Zum Umgang mit Destruktivität in der Paartherapie

Ohne Zusammenfassung     

Die Destruktivität in der psychoanalytischen Ausbildung

In this study, a survey of all criticism of psychoanalytic training and of the from its beginnings formulated problems is given. Doing so, the presented literature covering the issue is discussed from four perspectives: the candidate’s perspective, the socio-political perspective, the perspective of power and the perspective of professionalization. The latter perspective involves historical aspects too and thus shows the resistance towards change, proposes solutions and therefore may be deemed to be especially relevant. In order to summarize the criticism regarding psychoanalytic training, a systemic model was developed including its systemic structure, organizational aspects and its content. Furthermore, ten hypotheses are developed as to why psychoanalytic training proves to be to a large extent resistant to change. Against the background of the existing situation in training, current job-political conditions and changes for present trainees are presented and existing exacerbations are pointed out. Ignoring these aggravated conditions and simultaneously tightening and regimenting training guidelines are understood as a destructive process for psychoanalysis and its training by the author. At the same time it is pointed out that the presented problems are not related to one single psychoanalytic society, but have been developed over decades throughout different psychoanalytic societies and countries and therefore seems to be an international problem of psychoanalytic organizations. Finally, preexisting propositions for changes are discussed, and fourteen solutions, which could help to renew future psychoanalytic training, are shown; this may also serve as a plea for a basic reform in training and organization. Regarding a reform of the training, the author deems all three issues to be relevant: the systemic-structural aspect, the content and the organizational aspect.     

Destruktivität in Paarbeziehungen

Quarreling couples caught in destructive patterns of communication often cause difficult situations during couple therapy. Such communication patterns range from pure verbal humiliation and insults up to outbursts of violence. In order to remain capable of therapy, psychotherapists must know the underlying mechanisms that provoke and maintain the destructive viscious circles. Moreover, they must have at their disposal the required explanatory ideas and practical intervention strategies for de-escalation and interruption of these destructive patterns.     

Destruktivit?t in Paarbeziehungen Paartherapeutische Behandlungsm?glichkeiten

Streitende Paare, die in destruktiven Kommunikationsmustern gefangen sind lösen oft schwierige Situationen in einer Paartherapie aus. Die Kommunikationsmuster reichen von verbalen Entwertungen und Beschimpfungen bis hin zu gewalttätigen Auseinandersetzungen. Damit der Therapeut bzw. die Therapeutin handlungsfähig bleiben, müssen sie über Erklärungsmodelle zur Entstehung und Aufrechterhaltung destruktiver Interaktionszirkel verfügen. Darüber hinaus benötigen sie Handwerkszeug und konkrete Interventionsmöglichkeiten zur Deeskalation bzw. zur Unterbrechung dieser destruktiven Muster.     

Umgang mit gefährlichen Straftätern in England und Wales

Forensic psychiatric institutions exist in all western European countries. Their organisation depends on a number of factors including the legal framework and societal attitudes towards mentally disordered offenders. This article describes and critically comments on the forensic psychiatric system in England and Wales, its legal framework and approaches to dealing with dangerous offenders. England and Wales have a long forensic psychiatric tradition with the first high security hospital, Broadmoor hospital, having been established in 1863. Evidence-based treatment approaches in forensic hospitals as well as in prisons, training of forensic psychiatrists and research in the field of forensic psychiatry have gained international recognition. However, there are some worrying aspects in the system of forensic psychiatric care and the criminal justice system more generally, in particular the high and still increasing number of prisoners in comparison with other European countries, the low age of criminal responsibility, long sentences, increasing length of stay in forensic care and the increasingly risk averse culture. A number of differences to the German system can be found; one such difference relates to the role of criminal responsibility which is irrelevant for decisions regarding commitment in England and Wales. Only the mental state and need for treatment at the time of trial (or later assessment in prison) determine whether an offender is admitted to psychiatric care or receives a prison sentence. A number of new initiatives have been launched in recent years resulting in an increasing number of individuals being detained in forensic psychiatric and criminal justice institutions, in particular the initiative for the detention and treatment of individuals with so-called dangerous and severe personality disorders, the sexual offenders register and the new sentence of indeterminate imprisonment for public protection. These initiatives have been the subject of a number of complaints to the European Court of Human Rights. Nevertheless, the trend towards a more and more risk averse culture continues.     

Misserfolge in der station?ren Therapie von Patienten mit Pers?nlichkeitsst?rungen

While psychotherapy has proven its efficacy and effectiveness in the treatment of personality disorders (PD) there is a lack of studies on treatment failure, i.e. non-response or deterioration of psychopathology. In a naturalistic approach the failed treatment of1,239 inpatients with PD was studied by means of direct and indirect assessment of change from patient and therapist perspectives. For indirect assessment the global severity index of the symptom checklist SCL-90-R (self-report by patients) and the impairment severity score (judgement by therapists) were used. Depending on the method between 11% and 31% of inpatients did not show any relevant improvement in symptoms but concordance between the methods was poor (Cohen’s kappa between 0.10 and 0.30). Patients with treatment failure did not differ from those with successful treatment with respect to sociodemographic and clinical features. The findings are discussed with respect to methodological limitations but also reflect possible clinical and therapeutic implications as well as future research approaches.     

Konzeption zum Umgang mit rückfallgef?hrdeten Sexualstraft?tern (KURS NRW)

The concept of the management of sexual offenders at risk for recidivism in Northrhine-Wesfalia (Konzeption zumUmgang mitrückfallgef?hrdetenSexualstraft?tern in Nordrhein-Westfalen, KURS NRW) came into effect on February 1, 2010 with a joint circular of the Ministries of Justice, Health and the Interior. Thereby Northrhine-Westfalia has created a systematic for monitoring sexual offenders at risk for recidivism, comparable to those already or in the meantime developed in other federal states in Germany. This article initially describes the procedural nature underlying the KURS concept, regarding mutual information routing and collaboration between the parties involved, i.e. justice, hospital order treatment, police and if necessary others as well. In addition, the framework in which KURS is ingrained, will be shown. Based on case reports this article will finally explain how actions and reactions will be specified in case conferences. Within the systematic KURS it is important that all participants reach all relevant information expeditiously, thus being able to react within their own jurisdiction. When planning actions it is essential to carefully consider the individual case parameters. Within the case conferences it remains a strength of the KURS concept that different perspectives of the case and the offender are bundled together. Ideally this and the case-specific actions will help to avoid similar offences to those committed previously.     

Umgang mit sexuellem Missbrauch Minderj?hriger durch Kleriker, Ordensleute und andere Mitarbeiter

The guidelines of the Catholic Church from 2010 have picked up on new findings and experiences which have arisen since the first guidelines from 2002. The necessity of a forensic psychiatric assessment of the prognosis or the credibility has been emphasized for the first time. The disjuncture of therapy and control will be considered as well as the basic obligation to report sexual abuse to the authorities if there are strong indications for a suspicion, except when there is a complete denial by the assumed victim. The history of guidelines in connection with the changing scientific, social and clerical judgement of pedosexual contacts will be discussed.     

Die Verleugnung der Realit?t

Denial is of great importance for the ego functions and for the constitution of the entire ego but little of this is reflected in case reports and theoretical treatises. The reason for this probably lies in the circumstance that two further problems play a role in the issue of denial: that of reality and that of truth. According to the theory of correspondence, truth is the equivalent of reality. According to this theory, subject and object are opposed. The repudiation of the theory of correspondence has led to blindness and deafness for many things. The modern concept of truth, according to which truth is constructed intersubjectively, destroys the opposition of subject and object. The destruction is an act of denial. Although the theory of correspondence may be outmoded, it could nevertheless retain its former appreciation. ??If we stopped reading canonical philosophy books??, wrote Richard Rorty, ??we would be less aware of the forces that make us think and talk as we do?? (citation from Habermas 2008, S.?34).     

„Intention to treat“ oder „treatment as received“ – Umgang mit Abbrechern in der Forschung zur Straftäterbehandlung

Lack of internal validity is a frequent problem in evaluation studies of offender treatment, as randomized controlled trials are difficult to implement and comparison groups in quasi-experimental studies are often not completely equivalent. Special matching procedures or statistical control of selection bias by using potentially interfering variables as covariates can provide a solution to some of these problems; however, a high dropout rate from offender treatment programs presents another problem, as the variables that cause attrition are often risk factors for reoffending. It is argued that a treatment-as-received (TR) approach which compares treatment completers with the comparison group may confound genuine treatment effects with selection effects. Particularly high recidivism rates in dropouts may be due to negative effects of attrition (e.g. stigmatization) but may more likely reflect a higher a priori risk for reoffending. Using data from some recent treatment studies, the authors show that alleged positive effects often disappear when a more adequate intention-to-treat (ITT) approach is used in which dropouts are retained in the treatment sample.     

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.     

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.     

Die Komplementarität in der Sowjetphilosophie

Ohne ZusammenfassungGekürzte Fassung eines Vortrages an der Universität Bonn am 19.XI.1963.     

Dynamische Komplexität in der Therapeut-Klient-Interaktion

The importance of client-therapist-relationship in psychotherapy has often been stressed. On the one hand, the quality of this relationship has proved to be an important predictor of therapy outcome, on the other hand the relationship itself is realized as a complex dynamic pattern of interpersonal interaction. It seems appropriate to investigate this dynamics by a microprocess analysis with high resolution. Interactive plans (idiographic self-presentation unities) of client and therapist were coded by a sampling frequency of 10 seconds. The coding system of plan activation follows the idea of synchronous musical score notation of different orchestra instruments. It allows for the representation of contextualized interactive behaviors. The context is introduced by the consideration of synchronous and diachronous plan-activation patterns of the interaction partners. The observed dynamic patterns are fulfilling the prerequisites of usual definitions of “chaos”: irregularity of the process, restricted prediction horizon, and still some global order of the dynamic process. Based on nominal data (on-off-patterns), a method for the identification of order within irregular patterns of plan activations is presented. The frequency distributions of plans realize the shape of 1/f^α-noise, indicating features of self-organized criticality within the dynamic system of client-therapist-interaction.     

Kulturdynamisches Modell der bikulturellen Identit?t

In intercultural psychotherapeutic treatment, the psychological integration of different cultures within an individual has to be involved as an additional developmental dimension. Individual change during the process of migration considered as desirable adaptation has often been conceptualized in terms of a bicultural identity, which includes aspects of the culture of origin as well as aspects of the host culture. The theoretical foundation of the concept of bicultural identity, however, has remained insufficient. The culture-dynamic model presented here differentiates personal and social identity according to the identity concept proposed by Mead (Geist, Identit?t und Gesellschaft, 1988, Suhrkamp, Frankfurt a.?M.). Personal identity is essentially formed by an individual??s culture of origin, while influences of the host culture primarily affect the social identity. For healthy coping with the challenges associated with migration and adequate support of this process in intercultural psychotherapy, it can be assumed that a stabilization of personal identity is required to allow for a dynamization of social identity. Implications for identity constitution in second generation immigrants, in different stages of lifespan development and in the process of learning the language of the host culture are discussed.     

Abt?tung der Kreativit?t im Faschismus am Beispiel der Kunst

In history the era of fascism is considered to be the major period of evil per se. Fascism is a ??death ideology?? which lingers behind the facade of strong willpower and conjuration of life. Fascism is marked by an ongoing effective fear of life and vitality. This fear creates the desire to control life in every possible aspect. This can be especially expounded through the example of its association with the arts. Links are created to possible fascist tendencies in the present.     

Die Perestrojka in der Sowjetischen Philosophie: Mythos oder Realität?

Ohne ZusammenfassungDiese Arbeit wurde im Rahmen eines Stipendiums der A. v. Humboldt-Stiftung (Bundesrepublik Deutschland) erstellt.