Identit?t, Identit?tsdiffusion, Identit?tsst?rung

Identity takes place in the transitional space between the individual and society. It means that the individual has the feeling to be a unique being with past and future, to be different from others but also to be similar to them in many aspects and share a great deal with them. This sense of coherence and continuity in the context of social relatedness shapes life. A differentiation is made between primary identity, personal identity and current identity. The development is essentially determined by preverbal interpersonal processes. If the balance which sustains the feeling of identity becomes lost then disturbances of the identity occur, which compromise the sense of identity especially in social contexts. An identity diffusion arises. Depending on the fixation, a differentiation is made between phase-specific identity crisis, developmental disorder and reactive identity disturbance.     

Psychotherapie und Internet

The Internet plays an important role in healthcare. Approximately two thirds of Internet users search the medium for, e.g. personal questions of health, including aspects of mental health. In countless discussion forums or blogs mentally stressed people discuss their problems and search for contact to other affected individuals but also to professional helpers. In this article an attempt is made to systematize the interface between Internet and psychotherapy in the narrower and broader sense. In particular five topics and problem areas will be dealt with: (1) as information medium Internet delivers an immense number of resources on mental disorders, which raises the problem of quality assurance. (2) As a communication medium it can provide support for therapeutic interventions. Psychological online counseling has now been proven to be effective. (3) Internet alters the traditional therapeutic relationship in one way or another. In particular e-mail communications supplement a face-to-face treatment. (4) Use of the Internet also brings along clinically relevant problems and because of this patients visit psychotherapeutic practices increasingly more often. (5) Internet can be fruitful for psychotherapy research.     

65 Jahre später

Research on the long-term emotional impact of World War II experiences is an important psychoanalytical issue and requires an interdisciplinary approach. In the project: “Witnesses of the ‘Operation Gomorrha (Hamburg Firestorm)’ (1943) and their families” long-term processing of and coping with war experiences of former children and adolescents are investigated by historians and psychoanalysts. A sample of 64 witnesses (34 women, 30 men, average age 75 years) and their families was recruited and investigated by semi-structured interviews. The interviews were analyzed by methods of “renarrated and interpreted history of coping” and group analysis against the background of historical, psychological and cultural approaches. A total of nine prototypical cases give insight into different biographically determined representations of the “Firestorm” and the conjunction with socio-cultural processes. Analysis of coping over the life-time has to take life experiences after the war and during the time of rebuilding into account. The research project attracts much interest among the former “war”-children.     

Mein Konzept der Supervision

The reflections on supervision presented in this paper were written against the background of a psychoanalytic training. The paper describes what – in the author's view – characterizes a patient in psychoanalytic psychotherapy, a psychoanalytic therapist, and a supervisor. In addition, the author reports on his personal experiences which he has made with supervision in the course of his activity as a psychoanalyst in the roles of supervised and supervisor. In this context, he presents some actual memories from supervisory experiences with M. Balint, H. Argelander and F. Morgenthaler.     

„Beyond efficacy“:

In this study, treatment efficacies of 30 short and long-term treatments with adolescents were presented from the perspective of the afflicted adolescent, the parents and the therapists. Assessments were made 3 times over 1.5 years after 97 therapy sessions on average. Short-term psychotherapy did not significantly contribute to symptom reduction. In the long-term treatments, therapists reported a strong reduction in symptomatology and in communicative disturbances with parents, siblings and friends over time. However, parents perceived less change in symptomatology compared to their children. The quality of the therapists' work with parents did not impact psychotherapy outcome. Tendentially, the type of treatment and the experience of the therapist were relevant for treatment efficacy.     

Facetten eines „deutschen“ Gegenübertragungsproblems

Departing from two case vignettes of psychoanalytic treatments of foreign children of parents who had collaborated with the Germans during the second world war, we are pondering whether there is a specific form of German counter transference defense, making it impossible to allow destructive narcissistic transference offers full of relish through the patients out of the fear that their activation in the analyst might end up in shame and horror as in the previous generations. The nearly complete renunciation to work analytically on the Nazi and Wartime could be described as a secret agreement of the protagonists, finding its justification in keeping out this delightful destruction. The consequences of this abandonment are the disability to establish a solid oedipal position and a regression to the anal world, being characteristic for both postwar German states including much of the analytic work.     

Gewalt und Vertrauen

Puzzles are often the result of wrong questions. Not the question is interesting, how it is possible that “quite normal men” are capable of extreme violence, rather the question why in face of world history this question persists and is still considered as being interesting. This article is an attempt to find an answer to this question by discussing the special relation developed by the cultural formation named “modern age” to violence in general and last but not least to its own violence. Violence underlies in modern age a pressure of legitimation which strongly differs from other cultures, and the trust in modern age is to a great extent based on the – all too often counterfactual – assumption that it is non-violent or at least on the way to that. In the course of these considerations it should be examined why there is no satisfying sociology of violence although just this lack is known and bemoaned –, as well as the question on which bases such a sociology could be established: systematically, considering a phenomenology of physical violence and the analysis of the relation of power and violence as well as the communicative function of violence; historically, considering the question how the special relation of modern age to violence was developing and to which changes it is subjected in face of the excesses of violence of the 20th century.     

Angriffe auf Körper und Seele

Experiences of abuse and neglect in early childhood generate mostly manifold adverse consequences differing from disturbances due to traumatizations in later developmental phases. They justify the diagnosis of developmental trauma disturbance. They lead to traumatization in the attachment with characteristic relationship configurations repeating the “attachment trauma”. For therapeutic work it is important to recognize these reenactments, otherwise it may come to entanglements at the level of the equivalence mode or because of pseudomentalization, thus preventing therapeutic work. In these cases the space for communication, the ability of symbolization in language and play collapses.     

Tinnitus und das Leiden am Tinnitus

Psychosomatic findings from 287 patients with tinnitus are presented in this article, who were seen by medical psychotherapists specialized in ENT for a period of 15 months. They were assigned to all of the therapeutic methods being offered. As relevant proved to be the neurootological professional competence, especially for recognizing and treating auditory limitations (in 41% of the patients) as well as noticing and treating the psychological comorbidity (in 45.3% of the patients). While neurophysiological and psychophysiological models interpret the subjective tinnitus stress as the failing of habituation, dysfunctional attention processes and assessments, from a psychodynamic view a symptom having pathological significance, such as the suffering from tinnitus (not the tinnitus itself) may develop if the defensive mechanisms are exhausted, a conflict cannot be resolved on the conscious level or traumatic experiences were made. It is recommended that an approach specifically matched with the disturbance is made taking into account both possible psychodynamic causes and sustaining factors in the cognitive behavioral sense, all on an audiologic background.