Die Verantwortung der Psychoanalyse für die Psychotherapie

Whether psychoanalysis can take over the responsibility for psychotherapy when it is not operating as a part of psychoanalysis but on its own is a question which has currently become significant again. The present paper gives an affirmative answer, but under certain limiting conditions only. Psychoanalysis can take responsibility for psychotherapy. It can base this on the fact that the definition of “depth psychological psychotherapy” binds psychotherapy—as it is usually called—to psychoanalysis. How this is possible in practice is determined during the training. The training at the Michael-Balint-Institute in Hamburg is presented which partly occurs jointly and partly separately, in this way representing the reality of the two separate fields linked to each other and yet independent. The common ground is constituted by the basic principles of psychoanalysis. As an example of this common ground, the seminar on the technique of diagnosis and treatment, which is part of the early curriculum, is discussed in detail. Later on in the training, the two curricula separate more and more, each taking over its own responsibility. Not only questions of the contents but also formal aspects have to be considered. There are good reasons for establishing an independent Institute for Psychotherapy which runs the necessary arrangements together with the Institute for Psychoanalysis, from which it derives, and also remains close to the latter. Finally, it is pointed out that all of this is only possible when respecting each other’s work. Independent psychotherapy is not less valuable than psychoanalysis, but simply something else.     

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Zusammenfassung W?hrend im ersten Teil der übersicht über die Relevanz der Bindungstheorie Grundlagen und Methoden der Bindungsforschung skizziert wurden, werden nun die m?glichen Implikationen der Theorie für die Psychotherapie und Psychosomatik er?rtert. überlegungen zur allgemeinen klinischen Relevanz und zum Verh?ltnis der Bindungstheorie zur Psychoanalyse bilden die Basis für die Darstellung konkreter Anwendungen von Ergebnissen der Bindungsforschung in der therapeutischen Praxis. Es folgen zusammenfassende Darstellungen von Untersuchungen, die sich mit der Bedeutung von Bindungscharakteristika für die Entwicklung psychosomatischer St?rungen und die Krankheits- bzw. Stre?verarbeitung befassen sowie von Studien, in denen Bindungscharakteristika psychischen St?rungen zugeordnet wurden. Schlie?lich wird die Bedeutung der Theorie für die Psychotherapie und die Psychotherapieforschung dargestellt.      

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Ten years ago, two reviews of clinical attachment research were published in this journal (Schmidt and Strauß 1996; Strauß and Schmidt 1997) dealing with the question whether this theory might be of relevance for psychotherapy. Since that time, numerous theoretical and empirical papers related to this issue have been published, thus, justifying an update. The prediction that attachment theory would gain importance within psychotherapy and psychosomatics has been clearly confirmed. Elements of attachment theory have been incorporated into non-specific and specific psychotherapeutic approaches. Recently, also including neurobiological evidence, clinical attachment research continues to deal with the question whether clinical diagnoses or constructs can be differentiated on the basis of attachment characteristics. Related to this question, problems in assessing attachment characteristics are still of relevance. Within psychotherapy research, attachment-related characteristics are primarily investigated in relation to a) their value to predict treatment outcome, b) their significance for the psychotherapeutic process and c) their change during treatment.     

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Zusammenfassung Die ursprünglich von John Bowlby entwickelte Bindungstheorie gewinnt zunehmend an Relevanz im Bereich der Psychotherapie(forschung). Diese übersicht beginnt mit einer Kl?rung der zentralen Begriffe und Annahmen dieser Theorie und fa?t einige Befunde zur Entwicklung und den Korrelaten von Bindung zusammen, die vornehmlich aus entwicklungspsychologischen Untersuchungen stammen. übertragen auf Erwachsene, bedürfen die Konzepte der Bindungstheorie einer Revision, die in dieser Arbeit skizziert wird. Schlie?lich werden auf dieser Basis einige heute übliche Methoden zur Erfassung von Bindungsstilen und Bindungsverhalten im Erwachsenenalter dargestellt, die bei Untersuchungen im klinischen Feld (Inhalt des 2. Teils der übersichtsarbeit) eine wichtige Rolle spielen.      

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.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

Sexualität und Gewalt

Sexual assault as defined by law, psychiatry and sociological research is contrasted to the everyday definition of rape. Official figures on the frequency of sexual assaults as communicated in annual reports by the police differ greatly from figures found by research on sexual victimization or representative studies using different definitions of violence and abuse in sexual relations. Overpowering and violence is not a rare phenomenon in sexual relations – nearly every second woman and 10% of men are familiar with such situations. There are not only biological conditions (individual variance in neurophysiological parameters) but also psychological conditions favoring the use of power and threat instead of courting in sexual partnerships. External conditions are certain popular opinions in parts of society and certain subcultures which may also be more or less in favor of male superiority, thus helping the perpetrator to justify his assault or on the contrary helping the victim to find support in court procedures and therapy if necessary. Prevention therefore has two targets: a general one by changing popular opinions which are in favor of the use of power in sexual relations and informing persons in danger of becoming victims about the risks and the possibilities to protect themselves and an individual one by treating victims to overcome their psychological injuries and to treat perpetrators inside and outside the judicial system. The current discussion on increased availability of pornography in the internet shows both aspects: a general target to reduce negative influences of pornography which produces devaluating views on sexuality and women and the more individual task of tackling new forms of pathology created by the media at least for some of the consumers.     

Dokumentation auf einer Station für psychosomatische Medizin und Psychotherapie

The documentation system for a psychosomatic-psychotherapeutic ward must integrate and process medical and psychotherapeutic treatment in a way that allows, over and above transparence and completeness, the constructive use of the collected information. But how to describe the increasingly complex picture of the patient during a stay on the ward, and how to utilize it effectively for his treatment? The search for satisfying answers has led the Department of Psychosomatics and Psychotherapy of the Clinic of the University of Münster to develop a new documentation system that will meet such demands. The system is innovative in visualizing and using the progression of the different therapeutic offers, in addition to introducing a “synopsis” of the dysfunctional relationship patterns and the individual psychodynamic background, which permits a swift overview of a patient’s treatment during his whole stay. This allows optimization of the multimodal treatment concept.     

Die Bedeutung der Tiefenpsychologie für die geschichtliche und soziologische Forschung

Ohne Zusammenfassung     

Stationäre Psychotherapie in der Kinder- und Jugendpsychiatrie: “Die Kunst des Unmöglichen?”

Inpatient psychotherapy of children and adolescents occurs in a tangle of reciprocal psychodynamic effects. It comprises the individual level of each patient, the dynamics within the group of the patients and within the staff on the ward and as well the influence of the institution and its structure. The psychopathology of the patients will be coloured by these interactions. They have to be cared for and analysed to prevent the repetition of patients' traumatic experiences and the failing of the goals of the treatment directed on autonomous functioning of the patients outside of the hospital. The statements are illustrated by case vignettes.