Der biopsychosoziale Krankheitsbegriff in der Praxis

Many of the recent approaches in diagnostics and therapy, e. g. the behavioral medicine, consider themselves as “holistic” or “multidimensional”. By closer consideration, however, it turns out, that while more or less referring back to the system-theoretically founded “bio-psycho-social model” (Engel, Weiner et al.) its implications are not taken seriously in practice. Presenting a concrete work project (“simultaneous diagnostics”) we will show, how to implement this (theoretically potent) bio-psycho-social conception of disease in clinical practice. It can be clearly seen, that it cannot replace the conventional reductional approach of medicine which focusses on the examination of single processes and structures under simplified conditions. On the contrary, such reductionism remains indispensable, because to be able to grasp any higher (more complex) structure one has to know its elements. Comprehensive explanation of phenomena, however, is not possible in a reductionist way. Therefore, the bio-psycho-social disease model in its operationalization is not a new way of medicine, rather an expanded approach to diagnostical and therapeutic issues.     

Kasuistik und Praxis – Grundpfeiler der medizinischen Methodik

psychopraxis. neuropraxis -     

Der Facharzt für Psychotherapeutische Medizin: Realisierung in der Praxis

Ohne Zusammenfassung     

Der Richtungsbegriff in der Psychologie

Ohne Zusammenfassung Mit 49 Textabbildungen     

Der Graupapagei in der Gefangenschaft

Ohne Zusammenfassung     

ICD-10-Diagnosen in der psychotherapeutischen Praxis

An evaluation of the ICD-10 manual (Chapter V) reveals severe shortcomings of this diagnostic instrument concerning outdoor psychotherapy. It is well known that ICD diagnoses are restricted to symptoms and deficits of psychic functions; this restriction contradicts the definitions of psychic diseases as stated by the German “Psychotherapie – Richtlinien”. In Germany, third-party-payment is bound to therapies taking etological aspects into account. It doesn't make sense that the diagnostic system abandons any etiological foundation, making no difference between neurobiological, psychological and psycho-reactive factors fostering psychic diseases. The diagnostic principle of the co-morbidity impairs the therapist's diagnostic and therapeutic capacity to synthetize different phenomena to a common gestalt. Moreover, the new diagnostic category “personality disorder” is ill-defined and doesn't allow any conclusion of therapeutic relevance. The ICD-10 manual is maybe a suitable instrument in a research context, but its usefulness to promote quality assurance in outdoor psychotherapy is considerably restricted.     

Die tiefenpsychologisch fundierte Methodik in der Praxis

Depth psychologically founded psychotherapy (tfPT) is historically a method derived from psychoanalysis. It was introduced in 1967 into the scope of psychotherapy in Germany by the Psychotherapy Guidelines and has developed since then a certain autonomy. This contribution describes its methodical basis and its practical application in the context of the Psychotherapy Guidelines in Germany. A standard tfPT method for the treatment of neurotic conflict disturbances is distinguished from the modified tfPT for the treatment of developmental disturbances and posttraumatic disorders. The method is defined by several characteristics in this paper: Current psychosocial problems of the patients are worked through as re-actualised conflicts or results of structural deficiencies in their actual genetic unconscious dimension. The uncovering and working through of transference in external relationships is of special importance. The therapeutical regression is limited by the setting (one encounter per week in vis-a-vis position, limitation to 50 up to 80 sessions in total), by focusing on the psychosocial reality and by restriction of the transference. Specific intervention forms, particularly interpretations, can be combined with structure oriented interventions or eclectic techniques. The orientation at the unconscious dimension of the disturbance and at the process is the central reference point of the complete therapeutic strategy. This definition allows a clear demarcation against psychoanalytic psychotherapy. The essential difference is to be seen in the focusing on the re-actualised elements of the relevant psychodynamics and in including the external relationships into transference (“Dezentrieren”). The specific methodology requires a special education with a depth psychologically founded self experience as its core.     

Der Mensch in der Masse

Ohne ZusammenfassungPrivaat docent aan de Gemeente Universiteit van Amsterdam     

Der Analogiebegriff in der modernen Phyfik

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Der Aufbau der Psychose

Ohne Zusammenfassung     

Der gegenftand der pfychologie

Ohne Zusammenfassung     

Onkologisch Kranke als Patienten der psychotherapeutischen Praxis

Background

The high prevalence of cancer and the considerable psychological comorbidity is a challenge for psychotherapists. There are, however, relatively few patients in outpatient psychotherapy. Aim of the study was to survey outpatient psychotherapists concerning this issue and their attitudes towards the treatment of cancer patients.

Methods

All outpatient psychotherapists of an East-German city were surveyed using semi-structured interviews.

Methods

There are various reasons for the relatively rare visits of cancer patients in psychotherapeutic practices: For instance the subjective lack of specific competence, the fear of many psychotherapists to treat physically ill people, insufficient fitting of the relatively inflexible organization structure of psychotherapeutic settings with the vicissitudes of life among physically ill people, e.g. long waiting periods until the begin of treatment, furthermore the psychotherapeutic training focuses on psychosomatic and not so much on somatopsychic perspectives. A further problem is the widespread attitude about psychic causation of cancer, which is contradictory to scientific evidence.

Conclusions

Psychotherapists who want to treat cancer patients need specific and in-depth training in psychooncology.     

Der Rabe und der Bayesianist

The Raven and the Bayesian. As an essential benefit of their probabilistic account of confirmation, Bayesians state that it provides a twofold solution to the ravens paradox. It is supposed to show that (i) the paradox’s conclusion is tenable because a white shoe only negligibly confirms the hypothesis that all ravens are black, and (ii) the paradox’s first premise is false anyway because a black raven can speak against the hypothesis. I argue that both proposals are not only unable to solve the paradox, but also point to severe difficulties with Bayesianism. The former does not make the conclusion acceptable, and it entails the bizarre consequence that a great amount of non-black non-ravens substantially confirms the ravens hypothesis. The latter does not go far enough because there is a variant of the first premise which follows from Bayesianism and implies a weaker, but nevertheless untenable, variant of the conclusion.

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Der Rabe und der Bayesianist

     

Der politische Begriff der Freiheit

Ohne Zusammenfassung     

Der Kern der materialistischen Dialektik

Ohne Zusammenfassung