Zur Theorie und Praxis psychoanalytisch begründeter station?rer Psychotherapie

In the last 50 years inpatient psychosomatic psychotherapeutic treatment in Germany has undergone a special development in which the psychoanalytical and group analytical communities were substantially involved. This development will be analyzed in a review with respect to models of the clinical application of psychoanalytical treatment principles. Particular emphasis is placed on the analysis of transference and countertransference processes in a clinical multiperson situation and the resulting necessity of group and teamwork. Only such an integrative inpatient psychotherapy concept is from a psychoanalytical perspective in a position to utilize the interactional, scene-like restaging in a multiperson relationship field and to benefit therapeutically, by which the group analytical function of the team process plays a special role. The practical aspects of two applications of the integrative model in Essen and Dortmund will be presented and the results will be discussed.     

Die Auswirkungen der Wende 1989 auf Adoleszente

The significance of adolescence for psychosocial development is a controversial theme with discussions ranging from an emphasis on the importance of early childhood to the ideas propagated by Freud that the dynamics of adolescence play an important role in the psychological development of the individual and transculturation. The course of adolescence provides a starting point for understanding the psychodynamics of patients, which is often given insufficient consideration. Today, it can repeatedly be seen that patients in their mid-thirties are coming for treatment: patients who experienced their adolescence during the period of political upheaval in Germany. For a variety of reasons this proves to have been a vulnerable life phase, above all for East Germans. Puberty and adolescence comprise developmental tasks whose completion in a crisis situation, such as represented by the political change in East Germany with the reunification process, suffered considerably. Accordingly, the consequences of this conflict-laden coping process can be revealed during later therapy in transference and central relationship conflicts. The adolescents made considerable efforts to adapt to the new conditions, however, without adolescent altercations with GDR parents and conditions having taken place in sufficient measure. The treatment of a female patient is presented for whom the political change during adolescence proved to be a critical life event. Her narcissistic deficits together with her fragile identity were exacerbated as a result of the social upheavals. It is demonstrated how this ??critical life event?? was intertwined with her earlier psychological structure, the problems of adolescence and her search for identity during the course of psychoanalysis.     

Gibt es ein weibliches ?quivalent zur m?nnlichen Perversion?

Starting with the new definition of paraphilia as planned for the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) it will be shown that the topic cannot be handled without a structural definition of the former perversion. Using the most advanced definition for male perversions it will be investigated if there are female counterparts covering the same structural deficits and pseudosexual solutions. This is done using an interpretation by Beyer of a fairy tale from the brothers Grimm which can be considered as typical for these solutions. The basic clinical background will be exemplified using several long-term psychoanalytical cases of women during which it became clear that the creation and destruction of children??s lives is an equivalent to the reparative function of the sexual act in the male perversion, temporarily stabilizing an extremely vulnerable narcissistic structure. It will be discussed whether there are other structural equivalents of perverse solutions, for example taking power of the child??s or the own body as in anorexia or Munchhausen by proxy syndrome.     

Freud über Krankheit

The history of Freud??s illnesses shows us how he tried to circumvent the confrontation with his health disorders and consider them as unimportant. Similarly, in his personal letters, he left his ill body ??out there?? as if it were another person, Konrad, not himself. He avoids understanding it from the inside. In his correspondence, especially with Ferenczi, depressive symptoms were considered as somatic and were excluded from his reflexions. Important insights, e.g. about a relationship between cancer with hate do not change his basic attitude. Disavowel and masochism become important in his life and writings. In the post-Freudian literature these themes will be integrated in the dialogue, i.e. between analyst and analysand.     

Idealized and Industrialized Labor: Anatomy of a Feminist Controversy

Prompted by the ever‐increasing cesarean rate, this paper considers the interpretive disjunct between two significant strands of feminist analysis that have arisen in the last four decades as a consequence of the phenomenon of medicalized birth. In contrast to the dominant paradigm of bioethical “Principalism,” both modes of analysis, understood as “the critique of industrialized labor” and “the critique of idealized labor,” are attentive to the way in which social discourses inform bioethical deliberation and practice, but significantly diverge in the nature of their accounts. The “industrialization critique” understands the culture of medical intervention to be impelled by an “obstetric desire” to appropriate women's reproductive potency, whereas the “idealization critique” relates new mothers’ “low childbirth satisfaction” to a pernicious normative ideal propagated by the natural childbirth movement. This paper will explore the anatomy of both critiques and interrogate their fidelity to the phenomenological insight of the body as chiasm between material and ideal. I will argue that while the insights of the idealization critique are well grounded, we must exercise caution about the critique's tendency to reductively understand the embodied experience of labor as entirely discursively produced, a gesture that risks re‐performing the dematerialization of women often effected through obstetric intervention itself.     

Nebenwirkungen bei psychoanalytisch orientierten Therapien

Freud discovered that psychoanalysis is potentially a dangerous method consisting of multiple explosive elements. But what are the risks and where can they be found? The author describes the possible side effects of psychodynamic therapy, such as dependency on the therapist, avoidance of personal duties, fixation on problems, increased feelings of inferiority and difficulties in social relationships. He shows how these effects are connected with basic psychoanalytic techniques, such as free association, abstinence, interpretation and easing of the burden of the superego. Only if the therapist knows about such unwanted effects will he be able to identify them in time and be able to inform the patients as is obligatory according to current legal practice.