Imaginationen in der psychodynamischen Psychotherapie

Imaginations establish a direct access to central relational and emotional schemes. Thereby, they have considerable therapeutic potential, apt to enrich psychodynamic treatment to a high degree. In the experiential space of imaginations central wishes, anxieties and conflicts come to the fore, thus the earlier ones can be worked through and new ones may be tried. The continuous therapeutic support allows for a reasonable focussing of the imaginations by applying regression, progression, support, confrontation and stimulation. After an introduction into the therapeutic applications of imaginations the actual clinical work with imaginations as developed by the katathym-imaginative psychotherapy (KIP, guided affective imagery) is presented, exemplified by a case study. Finally, this example is discussed in the light of new theoretical and empirical findings.     

Aktuelle Entwicklungen der psychodynamischen Psychotherapieforschung

The effectiveness of psychodynamic psychotherapy has been a “hot topic” in scientific and healthcare related debates in recent years. During this time a significant amount of new evidence supporting the effectiveness of psychodynamic psychotherapy has been published. The paper provides an overview on current psychodynamic psychotherapy research, with a focus on meta-analytic findings and randomized effectiveness trials. The results in the literature show robust evidence for the effectiveness of psychodynamic therapies for a wide range of psychiatric disorders. The methodological quality of current studies is good and comparative trials with other forms of psychotherapy yield mostly equivalent results. However, further studies are needed with regard to different mental disorders as well as effectiveness studies in everyday practice.     

Beziehung und Exposition

In the treatment of anxiety disorders both psychodynamic and behavioral therapeutic methods have proved successful. Linking the two methods in one treatment is usually avoided by therapists, although there is evidence for using such an approach. There is a lack of a regulatory framework for the integration of the various procedures. Taking anxiety treatment as an example, a contribution to such a regulatory framework is developed: the use of exposure (as a cognitive behavioral element) and the examination of the transference aspect of the therapeutic relationship by the therapist (as a psychodynamic element) are systematically placed in relation to each other, whereby the understanding of the therapeutic process is deepened.     

Therapie und Theater

Theatre experience serve in drama therapies only as a background for a better understanding of the patients problems, whereas the dialogue between therapy and theatre contributes to the understanding of the process of therapy itself and the secrets of it’s effect. As the actor creates an “empty space” to express himself, so tries a therapist to eliminate all obstructions of understanding. Both dedicate their whole personality to the author respectively to the patient, which requires an enormous amount of humility and responsibility and can be achieved only by a continuous argument with himself. The closeness of profession and personal life is therefore unavoidable, which means various possibilities and impulses but great dangers as well. Therapy and theatre are not to compare with any other interpersonal relationship, for they are trying to achieve changes in the way of feeling, thinking and acting. Whether, on this way, the therapist’s and actor’s real emotional expression is more important than the rational analysis of all emotions or not, is a question often discussed controversially. Just like in a child’s play, it is always about the argument between fantasy and reality and, therefore, about the stimulation and development of the audience’s and the patient’s creativity. Therefore it is of greatest importance for the therapy as for the theatre that the process is immediate, vivid and unforeseen. They are paths towards life, experiencing their purpose and limits through this task.     

Werkzeugkasten des psychodynamischen Psychosetherapeuten

The authors describe the modification of the classical psychoanalytic treatment technique, which was developed in the past decades to treat people with schizophrenic psychosis. The technique which can be used in modified psychoanalytic as well as other psychodynamic settings, was adjusted to the specific problems which occur in the psychotherapy of patients with schizophrenia. This specific modified psychotherapy deals with a paradigmatic experience in the therapeutic relationship to reduce traumatic fear and to overcome interpersonal and intrapsychic dilemmas. This modification increases the possibility to reconstruct the personal history of the psychosis in a dialogical process together with the patient.     

Ein Kontrollzwang und seine Therapie

Das folgende nachempfundene Erlebnisprotokoll zeigt einen kurzen Ausschnitt aus dem Leidensweg einer Patientin mit Kontrollzw?ngen. Es handelt sich dabei um eine schwere St?rung, welche die Lebensqualit?t der Betroffenen stark beeintr?chtigen kann. In einem solchen Fall ist eine Psychotherapie unerl?sslich. Die Methode der Wahl ist dabei die Verhaltenstherapie.