Die Ambivalenz mit der Therapieforschung

Due to a presently growing demand for evidence-based medicine different psychotherapeutic methods are facing increasing political pressure to demonstrate their efficacy. The realization of evaluative projects is not only in need of study patients but also of study therapists. Although many psychoanalysts support the general need for research the number of actual participants is rather low. In this paper the motives of psychoanalysts to decide for or against participation in evaluative research were investigated. Guided interviews were conducted with six psychoanalysts working in outpatient practice. The results support the hypothesis that in particular the need for security and protection influence a psychoanalyst willingness by causing either a driving or inhibition force. Both the intraindividual and interindividual areas of the interviews displayed unresolved ambivalences towards participation in psychotherapy research. It was concluded that changes in psychoanalytic training could have the most profound influence on the personal motivation to participate.     

Die Hysterie im neuen Gewand und im Wandel der Zeit

Classical symptoms of hysteria – especially symptoms of hysterical neurosis (conversion type) – are not commonly seen any more. On the one hand, general knowledge about the function of hysterical has led to suppression of the underlying hidden conflicts, possibly up to resomatization. On the other hand, those affected may have rather subtle symptoms, e.g., vague pain, circulatory disorders, or fatigue. Overall, the hysterical phenomena have not become less common but have become “contemporary” and, therefore, more difficult to identify. Reliable epidemiological data, however, are difficult to obtain. Rough estimates indicate that 2–6?% of all people have dissociative disorders (ICD-10 definition). Histrionic personality disorder is estimated to occur with a frequency of 2–3?%. In 75?% of cases, the disease manifests relatively early, between the ages of 17 and 32 years and with a 3:1 female to male ratio. An average of 7 years elapses between first manifestation and the start of psychiatric–psychotherapeutic treatment.     

Die Gesamtgeschichte der Menschheit als Problem der Geschichtswissenschaft

Ohne Zusammenfassung     

Die historisch-hermeneutischen Disziplinen im System der Wissenschaften

Gegen einheitswissenschaftliche Nivellierung sind Grundlagen-, Natur- und Kulturwissenschaften zu unterscheiden (weniger als Unterschied von Gegenständen als von Fragestellungen und Vorgehensweisen). Zu den Kulturwissenschaften gehören die historisch-hermeneutischen Disziplinen, und zwar als handlungsverstehende Wissenschaften unter erschwerten Bedingungen. Die Geschichtswissenschaft soll die verborgenen Gründe und Zwecke vergangener Handlungen aufklären, die Textwissenschaften in Form problematischer Texte vorliegende Sprachhandlungen. Texte können in verschiedener Hinsicht problematisch sein: für ein Verstehensinteresse an begründeten Behauptungen oder an subjektiver Bekundung (in selbstdarstellender oder motivierender Absicht). Entsprechend ist hier methodisch zwischen apophantischer und ästhetischer Texthermeneutik zu unterscheiden. Ziel aller historisch-hermeneutischen Fächer sollte kritische Gegenwartsorientierung sein.     

Die Hysterie im neuen Gewand und im Wandel der Zeit

Hysteria as a classic clinical picture does not exist anymore. It was subdivided into various nosological diseases and hardly occurs in the current classification schemes DSM-IV and ICD-10. If we let Freud’s theories from over a hundred years ago act on us once more, it is impressive how many ideas and hypotheses of modern psychotraumatology can already be found in his early works. Even today, “hysteria” represents a challenge in dealing with the mind–body problem.     

Die Anordnung der musikalischen Intervalle im Raume

Ohne Zusammenfassung     

Die Metaphysik Whiteheads im Urteil der Sowjet-Philosophie

Ohne Zusammenfassung     

Die Zukunft gestalten im Angesicht der Vergangenheit

We report on the 4th Nazareth Conference with Jewish and German participants, most of whom are psychoanalysts. As Herman Beland has observed, these Conferences are intended to be “something like a self-experiment by Germans and Israelis to become, in the presence of the other group, aware of the unconscious identity of both people after the Holocaust.” There is still a widespread inability to mourn for the consequences of the terrible events in the years between 1933 and 1945 and deal satisfactorily with their effects. None of the groups, neither the German, nor the Israeli / Jewish, can do their own inner work without the other. For this reason, the method chosen as appropriate was the Tavistock-style “group relations conference”. This approach was developed by the Institute of Human Relations in London and does not focus on the individual’s behaviour but uses large and small groups to investigate group processes in the here and now. -The present work describes, among other things, the unexpectedly strong resistance towards changes of the conscious and unconscious inner images both of one’s own group and of the other. This process led to a feeling of hopelessness and paralysis within the German group that, due to the presence of the Jewish group, we could not avoid. For the Germans, it was hard to bear and observe the mutually shared history. Jewish participants were not able to accept their own German–Austrian childhood memories as a part of their own identity and connect them to the Germans. Each participant across the groups experienced the fantasy of destruction and the unfruitful effects of division. We had to feel how much the fate of the Germans and the Jews were interlocked to understand the participants’ tensions and efforts for opening new pathways.     

Die Rolle der Naturwissenschaft im Historischen Materialismus

Ohne Zusammenfassung     

Versorgungsforschung im psychosozialen Feld aus dem Blickwinkel der gesetzlichen Krankenversicherung

Since 2000 the statutory health insurance funds in collaboration with the Federal Ministry of Research have promoted health services research. In 2008 the statutory pension fund and the private health insurers joined this collaboration. This multidisciplinary program aims at the completion of the basic medical research and of the clinical research by research activities focusing on the actual health care under everyday conditions. This research that has been known in the USA since more than 50 years as ?health services research“ can be of growing importance for psychosocial care and psychotherapy if the systematic and early participation of decision makers, payers and providers can be further improved. From the perspective of the statutory health insurance, beside the quality of care also the effectiveness under everyday conditions, the efficiency and acceptance of treatment, of psychosocial support, and of complex care programs are top-ranking in the research agenda of health services research in the field of psychosocial care and psychotherapy.     

Die ambulante psychotherapeutische Versorgungslage der Erwachsenen im Saarland

Ohne Zusammenfassung     

Die Wiederherstellung der Zeit in der ambulanten Psychotherapie mit Psychosekranken

In psychoanalytic psychotherapy with psychotic patients, a disturbance in time experience quite frequently turns out to be central to the psychotic experience as a whole. These patients experience disruptions in the flow of time that lead to a loss of temporal continuity. This loss of temporal structures causes damage in thinking functions: Relations like causality, finality and others which imply a temporal dimension, cannot be established any more. Parts of treatment histories serve to demonstrate the reconstruction of temporal continuity by the patient in psychotherapy. Object-relation-theory and Piaget’s experimental psychology provide the frame of reference for the understandig of the mental processes involved. At the beginning of the psychotherapy the patient experiences being together with the therapist and being separated from him as two discrete conditions of existing which have no links. The periodical reappearance of being together in combination with the awareness of the therapist’s continuous ongoing care encourages the patient to remember and to envisage the meetings with the therapist. The reliability of the alternation seems to stimulate a specific mental activity which creates connections allowing for transitions between the different conditions — in the sense of Winnicott’s transitional phenomena. Transitional phenomena which sometimes are quite concrete things bridge the gap between presence and future. Narrating serves as a link to the past. Through these creative ego-activities temporal continuity is regained providing the basis for strucured thinking and — very important — for the perception of one’s own personality and its continuity over time, thus generating a sense of identity. This process of reconstructing time is interesting in itself, because it sheds light on the psychodynamics of the restitutional processes after a psychotic illness. Moreover, it allows for hypotheses about the development of the inner time dimension in early childhood.