Indikation zu Psychoanalyse und analytischer Psychotherapie

Based on the diagnostic process in the initial interview, which is an intersubjective encounter, the various developmental steps for establishment of the indications for psychoanalysis are presented. Freud and his followers, who were initially oriented to the psychiatric diagnosis, were later oriented to the criteria of approachability, analysability and in particular on the aptitude for psychoanalysis. The criterion of aptitude was not only elaborated from the perspective of Ego psychology but was also relevant for all high frequency non-terminated psychoanalyses which followed the basic psychoanalytical principles of “afocality”. This has so far characterized the standard procedure of all psychoanalytic schools. Due to the experiences of psychoanalysts with early disturbed, structurally Ego-disturbed neuroses and personality disorders, the extent of lability of the mental structure and by turning to countertransference analysis, the person of the psychoanalyst become more important for the assessment of the indications. In Germany the integration of psychotherapy, which is financially supported by healthcare insurance, ultimately leads to differential indication assessments between high frequency psychoanalysis or analytical psychotherapy, modified psychoanalytical psychotherapy and less frequent psychodynamic procedures.     

Sprache, Neurowissenschaften und Psychoanalyse

In this article some general thoughts on the application of language in psychoanalysis and psychotherapy will be expressed against the background of the most recent findings in linguistics, neurolinguistics and neuroscience. The conclusion is that consideration of the subsymbolic/symbolic linguistic development of a child and the affective coordination between child and environment is of fundamental importance in the psychotherapeutic relationship.     

Psychoanalyse und Traumatherapie

The author is of the opinion that for patients with combined traumas of commitment and violence a psychoanalytical long-term treatment which takes into consideration the peculiarities of this group of patients will continue to be the therapy of choice. Special ??trauma therapies?? may be useful after acute traumas and in cases in which external conditions exclude psychoanalytical treatment. Depending on the situation of the individual case, though, specific modifications of the technique may be necessary, which possibly include proven specific trauma therapeutic techniques as parameters. Based on the parallelism of the economic aspect of the trauma and the aspect of object relationship, a decisive role in the therapeutic process befits the recognition of the traumatic reality and the working out of traumatic transference, which, however, must not traumatize under any circumstances. This is accompanied by the restitution of a good interior object, which only becomes possible within a frame giving security and support. The establishment and preservation of this frame may also be due to especially required parameters derived from trauma therapies, the psychodynamic significance of which must be analyzed with the individual patient. The author's approach is clarified by two case vignettes in which the theoretical reflections have led to very different technical procedures. The author comes to the conclusion that the psychoanalytical trauma therapy shows how therapeutic concepts aiming at an optimum result must still be tailored to the individual case.     

Psychoanalyse und Verbrechen

Foulkes’ paper on “Psycho-Analysis and Crime” was first published in 1943. Today, only parts of this paper are published in the Selected Papers (1990). Foulkes’ paper is part of the tradition of psychoanalytic work and psychoanalytically inspired social research in delinquent behaviour. The paper is of special interest for the development of Foulkes’ works as it seems to mark the transition from a Freudian psychoanalyst to the founder of Group Analysis.     

Bindungstheorie und Psychoanalyse

Bowlby’s attachment theory and more recent versions of it are examined from an epistemological viewpoint and subjected to questioning on whether they are in line with central psychoanalytic concepts. It is argued that Bowlby’s basic tenets regarding attachment theory, which later attachment theorists never seriously questioned, do not conform to scientific standards, and that psychoanalytic issues such as the dynamic unconscious, internal conflicts, the interaction between drive wishes and defence in establishing substitutive formations are either ignored or not treated in sufficient depth. In the light of this, the assertion that psychoanalytic criticism of attachment theory arose from mutual misunderstandings and is outdated nowadays stands the matter on its head: psychoanalytic criticism can only be regarded as outdated if either psychoanalysis, or attachment theory or both are misunderstood.     

Psychotraumatologie und Psychoanalyse

Ohne Zusammenfassung ¹ Forum Psychoanal (2005) 21:143–155.     

Eigensinn und Psychose, Peer-Beratung und Psychotherapie

The narrow concepts of illness insight and compliance in psychiatry and psychotherapy will be discussed, not least because they contradict the dynamics of psychosis. Demands on therapeutic relations will be deduced from the therapeutic relationship between psychosis and ownness as well as of the experiences of untreated patients. The particular prospects of the accompaniment of a trained peer counsellor during convalescence will be represented and explained by the experiences of the Hamburg psychenet project. This new form of treatment in Germany is conceived as a supplement and not as competition to psychotherapy.     

Psychotherapie und Pharmakotherapie

Zusammenfassung Psychotherapie und Pharmakotherapie verk?rpern jeweils eigenst?ndige Zugangsweisen zu psychisch kranken Patienten. Eine Kombination in einem integrativen Behandlungsmodell tr?gt der multifaktoriellen ?tiopathogenese von psychischen St?rungen Rechnung. Sie verlangt eine besondere Beachtung der Psychologie der Medikamentenverschreibung und -einnahme. Bewu?te und unbewu?te Bedeutungen der Medikamente für und in der aktuellen psychotherapeutischen Beziehung sind grundlegend für eine sichere Pharmakotherapie. Sie vermitteln aber auch entscheidende übertragungs- und Gegenübertragungsmuster im psychotherapeutischen Proze?. Für diagnostisch definierte, nicht-psychotische St?rungen (depressive, Angst-, Zwangs- und Pers?nlichkeitsst?rungen) werden vorliegende empirische Studien zur Pharmako- und Psychotherapie referiert und im Hinblick auf eine Kombinationsbehandlung reflektiert.