Philosophie und Geometrie. Zur jüngeren Protophysik-Kritik

The critique of my protophysical approaches to operational foundation of geometry by Lucas Amiras (Journal for General Philosophy of Science Vol. 34 (2003)) concerns my first publication from 1976 but not the further 30 years of work. It does not offer any argument leading from the (erroneous) judgement “lacking success” to the conclusion “impossible”. And it is, in general, based on a philosophical defect: it ignores the principle of methodical order as leading for constructivist protophysics.     

Prüfungsangst bewältigen

Test anxiety or exam anxiety is a prevalent problem among students. Therefore, a high proportion of students seek help in university counseling centers. Based on a theoretical review of psychological theories and models of test anxiety, a cognitive-behavioral training program for coping with test anxiety as well as the evaluation of the program is presented. The program includes elements of behavior training with video-supported role playing and simulation of (oral) test situations, enhancement of learning and preparation strategies including time management as well as cognitive intervention strategies and relaxation training. Evaluation of the workshop program shows significant reduction of test anxiety and the strengthening of self-efficacy. The group program also lends itself for application with other groups, such as school students or for the preparation of job interviews.     

Qualitätsmanagement für Psychoanalytiker

The article discusses current problems with the quality of psychotherapeutical services. Based on professional quality-management models (ISO 9.000, EFQM) a concept of quality management and accreditation for psychoanalysts is proposed.     

Ein Plädoyer für die Menschenwürde

Dass wir heute einen so dringenden Ethikbedarf in der Medizin haben, hat – nach Elmar Waibl, Professor für Philosophie in Innsbruck – eine sonderbare, ja eine paradoxe Erkl?rung: Der Grund ist nicht ein Moralversagen der Medizin, sondern eine Moralüberforderung als Resultat des gro?en Erfolges der Heilkunst. überarbeitete Fassung eines am 20.9.2008 in Wien anl?sslich der 21. Jahrestagung der ?sterreichischen Alzheimer Gesellschaft gehaltenen Vortrages     

Psychotherapie für Straftäter

The legal and administrative framework for psychotherapy of offenders in prisons and secure forensic hospitals is outlined. Established treatment programs for offenders are presented including different variations of standardized cognitive behavioral approaches, e. g. relapse prevention programs (RP), dialectic behavioral therapy (DBT), transference-focused psychotherapy (TFP), and mentalization-based treatment (MBT). The foci of the individual programs as well as their integrative tendencies are described. In psychodynamic therapies cognitive processes are taken into consideration and, vice versa, cognitive-behavioral therapists discover the significance of the therapeutic relationship.     

Bewältigung des unerfüllten Kinderwunsches

The article reviews current research in relation to two aspects of involuntary childlessness; firstly, the extent to which involuntary childlessness can be considered a critical life-event and secondly, the short-term effects of childlessness on life-satisfaction and well-being. A study is reported in which 68 middle-aged women (45 to 65 years) who are long term childless because of infertility, are investigated. The study focuses on the extent to which unfilled desire for a child has long term effects on well-being and life-satisfaction. The control group comprised 68 women who did not suffer from fertility problems and became pregnant spontaneously. Life-satisfaction and well-being were assessed using the life-satisfaction questionaire (FLZ; Fahrenberg et al. 2000) and the SCL-90-R (Symptome-Checklist, Derogatis, the German version of Franke 1995). The study shows clearly that psychological well-being is significantly lower in childless middle-aged women compared to women of the same mean age, who have a child. No significant differences were found in social well-being and health. The results support the view that unwanted childlessness may become a chronic stressor. Unintentionally childless middle-aged women do not constitute a clinical group whose need for psychotherapy is urgent. However, the development of specific counselling for women who fail to conceive and those who remain childless in the long term is recommended.     

Gegenübertragung im stationären Therapie-Setting

Background

Countertransference is seen as an instrument of research into a patient’s unconscious and is therapeutically useful in furthering psychodynamic work. For inpatient psychodynamic psychotherapy, where patients are treated by a team of psychotherapists, countertransference is much more complex and makes consideration and integration of different countertransference feelings necessary. Using the first German translation of the countertransference questionnaire (CTQ, Zittel Conclin and Westen, the countertransference questionnaire, 2005) an attempt was made to identify differences in countertransference phenomena in a team of psychotherapists and to show the impact countertransference has on therapy outcome.

Materials and methods

A total of t multiprofessional teams of psychotherapists (15 physicians, 5 psychologists and 9 body and art therapy psychotherapists) took part in the study and completed the CTQ for 137 patients (100 female, 37 male) at the beginning and at the end of inpatient psychotherapy. In addition, the patients completed two questionnaires, the Symptom Check List Revised 90-R (SCL-90) for the severity of symptoms and the Assessment of DSM-IV Personality Disorders Questionnaire (ADP-IV) for personality disorders.

Results

Body and art therapy psychotherapists expressed more positive, protective and involved countertransference feelings whereas psychotherapists for single and group therapy expressed more aggressive and hopeless feelings. Countertransference has an impact on therapy outcome and feelings of a lack of interest, aggression and resignation at the beginning of therapy can point to a poor outcome. Patients with personality disorders activate more negative countertransference reactions than patients without personality disorders but at the same time they may also evoke parent-like feelings of protection.

Conclusions

Using the CTQ it is possible to differentiate countertransference phenomena in a team of psychotherapists treating inpatients with psychodynamic psychotherapy. The timely perception and integration of countertransference feelings has a positive influence on the therapeutic process and therapy outcome.     

Mindestanforderungen für Schuldfähigkeitsgutachten*

Ohne Zusammenfassung Wegen der besonderen Bedeutung für die Bemühungen um die Qualit?tssicherung in den forensischen Disziplinen wird der folgende Artikel, entstanden aus einer interdisziplin?ren Diskussion am BGH, hier nochmals den Fachkollegen zur Kenntnis gegeben. H. Sa? * bereits 2005 erschienen in NStZ 25:57–62     

Prädiktiver Gentest für Chorea Huntington

The development of predictive tests for genetic diseases such as Huntington’s chorea, not only raises new ethical and psychosocial issues for people at risk for genetic diseases, but also poses a challenge for the professionals treating them. The number of patients facing these issues will grow considerably with future advances of the human genome project. While there is general agreement among geneticists and neurologists that concurrent psychosocial and psychotherapeutic counselling for patients considering getting tested should be a prerequisite for predictive test-ing, much less agreement exists in the field of psychotherapy on the form and content of psychotherapeutic counselling for patients with a genetic risk factor. By their very nature, hereditary genetic conditions are a family affair. Whatever the test result will be in the end, it will have repercussions on other family members. In conse-quence, this article argues in favor of a counselling approach that is family and re-source oriented. From their experience with a collaborative treatment project, the authors present the major topics which psychotherapists need to address when working with patients at risk.     

Hörräume – Klanghüllen

In psychoanalytic research little attention has been given to one of the analyst’s chief instruments, namely his/her voice, although, apart from a few exceptions, the patient has to rely mainly on the acoustic channel in the course of the psychoanalytic process. The author presumes this to be a sign of a collective resistance among analysts which protects them against an unsettling idea: Our utmost restraint notwithstanding, it is in our voice that our physical nature materializes, that our presence is felt in a sensory way thus affecting our patients. An attempt is undertaken to show to what extent the analyst’s voice as a part of the atmosphere in the analyst’s practice affects the patient physically, thus making it possible for him/her an aesthetic experience, which may as a sensory perception lead to changes of the habitual ways of perception and thus to new experiences. Using the concept of “The Performance” devised by Fischer-Lichte, a lecturer in the theory of drama, the author explains to what extent meanings are created by both participants of a psychoanalytic process: Fischer-Lichte regards the aesthetics of performance as aesthetics of presence which arouse the sensation of physical presence. If the patient’s focus on the voice is not merely interpreted as a means of defence against comprehending the semantic meanings of the words, but is accepted as a necessary transition stage leading to re-animating the patient’s conception of reality, then a new listening and performing horizon is opened where the presence of other things can be experienced.     

Rechtliche Gesichtspunkte zur Rückfallprognose und Vollstreckung bei älteren Straftätern

As our society ages, the number of offenders who are older than 60 when they are up to release from prison or forensic hospital also increases steadily. Instruments of prognosis (e.g. HCR-20, PCL, SVR, Static-99, Dittmann-List) currently in use are not validated for this group, which means that forensic-psychiatric and -psychological experts have to rely on casuistry with all it’s methodical problems for their reports on whether or not there is a risk for relapse (which are obligatory by German law). Therefore the Courts of Execution Matters (in Germany dealing with conditional discharge; same question for any kind of Parole Board in other countries) have to apply standards as provided by the law and the jurisdiction up to the Constitutional Court to a much higher degree than they have to do regarding the much better researched group of younger offenders. In doing so, the focus has to be much more on the special circumstances of senior citizen in general and specifically on the aged offender’s life. There is a urgent need to intensify research on this group of offenders.     

Therapieabbrüche in der stationären Psychotherapie

This article focuses on the patients’ view of the causes and consequences of premature therapy termination in inpatient psychosomatic setting. In this study, drop-out patients and non-drop-out patients were questioned in semi-structured phone interviews (n=62). The causes of early termination are seen in this study to be connected with an internal, somatic concept of disease, discontent with treatment, and social interaction problems in the hospital. In 80% of the examined cases more than two causes were reported. Consequently, early termination of treatment can be considered as an outcome of multifactorial influences. Furthermore, a group of “inner drop-outs” has been identified within the non-drop-out patients. Despite high discontent, these patients remained in treatment because they often feared possible negative consequences of early treatment termination. Both drop-outs and inner drop-outs scored lower in outcome analysis than the remaining patients. This study points to problem areas that can help identify potential drop-out patients.