Toward an Empirical Investigation of Malan's Triangle of Conflict: Psychophysiological Markers of Signal Anxiety in Naturalistic Psychotherapy

Malan's triangle of conflict, one of the tenets of psychodynamic theory, describes how unconscious conflict elicits an anxiety response, followed by defense mechanisms aiming to manage. While broadly adopted in clinical practice, this model has never been empirically validated. The present study aims to lay the foundations for its empirical investigation. The study consists in a multimodal analysis of 16 psychotherapy sessions from two patients. Multiple signals were explored on a common timeline: electrodermal activity, automatically estimated gaze and emotional expression, manually annotated non-verbal markers of activation and self-regulation, and verbal defence mechanisms coded from transcripts with the Defense Mechanisms Rating Scales. Anchoring on 1,593 detected rises in electrodermal activity, and separately on 256 defence episodes, the study aimed to characterise the multimodal configuration of events around each anchor, to examine whether behavioural markers were ordered with respect to it, whether defensive activity followed in the direction the model expects, and whether any pattern recurred across the two cases. The results are descriptive and are presented as candidate phenomena for replication rather than as a test of the model.