting and disapproving social judgment (Pennebaker, 1989; Pennebaker & Beall, 1986; Traue & Pennebaker, 1993). Accordingly, there was also a significant positive correlation between barrier imagery and inhibition words (e.g., block, constrain, and stop), which might be related to the inhibited expression of High Barrier patients’ thoughts and feelings. In contrast, the weak correlations between barrier imagery and verbs (e.g., walk, went, and see), including auxiliary verbs (e.g., am, will, and have) and present tense verbs (e.g., is, does, and hear) indicates a reduced reality-based behaviour and now-and-here concern associated with primordial mental activity (Robbins, 2011).

Barrier imagery also showed a weak positive association with death-related references (e.g., bury, coffin, and kill), such as self-directed aggressive behaviour in the form of suicidal ideation, e.g., [Patient 6] “Well, when I tried to kill myself about two years ago or whenever it happened, and I saw a psychiatrist where I was when I got out of the hospital.” Given the relationship between destruction and anger, as noted in the psychoanalytic literature (see Hurvich, 2003), the use of anger words and destructive death-related references might also be indicative of the presence of annihilation anxieties, such as through the use of death-thematic fantasies, e.g., [Patient 32] “I cannot conceive of it, and yet, personally — if everyone I knew now died, I think my life would be completely different because I would not have any expectations to live up to their expectations.” Particularly, and consistent with Fisher and Cleveland's (1958) observation, Bowlby (1980) conceptualised death-related fantasies to represent patients’ unconscious revenge and desire to hurt their parents due to the parental rejection of the patient's feelings and inner self that created feelings of loneliness and the parental demands that require compliance in which the patient would feel responsible for their parent's sense of well-being to be deemed lovable and worthy.

Similar to affective processes, cognitive processes (e.g., cause, know, and ought), including insight words (e.g., think, know, and consider), causation words (e.g., because, effect, and hence), discrepancy words (e.g., should, would, and could), tentativeness words (e.g., maybe, perhaps, and guess) and exclusion words (e.g., but, without, and exclude), and negations (e.g., no, not, and never) were weakly to moderately negatively correlated with barrier imagery. Specifically, the reduced use of insight words, tentativeness and causation words indicate a lower presence of self-reflection and the sense-making processes of the content that is being explored within the therapeutic context. Similarly, low frequencies of discrepancy words and exclusion words indicate a reduced presence of complex cognitive processes to produce accurate accounts of experiences and insights. To some extent, the reduced usage of semantic content that is classified to measure cognitive processes may indicate a lowered neurotic defence mechanism of intellectualisation in which patients would avoid unconscious conflicts through the process of reasoning and logic (Freud, 1936).

Furthermore, barrier imagery was weakly to moderately positively correlated with biological processes (e.g., eat, blood, and pain), including references related to the body (e.g., cheek, hands, and spit), health (e.g., clinic, flu, and pill) and ingestion (e.g., dish,

eat, and pizza), e.g., [Patient 3] “She would be sleeping (Body) and wake (Body) up the next morning, I am dead tired (Health) because I laid there and worried all night about something I really did not need to be worried about. I used to chew (Ingestion) my fingernails (Body) clear back to the quick ….” The moderate to strong positive correlations with relativity (e.g., area, bend, and exit), including references related to motion (e.g., arrive, car, and go), space (e.g., down, in, and thin) and time (e.g., end, until, and season), as well as prepositions (e.g., to, with, and above), further reflect the psychosomatic characteristic and somatosensory impressions associated with primordial functioning (Robbins, 2011) — e.g., [Patient 124] “How will I interact now (Time)? Why should I have done that? Why should not I have just come (Motion) in (Space) here and be honest? I hope I am being honest. However, just the thought that….” Barrier imagery was also moderately positively associated with articles (e.g., a, an, and the), which correspond to the tendency of objectification, which reflects the concreteness in primordial mental activity (Bucci, 1997; Mergenthaler & Bucci, 1993; Loewald, 1978) and a heightened focus on surface-defining objects — e.g., [Patient 11] “Not that I care about the fellow. It is just the point of the thing.”

Conversely, barrier imagery was weakly negatively correlated with perceptual processes (e.g., observing, heard, and feeling), including feeling words (e.g., feels and touch), indicating a reduced receptivity to environmental sensory stimuli and lowered sensitivity of the external skin body boundary in spoken therapeutic discourses compared to written autobiographical memories (Cariola, 2015b). This low activation of perceptual processes typically relates to conceptual thought (Robbins, 2011). Based on cognitive psychology, a deflation of sensory processes has also been identified as a marker of memory inaccuracies (e.g., ; Hernandez-Fernaud & Alonso-Quecuty, 1997; Schooler, et al., 1986). Within the therapeutic context, a reduction of perceptual processes might relate to discursive themes that are based on patients’ fuzzy memory representations of their inter- and intra-psychic experiences that form part of their personal truths (Brainerd & Kingma, 1984; Reyna & Brainerd, 1998; Spence, 1982). A reduction of perceptual process is also consistent with the Rogerian (1961, p. 110) assumption that individuals would defensively exclude insights that are inconsistent with their internalised value systems. Lower frequencies of perceptual process in heightened barrier awareness would then indicate patients’ dysfunctional ability to acknowledge their internal and external reality, as well as their lowered ability to understand their own or others’ implicit or explicit mental states. This decreased ability indicates a limited capacity to engage in self-reflective and mentalisation processes (Fonagy & Target, 1996).

Strengths of Association between Barrier Imagery and Psychotherapy Sessions

A Spearman rank correlation coefficient showed that in High Barrier patients, progressive sessions were weakly negatively correlated with barrier imagery, r = -.216, p < .05, but progressive sessions were not significantly correlated with barrier imagery in Low Barrier patients, p > .05. Therefore, the second hypothesis (H2) was only partly confirmed.

The reduction of barrier imagery in High Barrier patients suggests that a supportive therapeutic environment that enables patients with previously heightened body boundary

finiteness to clarify their parental and social introjects that were incongruent with the phenomenological self. The empathic and non-judgmental therapist allows patients to explore and reflect on their emotions and thoughts, including frustrations and traumatic experiences. This factor results in the lowering of the encapsulating body boundary. Particularly, the absence of punishing interpersonal judgment would result in the reduction of muscular sensitivity associated with a socially conditioned punishment-reward response (Fisher & Cleveland, 1958).

Given that body boundaries develop as a response to the internalisation of social values that are to some extent inconsistent with the patients’ phenomenological self (Fisher & Cleveland, 1958), the nurturing and empathic environment of the person-centred therapeutic environment would encourage functional forms of self- and other-relating, as well as facilitating the patient to formulate values and behavioural responses that are congruent with the needs of their phenomenological self. A reduced body boundary embodies a functional self-other differentiation that might enable patients to acknowledge their feelings and rely on their own judgments and values, in addition to a greater capacity to trust others and to engage with their experiences. This functional body boundary would further allow patients to fulfil the potentials of their ideal self.

Discussion and Conclusion

The results of this study were partly consistent with some of the research hypotheses. Consistent with the first hypothesis (H1), barrier imagery positively correlated consistently with semantic content associated with primordial mental activity, such as group-references, biological processes, relativity and personal concerns, whereas barrier imagery correlated negatively with semantic content associated with primordial thought, such as self-references, verbs, and cognitive and affective processes.

Because the correlations of barrier imagery in relation to the patients’ verbal behaviour within the psychotherapeutic context were consistent with the semantic tendency of the written narratives of everyday memories (Cariola, 2015), to the extent that that it can be generalised to both experimentally derived autobiographical memories and naturally occurring psychotherapy-based language behaviour (; ). Conversely, barrier imagery correlated positively with anger words, which are typically associated with conceptual thought. Such an inflation of anger words in relation to body boundaries provide some confirmation of the patients’ frustrations regarding internalised parental values that constitute a thickening of the body boundary. The person-centred therapeutic approach would then represent a process in which these parental and social internalisations and their inconsistency with the patients’ phenomenological self would form part of the patients’ conscious awareness.

The results also demonstrated that barrier imagery was reduced in High Barrier patients and that barrier imagery did not increase in Low Barrier patients (H2). This change in barrier imagery suggests that the empathic and unconditional acceptance of the therapeutic relationship in person-centred interventions enable patients to explore their emotions and insights in addition to ridding themselves of inauthentic values that are not

congruent with the phenomenological self or their personality predispositions. This psychotherapeutic process resulted in changes of body boundary finiteness.

There was also a reduction in barrier imagery in High Barrier patients throughout the therapeutic process, but barrier imagery did not increase in Low Barrier patients (H5). Such a change of barrier imagery might confirm that the empathic and unconditional acceptance of the therapeutic relationship in person-centred interventions enables patients to explore their emotions and insights while ridding themselves of inauthentic values that are not congruent with the phenomenological self or their personality predispositions, thus resulting in the changes of body boundary finiteness. High Barrier patients also showed a reduction of self-references, anxiety words and death-related semantic content (H7). Such a reduced self-focus and lower use of negative affective themes would further indicate the effectiveness of the therapeutic process in alleviating patients’ psychological suffering, such as their experiences and emotions associated with hopelessness, rejection and disappear. Negative emotion words, however, were not reduced in High or Low Barrier patients when comparing the first and final psychotherapeutic sessions (H4).

The results did not produce compelling evidence that would suggest a change of semantic content associated with primordial mental activity in Low and High Barrier patients (H3 and H6). High Barrier patients, however, showed a reduction in discrepancy and insight words at the final psychotherapy session. A reduction in discrepancy words indicates the lowering of absolute claims, the so-called ‘shoulds’, ‘oughts’ and ‘musts’ (; ) that represent the internalised social values that hinder patients’ ability to respond more spontaneously and openly to their environment and to be more tolerant towards the self and others (Higgins et al., 1986; Ogilvie, 1987; Tajfel, 1959; Tajfel & Wilkes, 1963). An increase in insight words also reflects heightened levels of self-reflection and understanding of one's own psychological processes, such as needs, emotions and behavioural tendencies. A comparison between the first and final psychotherapeutic sessions of Low Barrier patients shows a reduction in achievement and work related references, which indicates a reduced focus on labour and success. Conversely, an increase in references related to money is congruent with the concrete and materialistic focus of High Barrier personalities. An increase in motion processes is also typically associated with the primordial mental activity. The reduction of human references, however, indicates a lower focus on social relationships, which would be associated with a Low Barrier personality. Low Barrier patients’ increased used of hearing words from the first to final therapeutic session, however, might indicate an increased sense of openness to experience (Hirsch & Peterson, 2009).

The semantic changes might also suggest that Body Boundary personality represents a personality state rather than a stable personality trait, as put forward by Fisher and Cleveland, 1958). In this sense, the Body Boundary personality might be a temporary personality state that is influenced by situational and external events. As pointed out by Allport (1961, Allport & Obert, 1936), the expression of personality states are largely motivated and regulated in relation to the satisfaction of basic biological necessities (e.g., hunger, food, sleep, feelings of love and anxiety). In particular the High Barrier personality typically tends to adapt to behavioural expectations and social values to gain approval from their social environment (e.g., parents and friends) in order to maintain a positive self-image and get their basic biological needs met (Fisher & Cleveland, 1958). The semantic changes exhibited by the High Barrier personality indicate an adaptation to

the expectations that typify the therapeutic context, such as a reduction of anxiety, rather than representing a genuine personality change.

In summary, the results provided some confirmation of the research premise that person-centred psychotherapy would clarify patients’ social value systems and behavioural expectations that are embodied in the increased body boundary finiteness. Out of this context, the results of this study indicated that individuals with high body boundaries tend to differ in their semantic expression from patients with lower body boundaries. In this sense, the use of linguistic features may enable therapists to differentiate between patients with high and low body boundaries, and changes in linguistic features may indicate defensive mechanisms that are associated with the hard body shell being dissolved through the psychotherapeutic process.