Verführung in der Gegenübertragung

The author presents a counter-transferential dream of the director of a flat sharing community for mentally disabled persons. On the one side she realizes hereby a tension between the performances which have to be presented for external quality assurance and the “work which is not to be seen”, i.e. the coping with emotions and phantasies of the caring staff. On the other side she discovers, motivated by Freud, Morgenthaler and most of all by Elisabeth Lenk, in this dream a mimetic (ecstatic, sexual) dimension which may become a threat for the coherence of the subject. An attempt at interpretation leads to the extremes of exhibitionism and voyeurism as they are activated in the care work. Institutions produce their own counter-transferences steeped in the phantasms prevailing in these institutions (here: mental disability). In the counter-transference dream analyzed here the author discovers elements of the primal scene and examines the relevance of the associated phantasies in the constitution of the subject of the caring staff, of the cared-for persons and of the author herself.     

„Schicksalsklüfte“

The present paper deals with the derivation of the fate concept and its application in psychotherapeutic theory and practice. Conclusions for an extension of the practical therapeutic view on existential themes, such as meaning, freedom, loneliness and death are drawn and effects on the therapeutic relationship are presented.     

„Nanotechnologie“ als neue „Schlüsseltechnologie“?—Versuch eines historischen und systematischen Vergleichs mit anderen Technologien

Nanotechnology seems to be a new “key-discipline”, which should lead to basic changes in many areas of living and producing. This estimation is questioned by a comparison with established technologies, which reach from heat engines to biotechnology. In this line it is possible to come to a more realistically assessment of nanotechnology. “Technologies” in the narrower sense are understood as techniques based scientifically and integrated systematically into a network. The development of these technologies starts first in the early modern times. Before this background the established technologies are characterised looking at relevant questions and problems, the role of researchers and inventors, the importance of theoretical foundations, important applications and innovations, as well as the relevance of visions and then confronted with nanotechnology in its present state. It is accentuated that there are no explicit theories and no specific applications of nanotechnology and it seems to be only a kind of chemical technology.

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.     

Gegenübertragung und Identifizierung in der kompetenten Position

The concept of the terms “competent position” and “identifying with superiority” are introduced to give a better explanation for the mental procedures occurring within the analytical therapist in cases of boundary violations during treatment. In part two attention is called to the latent preventive exculpating tendency in known theories of countertransference.     

„Innerer Richter“ und „Herzenskündiger“ im Wandel der Zeit

The last few years have seen a deepening of the understanding of the role of metaphor and metaphorical processes first in the cognitive sciences, more recently also in psychoanalysis. What had for a long time been viewed as an imprecise way of understanding turned out to be central for a comprehension of how the mind functions. Most important was the step of distinguishing metaphorical processes as a fundamental way how the mind works from the linguistic form of metaphor. The essay deals with a number of core metaphors for superego conflicts and for interpersonal relations; In particular, the differentiation between people who focus more on things versus those who stress inner life and emotions.     

Übertragung und Gegenübertragung in Verhaltenstherapie und Psychoanalyse

Most psychotherapists and researchers agree that a good relationship essentially contributes to therapeutic change. The psychoanalytic concepts transference and countertransference which describe fundamental aspects of the psychotherapeutic relationship have now become integrated into behavior therapy. These concepts, however, are used differently in psychoanalysis as well as in behavior therapy. This makes the communication between psychotherapists coming from different orientations difficult. Therefore, a research approach which describes the important verbal and nonverbal elements of a helpful therapeutic interaction independently from therapeutic orientation could help to evaluate their effectiveness in different psychotherapeutic methods. In this way a culture of integration into psychotherapy could be encouraged.     

Gegenübertragungsdiagnostik in der Psychotherapie suizidaler Männer

The diagnosis of suicidality is an important challenge in psychotherapy: The threat of life has to be determined, decisions in differential therapy must be made and the therapeutical relationship must be established. The psychoanalytical contribution to the diagnostics of suicidality is the analysis of transference and countertransference phenomena, of "scenic" actions and of enactments between patient and therapist. By a systematic qualitative research method ("forming ideal types by understanding") 5 prototypical transference-/countertransference situations at the beginning of outpatient psychodynamic psychotherapy of suicidal men are identified and out of them 3 ideal types are constructed. The object-alienated ideal type with an avoidant transference and "weak", e.g. unemotional complementary countertransference appears to be a special problem. If aggression and strong attachment wishes toward the object come into the therapeutic relationship, this often is an indicator for the contacts’strength and can lead to deactualisation of suicidality. The results are discussed with and supported by methodically different publications on object relations orientated aspects of suicidality.     

„Bluttaten“ und „schizophrene Politik“

Background

The role of printed media in the maintenance of stigmatization has been a subject of debate for several years now. As for stigmatization of schizophrenia, previous research has frequently focused on stereotypes in newspaper articles and the metaphoric use of the word “schizophrenic” for something contradictory, aloof or ridiculous.

Aim

The objective of this study was to quantify the frequency of stigmatizing articles with regard to the specific type of stigmatizing content in German broadsheets and tabloids.

Material and methods

A total of 391 articles extracted from the entirety of all issues of the Süddeutsche Zeitung, Spiegel, Frankfurter Allgemeine Zeitung and the tabloid BILD from 2011 were content-analyzed for stereotypes, false statements and metaphoric use of schizophrenia.

Results

Stigmatizing elements were prevalent in each newspaper (40.4–66.7?%). Among broadsheets the metaphoric use constituted the predominant form of stigmatization, whereas depictions of persons with schizophrenia as dangerous and unpredictable prevailed in the tabloid BILD.

Conclusion

Metaphoric use and blatant discrimination are still highly prevalent in German newspapers. While metaphoric use may be stopped by renaming the disorder schizophrenia, further efforts are needed to raise awareness for and ultimately prevent the reification of stereotypes in printed media.     

„FreiRaum“

Zusammenfassung  Ein Blick in die kunsttherapeutische Praxis und Theorie ergibt weiterhin — nach einer vieljährigen Entwicklungs- und Etablierungsgeschichte in unterschiedlichsten Praxisfeldern in Deutschland — ein sehr buntes und vielfältiges Bild. Diese Vielfalt bezieht sich auf die Vorgehensweisen, die Arbeitsfelder und die zugrunde liegenden Theorien. Sie birgt viele Chancen eines individuellen Freiraums und macht die Kunsttherapie zu einem wertvollen Teil des therapeutischen Angebots in Medizin, Psychotherapie und Pädagogik. Gleichzeitig erschwert die Vielfalt den Versuch einer systematischen Erfassung der verschiedenen Facetten. Unser Augenmerk bei der Sichtung wichtiger Grundorientierungen und Konzepte von Kunsttherapie liegt dabei besonders auf den Potentialen der bildenden Kunst in der therapeutischen Beziehung.

Diagnose „Gesundheit“

In the early days of psychotherapy diagnoses were seen as unnecessary and even not helpful. After psychotherapy has become a method of medical treatment diagnoses are necessary in order to justify reimbursement of treatment by health insurance. Diagnoses are also useful to guide treatment, help communication between professionals and morbidity statistics. Diagnoses can have negative effects, such as simplification of complex problems, aggravation of normal life experiences or stigmatization and labelling. Therefore, diagnoses should be made when a person is suffering from an illness in order to avoid underrecognition and undertreatment. Similarly, the diagnosis “healthy” is important when no disease is present but only a normal problem in everyday life. To say that a person is healthy is an important and difficult task in all areas in medicine. Therapists must not only know the criteria for illnesses but also those for the spectrum of healthy problems in normal life. This can be done when the psychopathological assessment is professionally precise and makes a differentiation between signs of illness and other negative feelings. Also, normal life events must not be directly translated into illness states. Furthermore, therapists must be aware of their diagnostic preferences and bias. In the training of psychotherapists recognition of healthy states should get as much attention as the diagnosis of illnesses.     

„Insightfulness Assessment“

In this article a new method of Oppenheim and Koren-Karie (2002) is presented for the assessment of the insightfulness of parents regarding their children’s inner world. Parental insightfulness involves the capacity to see things from the child’s point of view, and is based on a) insight into the child’s motives, b) a complex view of the child and c) openness to new information about the child. Insightfulness is seen as the capacity underlying sensitive and positive parenting and providing the context for secure child-parent attachment. In the assessment of insightfulness parents view video segments of their interactions with their children and are subsequently interviewed regarding their children’s and their own thoughts and feelings during the segments. Interviews are transcribed, rated in 10 scales and subsequently classified into 1 of 4 groups. The first of the four groups indicates insightfulness while the remaining three indicate a lack of insightfulness.