Übertragung und Gegenübertragung in Verhaltenstherapie und Psychoanalyse

Most psychotherapists and researchers agree that a good relationship essentially contributes to therapeutic change. The psychoanalytic concepts transference and countertransference which describe fundamental aspects of the psychotherapeutic relationship have now become integrated into behavior therapy. These concepts, however, are used differently in psychoanalysis as well as in behavior therapy. This makes the communication between psychotherapists coming from different orientations difficult. Therefore, a research approach which describes the important verbal and nonverbal elements of a helpful therapeutic interaction independently from therapeutic orientation could help to evaluate their effectiveness in different psychotherapeutic methods. In this way a culture of integration into psychotherapy could be encouraged.     

Transparenz und Fairness in der Therapie von Sexualstraftätern in Haft und Maßregelvollzug

It makes sense to treat sexual offenders in prison. Treatment can be successful even if coerced. However, particular difficulties arise due to the great power disparity between therapist and patient and the latter’s remoteness from normal living conditions. This report will describe the current status of treatment techniques/approaches for sexual offenders in prison (with particular regard to social therapy) and special forensic hospitals as viewed by an external reviewer judging the process, methods and success of treatment for preventing relapse and estimating criminal prognosis. We mention standards for a respectful and positive approach towards the patient client. With regard to the Good Lives Model, it is supportive to develop positive resources in the perpetrator. This also requires a heightened readiness from therapist and team for transparency (instead of confidentiality) towards the perpetrator as to the assessment of progress and status of therapy. We criticize tendencies for a confrontative, if not humiliating approach, which undermines the self-esteem of the client and exploits the power disparity between therapist and perpetrator.     

Belastungen in der Kindheit und in der Jugend Essgestörter

Depending on definition and sample, a minority of varying size of women with eating disorders report to be victims of sexual and/or physical abuse. These stressful experiences are risk factors for mental disorders in general and not specifically for eating disorders. Parental high expectations and pre-morbid negative self-evaluation seem to be specific risk factors for anorexia nervosa and bulimia nervosa. Probably, patients with bulimia nervosa suffered more childhood adversity than those with restrictive anorexia nervosa. Patients with a history of sexual and/or physical abuse may be more severely ill and more difficult to treat than other patients with eating disorders. Careful questioning about childhood adversity seems advisable. In therapy, maintaining factors—like problems of self-esteem—are more important than predisposing or precipitating factors. For prevention, it is recommended to provide for the safety of children when treating their parents with mental illness—particularly substance use disorders—and to avoid parental high expectations.     

Ersch?pfung und Depression in der Schwangerschaft

For women pregnancy represents a condition of intense physical and psychological changes which subject the pregnant women to a number of potentially stressful situations. Hormonal changes during pregnancy predispose to exhaustion and therefore to an increased vulnerability to affective disorders. Depression is one of the most commonly diagnosed psychiatric disorders in the female population with an increased incidence during the reproductive years. Recent studies showed that approximately 10?C13% of patients suffer from a depressive episode in the perinatal period requiring specialized treatment including psychotherapy and/or pharmacotherapy. Underestimation of this condition and a lack of proper management can hinder normal mother-child bonding leading to impaired cognitive and emotional long-term development of the child. In this article the medical literature related to the prevalence and clinical presentation of depression during the perinatal period and its association to maternal exhaustion is reviewed. The clinical implications and therapeutic options are discussed.     

Veränderungen kriminogener Faktoren bei Sexual- und Gewaltstraftätern in Sozialtherapie und Regelvollzug

In the evaluation of offender treatment programmes, recidivism is still the most common measure of success. However, positive effects concerning future delinquent behaviour do not prove that treatment led to changes in the targeted criminogenic risk factors. Furthermore, little is known about whether such changes differ among the various offender types. This study investigated changes in self-reported criminogenic personality patterns and cognitions in a sample of treated and untreated sexual and violent offenders. Specific prosocial changes in treatment targets, such as self-control, excitability and neuroticism were found but similar improvements were also found in untreated offenders. In addition, changes in measured risk factors did not differ between offender types, although self-control, aggressiveness and neuroticism showed significant interactions between offence type and treatment delivery. Whereas treated violent offenders exhibited more positive changes than untreated violent offenders, an inverse pattern was observed in the case of sex offenders. Minor specific treatment effects as well as the limitations of the administered psychometric instruments are discussed as possible explanations for these results.     

Behandlung und Teamprozesse in der stationären Psychotherapie

Ohne Zusammenfassung     

Mentalisierung und externalisierende Verhaltensstörungen in der Adoleszenz

Social cognition creates the conditions for successful human interaction. Externalizing disorders are characterized by a failure of adequate social cooperation. Therefore, social cognition seems to be a key factor in understanding externalizing behavior, its etiology and treatment options. The present article combines the clinical theory of mentalization with the state-of-the-art of empirical data on externalizing behavior and of the theory-of-mind research as well as research on social information processing. Empirical evidence suggests that there are distinct deficits in social cognition depending on the type of aggression (proactive or reactive). However, even though it is known from a neurobiological perspective that social cognition is reorganized in adolescence, research on externalizing behavior and social cognition in adolescence is limited. Hence the analysis of two studies is presented which compared reflective functioning between a group of late adolescent violent offenders and a control group. A total of 42 young men participated in the studies and were interviewed with the adult attachment interview. Interviews were coded with the reflective functioning scale. Results showed that violent offenders scored significantly lower on the reflective functioning scale than age and gender matched controls. This result is independent of intelligence. Instrumental proactive aggression and psychopathic tendencies are also strongly associated with lower reflective functioning. The results underline the importance of therapeutic interventions for externalizing adolescents which enhance reflective functioning.     

Anpassungsleistung und Täuschung in der forensischen Therapie

The term adaptation is often used in forensic interventions in a negative sense to describe courses of treatment without a real modification of thinking and behavior. In many cases adaptation means only a superficial problem adaptation with a risky process. This article describes and explains that in many cases adaptation can be a fundamental performance of development in a positive sense.Finally, key questions for the assessment of different adaptations and a typology of adaptations are presented. Additionally, the difference between a positive or rather desirable adaptation and deception will be defined.     

Gegenübertragung und Identifizierung in der kompetenten Position

The concept of the terms “competent position” and “identifying with superiority” are introduced to give a better explanation for the mental procedures occurring within the analytical therapist in cases of boundary violations during treatment. In part two attention is called to the latent preventive exculpating tendency in known theories of countertransference.     

Qualifizierung und Qualit?tskontrolle in der forensischen Psychiatrie

At the end of the last decade severely violent and sexual crimes by previously convicted persistent offenders initiated a discussion about the necessity of quality control in the forensic psychiatric practice in Switzerland. Subsequently, measures similar to those in Germany were adopted, e.g. the implementation of a specialisation in forensic psychiatry. In addition, they included the creation of commissions with the duty of evaluating the dangerousness of serious offenders, the implementation of a standardized and certificated postgraduate training in forensic psychiatry and guidelines for the qualification of forensic assessment experts and the quality of reports. The following article presents the implemented measures and discusses their possible consequences for the quality of forensic psychiatric work.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

Zur Miete bei Frege – Rudolf Hirzel und die Rezeption der stoischen Logik und Semantik in Jena

It has been noted before in the history of logic that some of Frege's logical and semantic views were anticipated in Stoicism. In particular, there seems to be a parallel between Frege's Gedanke (thought) and Stoic lekton; and the distinction between complete and incomplete lekta has an equivalent in Frege's logic. However, nobody has so far claimed that Frege was actually influenced by Stoic logic; and there has until now been no indication of such a causal connection. In this essay, we attempt, for the first time, to provide detailed evidence for the existence of this connection. In the course of our argumentation, further analogies between the positions of Frege and the Stoics will be revealed. The classical philologist Rudolf Hirzel will be brought into play as the one who links Frege with Stoicism. The renowned expert on Stoic philosophy was Frege's tenant and lived in the same house as the logician for many years.

In der Geschichte der Logik ist häufig bemerkt worden, dass einige der logischen und semantischen Auffassungen Freges in der Stoa antizipiert worden sind. Genannt wurden insbesondere die Parallelen zwischen dem Fregeschen Gedanken und dem stoischen Lekton sowie die Unterscheidung zwischen vollständigen und unvollständigen Lekta, die bei Frege ihre Entsprechung hat. Ein Wirkungszusammenhang ist allerdings nicht behauptet worden. Dazu gab es bislang auch keinen Anlass. Der vorliegende Beitrag versucht erstmalig, einen detaillierten Indizienbeweis für das Bestehen eines solchen Zusammenhangs vorzulegen. Dabei werden weitere charakteristische Übereinstimmungen zwischen Frege und der Stoa aufgewiesen. Als Mittelsmann wird der Altphilologe Rudolf Hirzel vorgestellt. Er wohnte lange Jahre als Mieter zusammen mit Frege im selben Haus und war ein anerkannter Experte der stoischen Philosophie.     

Intensität und Qualität in der Geruchswahrnehmung

Zusammenfassung Vier unterschiedliche Geruchsstoffe in je 4 Konzentrationen wurden von 23 Versuchspersonen nach Intensität beurteilt und paarweise auf ihre relative Ähnlichkeit hin verglichen. Eine Systematik der Versuchspersonenvarianz konnte weder in den Intensitäts- noch in den Ähnlichkeitsurteilen mit dem Tucker-Messick-Verfahren nachgewiesen werden. Mit den Medianwerten der Ähnlichkeitsurteile wurde das Skalierungsverfahren von Kruskal durchgeführt. Unter 25 Lösungen wurde diejenige mit einem Exponenten (Minkowski-Metrik) von r=2,5 und 5 Dimensionen als optimal ausgewählt und zur Grundlage der Interpretation genommen. Als wichtigstes Ergebnis erhielten wir eine unabhängige Intensitätsdimension mit Ursprung außerhalb der Reizkonfiguration, die eine hohe Übereinstimmung zur Intensitätsskalierung aufwies. Weiter konnte ein Qualitätswechsel jeweils innerhalb eines Stoffes zwischen den Konzentrationen festgestellt werden. Dieser Qualitätswechsel ist bei den einzelnen Stoffen unterschiedlich stark ausgeprägt.

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Quality and intensity in olfactory perception

Summary In an experiment on olfaction 23 subjects judged 16 odors (four chemicals each in four concentrations) with respect to intensity and with respect to similarity for each pair of stimuli. Systematic interindividual variation can he found neither in the intensity nor in the similarity data. Multidimensional scaling according to Kruskal's procedure reveals a configuration in 5 dimensions, the exponent of the optimal Minkowski-metric (out of 25 alternative solutions) is r=2.5. This scaling is based on the medians of similarity judgments. One of the dimensions corresponds to a subjective scale of intensity, with a zero-point lying outside of the configuration. The quality of the stimuli depends on their concentrations. The perceived quality-changes differ in amount and directions for each of the chemicals.

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Von der Philosophischen Fakultät der Universität des Saarlandes auf Antrag von Prof. Dr. K. Eyferth angenommene Dissertation.     

Bedrohungsszenarien und Gewalt gegenüber Dritten in der Psychotherapie

Aggressive behaviour, violent fantasies and potential threats against third parties are frequent topics in psychotherapy. Clinical, social and dynamic factors have to be considered for the risk assessment of aggressive behaviour. The appearance of aggressive fantasies and threats can be perceived as an indicator for potential threats. Legal aspects such as medical confidentiality, rights and duties to warn have to be kept in mind when dealing with threats against third parties. Concerning threats against children different laws have to be considered.