Treatment of atypical and neurotic depression

Hitherto it has not been usual to talk in the German language about the therapy-oriented concept of two forms of the progress of atypical depression (Type A and Type V). The characteristic symptom of Type A is angst, together with phobias, physical complaints, etc. In Type V there are vegetative symptoms, often towards evening (Hypersomnia, difficulty in getting to sleep, increased appetite, increased weight, increased libido), accompanied by hysterical extrovert personality traits, and of intermittent occurrence. These clinical pictures are amenable to psychopharmalogical therapy. In conformity with the assumption of "somatic accommodation" treatment with antidepressives is recommended in the case neurotic depression, too, at least in the initial stages of treatment.     

Aspects of process diagnosis in the psychotherapy of psychosomatic diseases

15 patients with psychosomatic diseases and the phenomenon of alexithymia, together with neurotic patients are treated psychotherapeutically in half-open groups. Contrary to the neurotics the patients show some special features regarding the process diagnostics. In assessing the wished and really experienced nearness to the group members there is a deficient ability to differentiate. During the therapeutic process the intrapsychic tension (EMI - Inventory of Emotionalities) is subject to great fluctuations or doesn't change. The occurrence of fluctuations in the EMI and of greater differentiations in the N-D-Test (Nearness-Distance-Test) suggest a good prognosis. A therapy of psychosomatic patients together with neurotic patients seems to be more effective than the treatment in homogeneous groups.     

Narcissism and the personal myth

Kris (1956) described the concept of the personal myth as an autobiographical story built around a family romance fantasy seen specifically in obsessive characters and serving a defensive function. In this paper the concept of the personal myth was expanded to include similar defensive constellations originating from within the grandiose self, built around omnipotent and omniscient fantasies and occurring in character formations with pregenital, narcissistic pathology. The case of a known author and poet, Nikos Kazantzakis, was used to illustrate the thesis of the paper. The available biographical material and the work of the author offer evidence to support the claim that the author's personal myth was a protective shield against anxiety originating in early narcissistic traumata.