Die Ambivalenz mit der Therapieforschung

Due to a presently growing demand for evidence-based medicine different psychotherapeutic methods are facing increasing political pressure to demonstrate their efficacy. The realization of evaluative projects is not only in need of study patients but also of study therapists. Although many psychoanalysts support the general need for research the number of actual participants is rather low. In this paper the motives of psychoanalysts to decide for or against participation in evaluative research were investigated. Guided interviews were conducted with six psychoanalysts working in outpatient practice. The results support the hypothesis that in particular the need for security and protection influence a psychoanalyst willingness by causing either a driving or inhibition force. Both the intraindividual and interindividual areas of the interviews displayed unresolved ambivalences towards participation in psychotherapy research. It was concluded that changes in psychoanalytic training could have the most profound influence on the personal motivation to participate.     

Die Wiederherstellung der Zeit in der ambulanten Psychotherapie mit Psychosekranken

In psychoanalytic psychotherapy with psychotic patients, a disturbance in time experience quite frequently turns out to be central to the psychotic experience as a whole. These patients experience disruptions in the flow of time that lead to a loss of temporal continuity. This loss of temporal structures causes damage in thinking functions: Relations like causality, finality and others which imply a temporal dimension, cannot be established any more. Parts of treatment histories serve to demonstrate the reconstruction of temporal continuity by the patient in psychotherapy. Object-relation-theory and Piaget’s experimental psychology provide the frame of reference for the understandig of the mental processes involved. At the beginning of the psychotherapy the patient experiences being together with the therapist and being separated from him as two discrete conditions of existing which have no links. The periodical reappearance of being together in combination with the awareness of the therapist’s continuous ongoing care encourages the patient to remember and to envisage the meetings with the therapist. The reliability of the alternation seems to stimulate a specific mental activity which creates connections allowing for transitions between the different conditions — in the sense of Winnicott’s transitional phenomena. Transitional phenomena which sometimes are quite concrete things bridge the gap between presence and future. Narrating serves as a link to the past. Through these creative ego-activities temporal continuity is regained providing the basis for strucured thinking and — very important — for the perception of one’s own personality and its continuity over time, thus generating a sense of identity. This process of reconstructing time is interesting in itself, because it sheds light on the psychodynamics of the restitutional processes after a psychotic illness. Moreover, it allows for hypotheses about the development of the inner time dimension in early childhood.     

瑞士特色的伦理学问题

本文基于作者在苏黎世大学伦理学中心学术访问期间的观察,研究分析了以死亡辅助和银行保密制为代表的具有瑞士特色的伦理学问题,并从某种角度展示了应用伦理学在瑞士的发展图景。     

Leugnen der Tat und Tatbearbeitung in der prognostischen Begutachtung

The perpetrator’s examination of his own criminal actions seems to be very important for the risk assessment by the German criminal justice and psychological and psychiatric experts. At the same time other risk factors like general dissociality, the structure of the future neighbourhood, the patterns of social bindings, and personal core competencies seem to be more important for the prevention of criminal recidivism. Anyway the analysis of one’s own criminal offence may enlighten the individual attitudes and behavioral problems and thus may become an important domain of cognitive restructuring. If a convict still denies his deed this not necessarily makes a parole impossible. Denial may indicate a general hostility against the law, but in other cases it is caused by overwhelming shame and indicates positive bindings to social norms.     

Die wende der Philosophie

Ohne Zusammenfassung     

Die Kinder der Verfolgten

The profound influence of the Holocaust on the further fate of survivors and on that of their children remained for a long time unrecognized. Psychoanalysis, too, noticed this influence of persecution not until the seventies. This article reviews the development ten years after and demonstrates by case studies, how the topic of survival determined the whole personal world of the next generation. The topics change along with the phase-specific developmental themes and depending on what happened to the parents. The connections of these topics to the developmental phases are prepared by the auxiliary ego-functions survivor-parents have for their children.     

Die Machtperzeption der UdSSR

Ohne Zusammenfassung     

Die Sprache der fiktion

Ohne Zusammenfassung     

Die Artistik der Psychoanalyse

Zusammenfasssung  Die Psychoanalyse wird im Rückgriff auf die Praxis Freuds als artistisches Handwerk begriffen, das der Phantasie als Erkenntnismittel und -zweck die entscheidende Bedeutung zuweist. Sie ist eine Imaginationslehre und der Phantasieschlüssel, die produktive Einbildungskraft eines Therapeuten, der Zentralbegriff für dessen Güte: Gegen das Klischee des Standardsettings werden die Fähigkeit und das Ausmaß phantastischer Induktion durch den Therapeuten gestellt, gegen die Fiktion von rekonstruktiver Arbeit der produktive Konstruktivismus der Psychoanalyse. Die antizipatorische Kompetenz des Therapeuten erweist sich als Quelle der Heilkraft, die dem Patienten eine sinnvolle Benennung für seine unerklärlichen und fremden Erfahrungen der Symptome gibt. Der Analytiker ist, wie der Künstler, ein Experte phantasierenden Umdenkens und Umgestaltens der vorfindlichen Wahrnehmungsrealität. Seine kompositorischen Fähigkeiten sind die Bedingung, dem Patienten das Noch-Nicht-Bekannte, Nichterfahrene aus dem Fundus seines Phantasievermögens hinzuzufügen. In diesem hermeneutischen Ergänzungsprinzip der Psychoanalyse, ihrem gestaltschaffenden Entdeckungsprinzip, liegt die Hauptquelle der therapeutischen Wirksamkeit. Die von uns entwickelte Technik der korrigierenden kognitiven Erfahrung ist eine Methode zur produktiven Sinnbestimmung der Symptome und wird in ihrer klinischen Bedeutung für alle Strukturen dargestellt. Die Wahrheit der psychoanalytischen Methode offenbart sich gleichwie das Wahre in der Kunst durch eine andere und neue Selbst- und Weltanschauung des Patienten.

---

The artistic quality of psychoanalysisIngeniousity and the corrective cognitive experience

Taking up the practice of Freud, psychoanalysis is regarded here as an artistic skill attaching central importance to phantasy as a means and also goal of insight. Psychoanalysis is a science of imagination. The key, the productive imaginative ability of the therapist is the central concept for its quality. The clichee of the standard setting is contrasted with the ability and the extent of phantasy induction by the therapist, as well as the fiction of reconstructive work with the productive contructivism of psychoanalysis. The anticipatory competence of the therapist is the source of the healing force offering a meaningful designation to the patients inexplicable and strange experiences and symptoms. The psychoanalyst is in the same way as an artist an expert of imaginative rethinking and reshaping of the given perceptional reality. His compositional abilities are the pre-condition for amplifying out of his imaginative resources the patients experience by still unknown and new experiences. The main source of therapeutic effectivity is this hermeneutic completion principle of psychoanalysis by which it creates through discovery new Gestalts. Our technique of the corrective cognitive experience is a method of productive sense-giving to the symptoms and is presented in its importance for all structures. The truth of the psychoanalytic method reveals itself just as the truth of arts in the patients new and different view of the self and the world.

---

---

Prof. Dr. Manfred Pohlen ist emeritierter Direktor der Klinik für Psychotherapie der Philipps-Universität, Marburg.* Der vorliegende Exkurs über die Artistik der Psychoanalyse folgt den umfassenderen Ausführungen zu diesem Thema in der von M. Polen und M. Bautz-Holzherr vorgelegten Monographie: Eine andere Psychodynamik - Psychotherapie als Programm zur Selbstbemächtigung des Subjekts (Huber 2001), in der wir eine psychodynamische Praxistheorie unter der Perspektive der Selbstbemächtigung des therapeutischen Subjekts veröffentlicht haben.

---

Die Dauer der Unterbringung in der Entziehungsanstalt

In Germany offenders can be sentenced to forensic addiction treatment which is realized in secure mental hospitals (according to section 64 of the German Penal Code). As a rule the persons concerned are transferred to the treatment institution after having served part of their prison sentence. There is an ongoing debate regarding the appropriate length of time of inpatient treatment. The average time in treatment differs considerably between the States of the Federal Republic of Germany and varies from somewhat over 1 year (Bavaria) to more than 2 years (North-Rhine Westphalia). In the trials mandating the treatment order, psychiatric experts are expected to exactly quantify the appropriate time of treatment for a specific person. For a number of reasons this surpasses expert capabilities as there is little empirical evidence regarding the effects of the duration of long-term treatment on outcome criteria, such as relapse or reoffending. This article discusses relevant aspects and suggests a pragmatic way to handle courts’ expectations in these lawsuits.     

Versuche mit der waagrechten strecke-punkt-figur

The straight line-dot-illusion with horizontally extending figure was ascertained experimentally and explored under several conditions. In the case of binocular perception two “external” and one “internal” factors were found influencing the intensity of the illusion. Observations with right eye and left eye respectively proved themselves to be unequal. The previous interpretations of optical illusions failed to provide a satisfactory explanation of the straight line-dot-illusion. A new explaining assumption was considered.