Facial expression and experience of emotions in psychodynamic interviews with patients suffering from a pain disorder. Indicators of disorders in self- and relationship regulation in the involuntaryfacial expression of emotions

In clinical practice, it is often difficult to establish a positive relationship with patients suffering from psychogenic pain disorder. The present study addresses this maladaptive relationship pattern that is characterized by a mixture of disappointment and rejection. Facial expressions of emotions of 21 female patients in psychodynamic interviews were analyzed and compared to a control group of 11 healthy subjects. The assumption of a maladaptive relationship pattern is supported by an increase in negative facial expressions, especially contempt, on the side of the patients and the interviewer. These negative emotions indicate a disorder of self- and relationship regulation and are negatively correlated with the level of structural personality organization (as measured by the operationalized psychodynamic diagnostic). They also correlate with the emotional experience of shame and fear and are negatively correlated with the experience of joy. The results demonstrate how maladaptive relationship patterns are implemented at the level of involuntary emotional behavior. They can help to understand and improve the emotional quality of therapeutic relationships.