Die Effekte psychoanalytisch orientierter und verhaltenstherapeutischer Langzeittherapien

This prospective study compares 31 patients in behavior long-term-therapy (with an average of 63 sessions) with 31 patients in psychoanalytically-oriented long-term-therapy (with an average of 185 sessions) in a naturalistic design. All patients passed a diagnostic interview (SKID) by an external interviewer. Only patients with depression and anxiety problems (Axis I of DSM III – R) were included in the study. Symptoms (SCL-90-R), interpersonal problems (IIP-D) and goals (GAS) were examined at the beginning, after 1 year, after 2.5 and 3.5 years. We found that the characteristics of patients, who choose – or were referred to – psychoanalytically oriented or behaviour long term therapy were different, even when their diagnosis were comparable, in a number of characteristics, such as education, access to psychotherapy (recommended by professionals versus patients introduce themselves), the taking of psychotropic medication, and the strain of symptoms. The results demonstrate how research comparing therapies using parallelized samples do not meet reality in every case: Even if psychoanalists and behavior therapists do treat equal disorders, – and they each do that very successfully, as we could prove – the patients differ in many ways. Effect sizes and clinically significant results about changes of the symptomatic and of interpersonal problems are presented that prove the efficacy of the treatments.     

Die allgemeine Grundlage der psychotherapeutischen Behandlungstechnik auf psychoanalytischer Basis

Throughout the world the question of the common ground has been asked, the common ground of the psychoanalytic treatment technique. The tendency is in the direction of negating the question if the differences are emphasized. If the common features are emphasized, as they are here, the question can be answered in the affirmative. With the differentiation into depth psychological and analytical psychotherapy a second question arises in Germany which concerns the question of the relationship of both approaches to one another. If they are regarded as independent there is a tendency to deny the common ground of the treatment technique. If, however, the two approaches are simply regarded as different forms of using psychoanalysis, as is the case here, then the second question can also be answered in the affirmative. In order to prove the matter, rules and recommendations of the classical psychoanalytic technique are used. They were there before the formation of any schools. Thus anybody can refer to them.     

Psychotherapeutinnen und Psychotherapeuten und ihr Beruf

Ohne Zusammenfassung     

Psychoanalyse und Psychotherapie, Bildung und Erziehung

Psychotherapy and psychoanalysis form a contrast – in particular in German-speaking countries – comparable to that between education and “Bildung”: psychotherapy and education intentionally and purposefully influence the patient or pupil whereas psychoanalysis and “Bildung” pursue the ideal of a development process which is to a great extent free from outside influences. The present paper aims to show that these seemingly contrasting pairs have been artificially differentiated into extremes. Both are supposed to solve the following paradoxes: the educational paradox “How is freedom possible under constraint?” and the psychoanalytical paradox “How is independence possible under dependency?” It might, however, be possible to overcome the unfruitful contrast in both cases and to keep the feared paradox in abeyance.     

Eigensinn und Psychose, Peer-Beratung und Psychotherapie

The narrow concepts of illness insight and compliance in psychiatry and psychotherapy will be discussed, not least because they contradict the dynamics of psychosis. Demands on therapeutic relations will be deduced from the therapeutic relationship between psychosis and ownness as well as of the experiences of untreated patients. The particular prospects of the accompaniment of a trained peer counsellor during convalescence will be represented and explained by the experiences of the Hamburg psychenet project. This new form of treatment in Germany is conceived as a supplement and not as competition to psychotherapy.     

Schreib- und Griffdruckuntersuchungen bei einfachen Hin- und Herbewegungen

Ohne Zusammenfassung     

Cannabiskonsum und -missbrauch bei Jugendlichen und jungen Erwachsenen

After a long time of growth current studies on representative samples of adolescents indicate that the number of adolescent cannabis users in Germany is possibly decreasing. However, it may be presumptuous to expect a similar trend concerning the number of clients with cannabis-related disorders. Even if there is in fact a downward trend which is not yet proven, the rapidly growing number of clients presenting with these disorders in recent years cannot be explained by a similar growth in the number of regular cannabis users. Treatment centres should therefore expect a further inreasing number of especially male adolescents and young adults seeking help for problems related to cannabis use. The development, evaluation and implementation of specific treatment options concerning cannabis use disorders will be increasingly needed in the future. Cognitive-behavioral and motivational interventions have been shown to be evidence-based treatments. The paper describes some promising or already successful treatment approaches and related research projects in Germany.     

Psychosomatische und psychotherapeutische Probleme in der Frauenheilkunde und Geburtshilfe

Ohne Zusammenfassung     

Ursprung und Entwicklung,Typen und Funktionen der Zeichen

Ohne Zusammenfassung     

Transzendentalpragmatik und Diskursethik. Elemente und Perspektiven der Apelschen Diskursphilosophie

Transcendental Pragmatics and Discourse Ethics. Elements and Perspectives of Apel's Discourse-Philosophy. The author follows Apel's intellectual biography and shows the conception of a critique of meaning qua ‘reflection upon the discourse within the discourse’ to be the centre of Apel's language-pragmatic ‘Transformation of Philosophy’ (Frankfurt a.M. 1973). Beginning with an explication of the situation of a speaker/thinker, especially of the situation of a philosophising speaker/thinker, Apel reconstructs a two fold apriori of communication: Every thought is situated within the context of a particular, historically evolved, community of language and interaction. At the same time, however, the validity-claims of thoughts transcend the context of their origin towards an unlimited community of argumentation. On the basis of the first apriori Apel criticises the methodical solipsism as well as the objectivism of modern philosophy and theory of science. Drawing upon the second apriori he develops a universalist critique of meaning of relativism and contextualism. In the sixties and seventies Apel worked out a differentiated theory of the – more or less – communicatively cognizing humanities and set it apart from the theory of the causal-explanatory natural sciences, thus challenging the objectivism of a Theory of Unified Science. Building upon this work Transcendental Pragmatics, as developed by Apel and others, sets philosophy primarily two tasks: firstly, a (fallible) internal reconstruction of argumentative discourse as the (logical) situation of speech and thought which seeks to elucidate the conditions of the meaningfulness, i. e. the presuppositions, of discourse. These presuppositions comprise, thus Apel with Habermas, the four validity-claims to intelligibility, sincerety/credibility, truth and normative rightness/legitimacy. Their moral content consists, thus Apel, not only in the recognition of the equality of all beings capable of discursive reasoning but also in their recognition of a co-responsibility for the realizability of discourses and of responsibility. The author argues that the existence of a co-responsibility of this kind is indisputable because the discursive claims to validity are intertwined with a set of ‘primordial promises of dialogue’. Only with the elucidation and explication of these promises can the reconstruction of the internal conditions of discourse be completed.The second task of a pragmatics of argumentation isthe strict resp. actual reflection of the thinker upon the presuppositions of the discourse in which he currently engages. This reflection has a Socratic character and can only be done in the form of discussion and debate (‘Auseinandersetzungen’, Apel, Frankfurt a.M. 1998) with critics of the reconstruction. In this context, the author proposes a method of Socratic reflection upon the presuppositions of dialogue which suspends the usual, theoretically oriented, attitude of the scientist and the philosopher in favour of an actual reflective attitude. Within a dialogue with a sceptic who doubts one of the results of the internal reconstruction of dialogical presuppositions, say X, it is tested whether his doubt as to the unrestricted validity of X can be understood as a sincere contribution to the current dialogue or whether this particular sceptical thesis does not make sense, because it is incompatible with the role of a sincere participant of argumentation which, after all, the sceptic cannot refuse to claim for himself.Finally the author explains Apel's characterization of the tension between “Discourse and Responsibility” (Frankfurt a.M. 1988). In the course of discussions with Max Weber, Lawrence Kohlberg, Hans Jonas et al., Apel formulates and justifies an ethics of responsibility and gives an affirmative answer to the crucial question of whether the fulfilment of the moral obligations connected with the recognition of co-responsibility can be demanded within the non-dialogical circumstances of social reality. Apel's answer employs the idea of counter-strategies which are morally legitimate in virtue of their being worthy of argumentative consensus. This revised version was published online in August 2006 with corrections to the Cover Date.