THE APPLICATION TO PSYCHOTHERAPY OF MEASURES BASED UPON THE INTERPERSONAL OCTAGON.

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1 THE APPLICATION TO PSYCHOTHERAPY OF MEASURES BASED UPON THE INTERPERSONAL OCTAGON

2 THE APPLICATION TO PSYCHOTHERAPY OF MEASURES BASED UPON THE INTERPERSONAL OCTAGON THIS APPROACH FOCUSES UPON RELATING DIFFICULTIES RATHER THAN SYMPTOMS.

3 RELATING THEORY Humans have evolved with a set of innate, relating objectives that carry advantages for the individual. Such objectives concern the attainment of certain states of relatedness. The attainment of such states is accompanied by the experience of pleasure and their loss is accompanied by displeasure. d UPPERNESS (RELATING FROM A POSITION OF RELATIVE STRENGTH) DISTANCE (REMAINING SEPERATE) CLOSENESS (BECOMING INVOLVED) LOWERNESS (RELATING FROM A POSITION OF RELATIVE WEAKNESS)

4 AARON T. BECK: I I AM CONVINCED THAT JOHN BIRTCHNELL IS ON TO SOMETHING IMPORTANT IN TERMS OF HIS HORIZONTAL AND VERTICAL AXES.

5 Upper Distant Upper Neutral Upper Close Neutral Distant Neutral Close Lower Distant Lower Neutral Lower Close A circular ordering of the eight categories of relating

6 Relating theory proposes that humans are born only with a disposition ition towards each of the four relating positions. Through the course of maturation, they t need to acquire the confidence and the competence to attain each of them. Confident and competent relating is called POSITIVE and relating that falls short of this is called NEGATIVE. Controlling, organising and maintaining order Leading, guiding and advising Protecting, helping and providing for Needing personal space and privacy. Self interest Friendly, interested, involved and concerned Obedient, conforming, and respectful Seeking direction, guidance and advice Seeking care, help and protection Positive Relating

7 Cruel, rejecting, tyrannising and exploiting Boasting, dominating, suppressing, putting down and insulting Possessive, imprisoning, restrictive and intrusive Suspicious, untrusting and keeping a safe distance Clinging and afraid of being alone Deferential, cowering and withdrawing Helpless and needing to be led. Self blaming and self punishing Dependant, afraid of causing disapproval and rejection Negative Relating

8 Relating theory differs from interpersonal theory in a number of important respects: 1. Interpersonal theory is not set within an evolutionary context. It considers interpersonal behaviour to be motivated by the avoidance of anxiety. 2. Interpersonal theory is not concerned with relating objectives or states of relatedness. It writes about preferred interpersonal style. 3. Interpersonal theory does not make clear-cut cut links between the attainment of relating objectives and emotion responses. 4. Relating theory does not require there to be a negative correlation between positions on opposite sides of the octagon. All states of relatedness are equally necessary. 5. Relating theory does not assume that maladaptive behaviour (negative relating) is on a continuum with adaptive behaviour (positive relating). Hence the need for a positive and a negative octagon. 6. Whilst the items of the interpersonal check list range from the adaptive to the maladaptive those of measures of relating are all negative.

9 In relating theory the ideal is that a person should be confident t and competent (relate positively) in every octant. The assumption is that people who seek psychotherapy lack confidence and competence (relate negatively) in one or more of the octants. The expectation is that psychotherapy will have the effect of improving confidence and competence, i.e. reducing negative relating. This seems to be so irrespective of whether the psychotherapist is actively trying to bring this about. Therefore all forms of psychotherapy should reduce negative relating.

10 For further reading see: Birtchnell, J. (1994) The interpersonal octagon: An alternative to the interpersonal circle. Human Relations, 47, Birtchnell, J. (1996) How Humans Relate: A New Interpersonal Theory. Hove, UK: Psychology Press. Birtchnell, J. (2002) Relating in Psychotherapy: The Application of a New Theory. Hove, UK: Brunner-Routledge.

11 THE PERSON S S RELATING TO OTHERS QUESTIONNAIRE (PROQ) IS A SELF-ADMINISTERED QUESTIONNAIRE IT MEASURES NEGATIVE RELATING ITS EIGHT SCALES CORRESPOND TO THE EIGHT OCTANTS OF THE OCTAGON IT IS SCORED BY COMPUTER A UNIVERSALLY GOOD RELATER WOULD GET A LOW SCORE ON EVERY SCALE A UNIVERSALLY POOR RELATER WOULD GET A HIGH SCORE ON EVERY SCALE GETTING A HIGH SCORE ON ONE SCALE DOES NOT PRECLUDE GETTING A HIGH SCORE ON ANY OTHER SCALE

12 The PROQ2 THE EARLIER AND LONGER VERSION IT HAS 96 ITEMS TWELVE ITEMS PER SCALE TWO OF THE TWELVE ITEMS ARE POSITIVE ITEMS AND ARE NOT NORMALLY SCORED. THEY ARE INCLUDED ONLY TO INCREASE MOTIVATION. HENCE THERE ARE 10 SCORED ITEMS PER SCALE. EACH ITEM HAS A SCORE RANGE OF 0-30 EACH SCALE HAS A MAXIMUM SCORE OF 30 THERE IS A MAXIMUM TOTAL SCORE OF 240

13 Comparing 276 non-patients and 432 psychotherapy patients PROQ2 coefficient alpha UN UC NC LC LN LD ND UD Non Patients Patients PROQ2 mean scores UN UC NC LC LN LD ND UD TOT Non sd Pat sd t p Birtchnell, J. & Evans, C. (2004) The Person s Relating to Others Questionnaire (PROQ2) Personality and Individual Differences, 36,

14 PROQ2 change in scores over the course of therapy (n=202) UN UC NC LC LN LD ND UD TOT Start sd End sd t p Birtchnell, J. (2002) Psychotherapy and the interpersonal octagon. Psychology & Psychotherapy, Theory Research and Practice, 75,

15 The PROQ3 The more recent and shorter version. It is presently the more widely used. IT HAS 48 ITEMS SIX ITEMS PER SCALE ONE OF THE SIX ITEMS IS POSITIVE AND IS NOT NORMALLY SCORED. IT IS INCLUDED ONLY TO INCREASE MOTIVATION. HENCE THERE ARE 5 SCORED ITEMS PER SCALE. EACH ITEM HAS A SCORE RANGE OF 0-30 EACH SCALE HAS A MAXIMUM SCORE OF 15 THERE IS A MAXIMUM TOTAL SCORE OF 120 On there is a self-scoring scoring version of the PROQ3. It is also possible to down-load the questionnaire and to down-load a PROQ3 scoring program. All thanks to Bill Birtchnell.

16 AN EXAMPLE OF A COMPUTER PRINT-OUT OF THE SCORES OF THE PROQ3 AT THE START AND AT THE END OF THERAPY. UN UC NC LC LN LD ND UD TOT START END UN UN UD UC UD UC ND NC ND NC LD LC LD LC LN LN

17 (Collaborators Sean Hammond, Eva Horn and Richard Shuker) PROQ3 Coefficient alpha n UN UC NC LC LN LD ND UD English Irish Dutch Psychother Prisoners PROQ3 inter-scale correlations. Irish sample (n=403) UN 1.00 UN UC NC LC LN LD ND UD UC NC LC LN LD ND UD

18 PROQ3 comparing the mean scores of 158 non-patients and 133 psychotherapy patients UN UC NC LC LN LD ND UD Total Non-pats Sd Patients , Sd T P Mean PROQ3 scores at the start and at the end of psychotherapy (n = 76) UN UC NC LC LN LD ND UD Total Start sd End sd t p

19 Mean PROQ3 scores of 120 male prisoners on admission and after nine months in a therapeutic community unit UN UC NC LC LN LD ND UD TOT Start sd End sd t p

20 The OPROQ3 (The O stands for observer) This questionnaire is to enable the patients in a group to rate the other group members. It can also be used for therapists or nurses to rate patients. The I statements of the PROQ3 have all been changed to he or she statements. The OPROQ3 can be scored using the PROQ3 scoring program. Copies of the OPROQ plus the scoring program can be downloaded from f the website. The usual procedure is for each patient to complete a PROQ3 for her/himself and an OPROQ3 for every other group member. So each patient has her/his name on the PROQ3, and her/his name plus one other patient s s name on each OPROQ: e.g. FRED ON MARY. It is preferable to use this procedure after the group has been running for some weeks. The scores are shown to the group and the patients are encouraged d to discuss them with each other.

21 Examples of the PROQ3/OPROQ3 scores of two group members MEM 2 OBS UN UC NC LC LN LD ND UD TOT PROQ MEAN MEM 3 OBS UN UC NC LC LN LD ND UD TOT PROQ MEAN ,

22 THE RELATING OF ONE SPECIFIED PERSON TOWARDS ANOTHER Up till now this presentation has been concerned with a person s s general relating tendencies. It is sometimes necessary to measure how one specified person relates to, or is related to by, one specified other person. In the next questionnaire one adult rates s how s/he was related to by a parent. THE ADULT S S RECOLLECTION OF A PARENT S S RELATING QUESTIONNAIRE (ARPRQ) A colleague (Cristina Sheppard) at the City University, London, has recently developed a 48-item, computer-scored, questionnaire (the ARPRQ) to be completed by adults, for rating their parents relating to them during childhood. There is one questionnaire concerning fathers and one concerning mothers. The questionnaire is based upon relating theory: It has eight scales, corresponding to the eight octants of the octagon, and, as with the PROQ3, each scale has five, f scored, negative items and one, unscored, positive item. The questionnaire can be scored using the scoring program of the partner-rating rating questionnaire of the shortened version of the Couple s s Relating to Each Other Questionnaire (CREOQ) see below. It is currently being administered to a population sample. Members of the sample can log on to a website and complete the questionnaires. The website also has a facility for scoring the questionnaires.

23 INTERRELATING In a relationship between two people, each person relates to and is related to by the other. This is called interrelating. It can be measured using four f questionnaires, which measure how each person considers that s/he relates to the other and how each person considers that the other relates to her/him. THE COUPLE S S RELATING TO EACH OTHER QUESTIONNAIRES (CREOQ) This is a set of four questionnaires that measure the interrelating ing within a couple. They are called MS (the man rating his relating to her), MP (the man rating her relating to him), WS (the woman rating her relating to him) and WP (the woman rating his relating to her). With the exception of the gender the MS and WS items are the same e and the MP and WP items are the same. So for homosexual couples the man uses the e woman s s partner items and the woman uses the man s s partner items. The CREOQ evolved out of the PROQ2, so each of the four questionnaires naires has 96 items, with 12 items for each of the eight (octagon-based) scales. As with the PROQ2, two items per scale are positive and therefore unscored. There is now w a 48-item version called the CREOQ3, with, like the PROQ3, six items per scale, with one item per scale unscored. The questionnaires and the scoring program can be downloaded from the website. As with the PROQ, the scoring program generates both numerical scores and a graphic representation of scores.

24 The graphic representation of CREOQ scores for a couple in therapy Pre-therapy Post-therapy therapy MS UN MP UN MS UN MP UN UD UC UD UC UD UC UD UC ND NC ND NC ND NC ND NC LD LC LD LC LD LC LD LC LN LN LN LN WS UN WP UN WS UN WP UN UD UC UD UC UD UC UD UC ND NC ND NC ND NC ND NC LD LC LD LC LD LC LD LC LN LN LN LN

25 Reliabilities for a community sample (n = 130) and a couple therapy sample (n = 157) UN UC NC LC LN LD ND UD Community MS MP WS WP Couple therapy MS MP WS WP

26 Mean scores of the eight scales of the four CREOQ questionnaires for a community sample (n=130) and a couple therapy sample (n=157) UN UC NC LC LN LD ND UD TOT UN UC NC LC LN LD ND UD TOT Com MS WS sd Ther sd t p UN UC NC LC LN LD ND UD TOT UN UC NC LC LN LD ND UD TOT Com MP WP sd Ther sd t p The scores for the therapy couples were significantly higher that t those for the community couples on almost all scales for both the self-ratings and the partner ratings. One striking exception was the LN self score. For men this was almost the same for the therapy couples and the community couples and for women it was significantly higher for the community couples. Thus s a degree of submissiveness appears to be good for a marriage.

27 Inter-scale correlations of the eight scales of the four CREOQ questionnaires for the community sample (upper triangle, n = 130) and the couple therapy sample (lower triangle, t n = 157). Correlations in bold are neighbouring scales UN UC NC LC LN LD ND UD MS UN UC NC LC LN LD ND UD UN UC NC LC LN LD ND UD WS UN UC * NC LC LN LD ND UD MP UN UC NC LC LN LD ND UD WP UN UC NC LC LN LD ND UD

28 Correlations between the self scales of the one partner and the partner scales of the other partner for the community sample (n = 130) and the couple therapy sample (n = 157). Correlations in bold are between identical scales Community sample MS UN UC NC LC LN LD ND UD WP UN UC NC LC LN LD ND UD WS UN UC NC LC LN LD ND UD MP UN UC NC LC LN LD ND UD Couple therapy sample MS UN UC NC LC LN LD ND UD WP UN UC NC LC LN LD ND UD WS UN UC NC LC LN LD ND UD MP UN UC NC LC LN LD ND UD

29 John Birtchnell, Stijn Voortman, Cor Dejong and Deidre Gordon (2006) Measuring interrelating within couples: The Couple's Relating to Each Other Questionnaires (CREOQ) Psychology & Psychotherapy, Theory, Research and Practice, 79,

30 INTERRELATING WITHIN FAMILIES A Greek colleague (Argyroula Kalaitzaki) has compared the interrelating elating in the families of a sample of patients receiving psychotherapy (n=84) with the interrelating in the families of a sample of non-patients (n=80). She found that both the patients fathers and the patients mothers (MS and WS) rated themselves as being significantly more distant towards each other r than the non-patients patients fathers and mothers. Also the patients fathers rated the patients mothers (MP) as being significantly more upper distant than did the non-patients patients fathers. THE FMIQ She then modified the questionnaires of the CREOQ so that they could c be applied to the interrelating between young adults and their parents. She called them the FMIQ (Family Members Interrelating Questionnaires). The modified questionnaires can still be scored using the CREOQ scoring program. Because this required there to be separate questionnaires for sons, daughters, fathers and mothers the tables reporting upon them are very long, so the findings can only be summarised.

31 INTERRELATING BETWEEN THE YOUNG ADULTS AND THEIR PARENTS There were many instances of the scores of the patients families being significantly higher, but no instances of the scores of the non-patients patients families being significantly higher. The daughters were much more inclined to make greater negative judgements j about themselves than the sons were. The daughters rated themselves significantly higher on all scales except LN towards their fathers and on al scales except LN and UC towards their mothers. Both the fathers and the mothers agreed with most of this. Both the parents and the sons (but not the daughters) were more inclined to make to make greater negative judgements about others relating to them than about their relating to others. Both the sons who were patients and the daughters who were patients rated their mothers significantly higher on the three upper scales.

32 COMPARING THE PATIENTS AND THE NON-PATIENTS WITH THEIR WELL SIBLINGS In a proportion of the families of both the patients and the non-patients the FMIQ was also administered to a well sibling and her/his parents. The significantly high levels of negative interrelating within the t patients families were entirely restricted to those between the parents and the patients. In particular, the parents view of the patients relating to them was significantly higher that the parents view of the siblings relating to them on all but the upper close scale. The exercise was repeated with the non-patients being compared with a sibling other than the one featuring in the previous analyses. All comparisons were non-significant apart from on two scales: The siblings scored higher than the non-patients in their view of the parents relating to them on UC and UD.

33 Argyroula Kalaitzaki & John Birtchnell (submitted) Interrelating within the families of young psychotherapy outpatients.

34 FMIQ scores for two adult siblings, mother and father

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