Measuring Changes in the Quality of Object Representations during Psychoanalytic Treatment

A Pilot Study in The Netherlands


  • Jos Dirkx
  • Jolien Zevalkink



Object representations, psychoanalytic psychotherapy, structural change


In this pilot study, we followed 22 patients during their psychoanalytic psychotherapy to monitor changes in the quality of their object representations (father, mother, partner/best friend, self) and level of psychopathology (OQ-45). The Differentiation-Relatedness Scale (DR-S) was used in two semi-structured interviews: Object Relation Inventory (ORI) and two questions of the Adult Attachment Interview (AAI). Results showed that the DR-S ratings are comparable in both interviews for father and mother, with significant changes during therapy for father using the ORI and mother using the AAI. The level of psychopathology also changed significantly during treatment. Despite some shortcomings, the DR-S in combination with the ORI and AAI-questions seems a useful instrument for clinicians to monitor structural change in personality functioning during psychoanalytic psychotherapy.


Jos Dirkx

Jos Dirkx, MD, is a psychiatrist, psychoanalyst, psychotherapist in private practice. He is a training and supervising psychoanalyst in the Dutch Psychoanalytical Society (NPaV). For the present research, he is affiliated PhD student at the Vrije Universiteit Amsterdam. He is chief editor of the Tijdschrift voor Psychoanalyse en haar toepassingen. He used to work at the Netherlands Psychoanalytic Institute (NPI) in Utrecht where the research was conducted.

Jolien Zevalkink

Jolien Zevalkink, PhD, is senior lecturer at the Department of Psychology, Vrije Universiteit Amsterdam is a developmental psychologist and social anthropologist. While working at NPI, she developed a routine outcome monitoring system that aims to follow the progress of patients before and during psychoanalytic treatment. She is the author of several papers in the field of developmental psychology and psychotherapy research.
029-035 31238



Dirkx, J., & Zevalkink, J. (2023). Measuring Changes in the Quality of Object Representations during Psychoanalytic Treatment: A Pilot Study in The Netherlands. Psychotherapie-Wissenschaft, 13(2), 29–35.