Vom Labor ins Feld

The mainstream of psychotherapy evaluation had moved away from naturalistic studies like catamnestic ones because their internal validity had to be questioned. The kind of studies which predominated after that have also been criticised in the last few years due to their lack of external and ecological validity. The new approach nowadays is to use controlled field studies which manage to combine the advantages of both previously mentioned evaluation methods. The possibilities with regard to contents and methodological requirements of such studies are described. However, this approach is only possible if it is firmly supported by psychotherapists in the field.     

Trauma und Traumafolgen aus psychodynamischer Sicht

Zusammenfassung Posttraumatische Störungen sind psychogene Erkrankungen, die durch Traumatisierungen bewirkt werden. Das sind seelische Verletzungen, die schwer oder gar nicht bewältigt werden können. Die Störungen beruhen auf unterschiedlichen Arten von katastrophalen Erlebnissen und können mit zeitlicher Verzögerung, unabhängig von einer spezifischen Disposition, also auch bei bis dahin völlig gesunden Menschen, zu einer vorübergehenden, länger andauernden oder lang anhaltenden Störung im seelischen und körperlichen Bereich und zu einer Veränderung der Persönlichkeit führen. Diese Störungen sind außerordentlich häufig und haben eine große Vielfalt in Hinblick auf ihre Entstehung und ihre Krankheitserscheinungen. Dynamik und Folgen traumatischer seelischer Verletzungen werden in diesem Beitrag systematisch aus psychoanalytisch orientierter Perspektive untersucht und dargestellt.     

Psychotherapie bei lebensbedrohlich Erkrankten

In den letzten 20 Jahren ist die begleitende psychotherapeutische Behandlung bei körperlich Schwerkranken fester Bestandteil der Tätigkeit von psychosomatischen Konsiliar- und Liaisondiensten im Krankenhaus geworden. Eine Konzeptualisierung dieser Tätigkeit auf psychodynamischer Basis wird beschrieben. Ziele der psychotherapeutischen Interventionen sind die Stabilisierung der Abwehr des Patienten und die Rückgewinnung eines strukturierten Umgangs mit der Krankheit, mit den Behandlern und den nahen Bezugspersonen. Therapiebausteine sind eine narrative Gesprächsstruktur, ein psychodynamisches Verständnis der aktuellen Krankheitssituation auf dem Hintergrund der Lebensgeschichte, aktives Zuhören, Fokusformulierung und systemische Sichtweise. Wichtige Wirkfaktoren sind eine empathische Beziehung, Verbalisierung von belastenden, negativen Gefühlen, Fokussieren auf aktuelle Probleme und Ressourcenorientierung. Probleme entstehen durch negative Gegenübertragung des Psychotherapeuten und ausgeprägte Verleugnungsvorgänge auf Patientenseite. Die Umsetzung erfordert vom Psychotherapeuten kontinuierliche Präsenz und regelmäßige Rücksprachen und Konsultationen mit dem behandelnden Team.     

Two ways of being a Christian in the Muslim context of the Middle East

This article identifies two fundamental outlooks and basic orientations of Christians living among Muslims in the context of the Middle East that result in two ways of being a Christian in that region. The origin of the two types, labelled the ‘Arab Christian’ and the ‘Eastern Christian’, is traced back to early Christian contacts with Islam, and the content of those two ways is explicated in their political, cultural and religious implications by briefly elaborating two contemporary Lebanese Christian conceptualizations of the two ways. It is argued that these two types provide a hermeneutical key not only for understanding the behaviour, actions and thought of Christians of the Middle East, but also for understanding and evaluating the perceptions of non-Middle Eastern writers and historians about the topic of Christians in that region.     

Educating the c Ulama: Centres of Islamic religious training in Britain

This paper brings together a diverse range of different sources to profile some of the centres of Islamic religious training in Britain. It distinguishes between dar ul-uloom (literally, ‘house of science’, or seminary) on the one hand, and Islamic ‘colleges’ on the other, the defining quality of the latter being their provision of undergraduate and postgraduate degree schemes which have currency in the world of British higher education. In relation to both types of institution, it explores their history and the nature of the curriculum (especially in Deobandi dar ul-uloom), and tries to offer some sense of the lifestyle. Drawing upon the findings of recent research, it also reports upon how interviewees representing a range of prominent British Muslim organizations view present arrangements for educating and training ^culama. The findings suggest that while Islamic ‘colleges’ have met many of the challenges of delivering religious training in contemporary Britain, in contrast many dar ul-uloom are at a critical and fascinating point of change.     

Psychosoziale Risiken von Arbeitsplatzverlust und Arbeitslosigkeit

In a society centred around employment the strain that is associated with the experience of job loss is carrying considerable health risks. The empirical evidence of the differential effects of unemployment is reviewed in the framework of the victimization model and related to the background of health risks resulting from the former employment biography. Individual reactions are co-determined by a series of moderator variables which have been identified by differential unemployment research. From a health-related perspective also the indirect effects on the “victims-by-proxy”, e.g., the partners and children of unemployed people, have to be taken into consideration. Interventions can limit the psychosocial effects, especially if they are tailor-made and if they try to integrate elements of employment, qualification and social support. The necessity of the development of societal concepts of a “social convoy” (in the sense of a professional counselling) in occupational transitions is stressed. These should, however, start already during employment before the dismissal takes place. Theses concepts will take over social responsibility for restructuring and provide those being affected by dismissals with a legitimate claim for social support.     

Videotherapie bei postpartalen Störungen

Video recording is currently part of in- and out-patient therapy programs for parents with infants. The observation and analysis of video sequences allow the patient to gain an extraordinary insight with respect to its own experience and behaviour. Video Microanalytical Therapy (VMT) looks for the mother’s positive qualities in her relationship to the child and employs these qualities in order to support successful interactions. VMT is well-suited to the treatment of mothers with postpartal affective or psychotic disorders, because the typical cognitive distortions and reduced perception shown by these mothers can be avoided to a large extent through the use of pictures. In this study, a video microanalytical therapy concept will be presented, that was developed for the treatment of postpartally disordered mothers at the Psychiatric Centre Nordbaden in Wiesloch, Germany.     

Stationäre körperbezogene Psychotherapie bei Anorexia und Bulimia nervosa

Disturbances of body-images in women with anorexia and bulimia nervosa are described at the behavioral, perceptional and affective-cognitive level. The disturbances of body image, which are often accompanied by personality-structural deficits and have a decisive influence on the course of disease, can be reached only in part by verbal forms of therapy. Considering these facts, we present an integrative clinical procedure in which the application of body-related therapy modules play a central role in supplement to cognitive-behavioral and psychodynamic forms of therapy. Process-oriented body-perception therapy in an individual setting and a communicative movement group therapy are used and their relevance to the in-patient therapy process examined from the patient’s point of view. The study reveals a high value of body-psychotherapy, wherebydifferences were observed between anorexia (15) and bulimia (27) patients in the course of the process. The results suggest an indication for the application of combined individual and group body-psychotherapy for hospitalized anorexia patients. A communicative body therapy in group form is also very important in the in-patient treatment of bulimia patients, but there is a differential indication with regard to individual body therapy.