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《Forum der Psychoanalyse》2005,21(2):143-155
The concept of psychic trauma has undergone an inflationary extension in recent years. Various authors cite real stress situations as the reason for psychical disorders and no longer regard them as part of a syndrome (“Psychotraumatology”). Trauma is expressly raised to the level of an influencing factor with an absolute status as a pattern that serves to explain psychical experience and behavior with no need for further explanation or reflection. In the present article, the author describes and criticizes these trends in research, and as a reminder to the existence of alternative models he considers the view elaborated by Fenichel, in which trauma can be understood not as the reason for certain after-effects, but as the result of various influencing factors. On the basis of the studies by Hillel Klein and the works of Jean Améry, it is shown that even extreme stress situations are processed by the afflicted persons as life experiences of their own. These drastic real events are analysed expressly not only with regard to the pathogenic effect by which they flood the subject’s ego. It is shown that these experiences encounter an individual, specific and highly varied subject by virtue of his constitution and life history, and are processed in an individual way by him. The assumptions about a regularly occurring, distinct and supraindividually valid effect of real events, therefore, have to be rejected. It is the author’s conviction that the use of the term trauma is unacceptable if the analysis of effects of real events fails to take into consideration the individual’s personality structure and life experience and the perceptual attitudes and sensitivities determined by them. The author calls for applications of the term trauma to be reconsidered in view of the ways in which its meaning has been stretched and overdetermined as described here. 相似文献
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Dr. med. Christian Maier 《Forum der Psychoanalyse》2013,29(4):477-497
Based on the analytic work on colleagues the author investigates a writer’s block of German psychoanalysts when writing about their patients. In the process of their own therapeutic analysis, an inhibition of association in these psychoanalysts comes to the fore by them falling into the professional role and talking about their patients. The accounts of these colleagues on their own patients function as a doubled imago revealing the unconscious conflicts of the patients as well as acting as a proxy of the psychoanalysts’ impulses, affects and foreclosed memories in their own analysis. The inhibition of thinking, leading to a writer’s block, is the result of the correspondence of the trauma of the patient with the trauma of the analyst when the transference-countertransference relationship evokes annihilation anxieties in the psychoanalyst. Therefore the writer’s block of these psychoanalysts is rooted in their professional work and is the result of the internalization of precarious emotional contents of their patients. The author examines the role of institutionalized psychoanalysis in developing a professional writer’s block, and the results of the paper highlight the need of an emotionally supporting professional environment for the psychoanalyst during his training and his practice work. 相似文献
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The right of inspection in the hospital documents, the hospital discharge report for example, is often refused to patients in in-patient psychotherapeutic treatment (psychiatry, psychosomatic and psychotherapeutic medicine) with reference to the protection of the patients themselves, their doctors or relatives. Within a systemic therapy approach patients of an acute psychosomatic care unit in a hospital the patients could inspect the report of their hospital treatment including all ?objective” and ?subjective” data of their hospital stay. The conversation with patients and their relatives about this report and modifications of the details and addresses of the report in case of patients’ objections is considered as a psychotherapeutic tool (narrative of doctor and patient) in order to improve the transparency of the diagnostic and therapeutic process and the insights in the psychosomatic mechanisms of the patient’s disease. We discuss our organisation of cocreating the hospital discharge report and our experiences with this type of patient-doctor-communication. 相似文献