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Changes in Speech Rhythm and Language-Style Between In-Person and Remote Treatment

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Abstract

This study examined differences in clinical process—as measured via pause length and frequency, and language-style—between in-person and Zoom treatment formats in the psychodynamic treatment of a man with a diagnosis of Body Dysmorphic Disorder. While the COVID-19 pandemic saw the widespread adoption of remote videoconferencing software across a range of talk therapy formats, differences in clinical process between Zoom and in-person treatment formats still have not been widely investigated. This study examined turn-taking dynamics in therapy, a development with ramifications for clinical process as conceptualized via the Referential Process construct of Multiple Code Theory. This study is the first application of the new T-DAAP, the Time-based Discourse Attributes Analysis Program, which analyzes transcripts using measures of Referential Process functions—Arousal, Symbolizing, and Reflecting/Reorganizing—in terms of elapsed time rather than standard methods based on word count. Differences in number and length of pauses, and Referential Process measures (WRAD and WRRL) were compared between 8 in-person and 8 Zoom sessions from the Spring of 2020. Mean pause length was significantly lower in the Zoom condition than in the in-person condition, for both participants, for both within-, and between-speakers pauses. The patient also showed a larger number of turn-taking pauses, and a higher level of Reflection in the Zoom condition, while other Referential Process measures remained largely consistent for the two participants. Ramifications for the understanding of clinical process were explored.

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References

  • Baranger, M., & Baranger, W. (2008). The analytic situation as a dynamic field. International Journal of Psycho-Analysis, 89, 795–826.

    Article  PubMed  Google Scholar

  • Beebe, B., Jaffe, J., & Lachmann, F. (1992). A dyadic systems view of communication. In N. Skolnick & S. Warshaw (Eds.), Relational perspectives in psychoanalysis (pp. 61–81). The Analytic Press.

    Google Scholar

  • Boland, J. E., Fonseca, P., Mermelstein, I., & Williamson, M. (2022). Zoom disrupts the rhythm of conversation. Journal of Experimental Psychology: General, 151(6), 1272–1282. https://doi.org/10.1037/xge0001150

    Article  PubMed  Google Scholar

  • Boomer, D. S., & Dittmann, A. T. (1962). Hesitation pauses and juncture pauses in speech. Language and Speech, 5(4), 215–220. https://doi.org/10.1177/002383096200500404

    Article  Google Scholar

  • Bucci, W. (1997). Psychoanalysis and cognitive science: A multiple code theory. Guilford Press.

    Google Scholar

  • Bucci, W. (2021). Development and validation of measures of referential activity. Journal of Psycholinguistic Research, 50(1), 17–27. https://doi.org/10.1007/s10936-021-09760-9

    Article  PubMed  Google Scholar

  • Bucci, W., & Maskit, B. (2006). A weighted dictionary for referential activity. In J. G. Shanahan, Y. Qu, & J. Wiebe (Eds.), Computing attitude and affect in text: Theory and applications. (Vol. 20). Springer.

    Google Scholar

  • Bucci, W., Maskit, B., & Murphy, S. (2016). Connecting emotions and words: The referential process. Phenomenology and the Cognitive Sciences, 15(3), 359–383. https://doi.org/10.1007/s11097-015-9417-z

    Article  Google Scholar

  • Christian, C., Bincoletto, A. F., Mariani, R., Negri, A., Lingiardi, V., & Tanzilli, A. (2024). Specificities of mental functioning and referential process in body dysmorphic disorder: A single case study using the psychodynamic diagnostic manual (PDM-2). Journal of Psycholinguistic Research, 106(5), 696–707.

    Google Scholar

  • Daniel, S. I. F., Folke, S., Lunn, S., Gondan, M., & Poulsen, S. (2018). Mind the gap: In-session silences are associated with client attachment insecurity, therapeutic alliance, and treatment outcome. Psychotherapy Research, 28(2), 203–216. https://doi.org/10.1080/10503307.2016.1177673

    Article  PubMed  Google Scholar

  • Escardó, A. (2021). Notes on a pandemic. Psychoanalytic Psychology, 38(2), 103–104. https://doi.org/10.1037/pap0000350

    Article  Google Scholar

  • Feldstein, S. (1964). Vocal patterning of emotional expression. In J. H. Masserman (Ed.), Development of Research (pp. 193–210). Grune & Stratton.

    Google Scholar

  • Frankel, Z., Levitt, H. M., Murray, D. M., Greenberg, L. S., & Angus, L. (2006). Assessing silent processes in psychotherapy: An empirically derived categorization system and sampling strategy. Psychotherapy Research, 16(5), 627–638. https://doi.org/10.1080/10503300600591635

    Article  Google Scholar

  • Goldman-Eisler, F. (1958a). Speech production and the predictability of words in context. Quarterly Journal of Experimental Psychology, 10, 96–106.

    Article  Google Scholar

  • Goldman-Eisler, F. (1958b). The predictability of words in context and the length of pauses in speech. Language and Speech, 1, 226–231.

    Article  Google Scholar

  • Graham, E. (2008). Telling silences in analytic sessions: clinical meanings of pauses and affective valence in the referential process. [Dissertation]

  • Harrison, A. M., & Beebe, B. (2018). Rhythms of dialogue in infant research and child analysis: Implicit and explicit forms of therapeutic action. Psychoanalytic Psychology, 35(4), 367–381. https://doi.org/10.1037/pap0000176

    Article  Google Scholar

  • Jaffe, J., Beebe, B., Feldstein, S., Crown, C., & Jasnow, M. (2001). Rhythms of dialogue in infancy. Monographs of the Society for Research in Child Development, 66(2), 1–132.

    Article  Google Scholar

  • Jaffe, J., & Feldstein, S. (1970). Rhythms of dialogue. Academic Press.

    Google Scholar

  • Levitt, H. M. (2001). Sounds of silence in psychotherapy: The categorization of clients’ pauses. Psychotherapy Research, 11(3), 295–309. https://doi.org/10.1080/713663985

    Article  Google Scholar

  • Levitt, H. M., & Morrill, Z. (2021). The pausing inventory categorization system and a review of findings. In A. Dimitrijevic & M. B. Buchholz (Eds.), Silence and silencing in psychoanalysis: Cultural, clinical, and research perspectives (pp. 233–250). Routledge.

    Google Scholar

  • Lichtenstein, D. (2021). Are you there? Psychoanalytic Psychology, 38(2), 107–108. https://doi.org/10.1037/pap0000361

    Article  Google Scholar

  • Mahl, G. F. (1956). Disturbances and silences in the patient’s speech in psychotherapy. Journal of Abnormal and Social Psychology, 53, 1–15.

    Article  Google Scholar

  • Maskit, B. (2014). DAAPMath. Figshare. https://doi.org/10.6084/m9.figshare.928469

  • Maskit, B. (2021). Overview of computer measures of the referential process. Journal of Psycholinguist Research, 50(1), 29–49. https://doi.org/10.1007/s10936-021-09761-8

    Article  Google Scholar

  • Maskit, B. (2025). A journey through the land of DAAP: Including visits to weighted dictionaries, smoothing, covariations, and the effects of word order, with connections to psychology, psycholinguistics, mathematics and statistics, and ending at time-based DAAP (TDAAP). Journal of Psycholinguistic Research, 54(3), 1–17.

    Article  Google Scholar

  • McBeath, A. G., Plock, S., & Bager-Charleson, S. (2020). The challenges and experiences of psychotherapists working remotely during the coronavirus pandemic. Counselling and Psychotherapy Research, 20(3), 394–405. https://doi.org/10.1002/capr.12326

    Article  PubMed  PubMed Central  Google Scholar

  • Negri, A., & Christian, C. (2022). Changes in clinical process as a result of online therapy: Findings from a single case study. Psychodynamic Psychiatry, 50(4), 659–671. https://doi.org/10.1521/pdps.2022.50.4.659

    Article  PubMed  Google Scholar

  • Negri, A., Mariani, R., Tanzilli, A., Bincoletto, A. F., Lingiardi, V., & Christian, C. (2024). A single case multimethod assessment to detect significant changes in the psychoanalytic treatment of psychosomatic disorders. Journal of Personality Assessment, 106(5), 696–707. https://doi.org/10.1080/00223891.2024.2312978

    Article  PubMed  Google Scholar

  • Nof, A., Amir, O., Goldstein, P., & Zilcha-Mano, S. (2021). What do these sounds tell us about the therapeutic alliance: Acoustic markers as predictors of alliance. Clinical Psychology & Psychotherapy, 28(4), 807–817. https://doi.org/10.1002/cpp.2534

    Article  Google Scholar

  • Ritter, M.S. (2009). Rhythms of Dialogue and Referential Activity: Implicit Process Across Procedural and Verbal Realms. Dissertation. The Gordon F. Derner Institute of Advanced Psychological Studies.

  • Rochester, S. R. (1973). The significance of pauses in spontaneous speech. Journal of Psycholinguistic Research, 2(1), 51–81. https://doi.org/10.1007/BF01067111

    Article  PubMed  Google Scholar

  • Sluis, R. A., Angus, D., Wiles, J., Back, A., Gibson, T., Liddle, J., Worthy, P., Copland, D., & Angwin, A. J. (2020). An automated approach to examining pausing in the speech of people with dementia. American Journal of Alzheimer’s Disease & Other Dementiasr, 35, 153331752093977. https://doi.org/10.1177/1533317520939773

    Article  Google Scholar

  • Steidtmann, D., McBride, S., & Mishkind, M. C. (2020). Experiences of mental health clinicians and staff in rapidly converting to full-time telemental health and work from home during the Covid-19 pandemic. Telemedicine & E-Health, 27(7), 785–791.

    Article  Google Scholar

  • Weinstein, L. (2021). Notes on the pandemic. Psychoanalytic Psychology, 38(2), 111–112. https://doi.org/10.1037/pap0000349

    Article  Google Scholar

  • Wolson, P. (2021). Some pros and cons of psychoanalytic teletherapy. Psychoanalytic Psychology, 38(2), 109–110. https://doi.org/10.1037/pap0000348

    Article  Google Scholar

  • Zellner, B. (1994). Pauses and the temporal structure of speech. In E. Keller (Ed.), Fundamentals of speech synthesis and speech recognition (pp. 41–62). John Wiley.

    Google Scholar

  • Zhou, Y., Maskit, B., Bucci, W., Fishman, A., & Murphy, S. (2021). Development of WRRL: A new computerized measure of the reflecting/reorganizing function. Journal of Psycholinguistic Research, 50(1), 51–64. https://doi.org/10.1007/s10936-021-09762-7

    Article  PubMed  Google Scholar

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Acknowledgements

This study was sponsored by the Pacella Research Center of The New York Psychoanalytic Society and Institute (NYPSI). The author would like to thank Wilma Bucci, Bernard Maskit, and Michael Peral for their invaluable help at every stage of this project.

Funding

This paper received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. The City College of New York, CUNY, 160 Convent Avenue, New York, NY, 10013, USA

    Henry Peterson

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Correspondence to Henry Peterson.

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Peterson, H. Changes in Speech Rhythm and Language-Style Between In-Person and Remote Treatment. J Psycholinguist Res 54, 38 (2025). https://doi.org/10.1007/s10936-025-10157-1

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  • DOI  https://doi.org/10.1007/s10936-025-10157-1

Keywords

  • Pause
  • Paralinguistic
  • Process
  • Referential process
  • Remote therapy

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