Gegenübertragung im stationären Therapie-Setting

Background

Countertransference is seen as an instrument of research into a patient’s unconscious and is therapeutically useful in furthering psychodynamic work. For inpatient psychodynamic psychotherapy, where patients are treated by a team of psychotherapists, countertransference is much more complex and makes consideration and integration of different countertransference feelings necessary. Using the first German translation of the countertransference questionnaire (CTQ, Zittel Conclin and Westen, the countertransference questionnaire, 2005) an attempt was made to identify differences in countertransference phenomena in a team of psychotherapists and to show the impact countertransference has on therapy outcome.

Materials and methods

A total of t multiprofessional teams of psychotherapists (15 physicians, 5 psychologists and 9 body and art therapy psychotherapists) took part in the study and completed the CTQ for 137 patients (100 female, 37 male) at the beginning and at the end of inpatient psychotherapy. In addition, the patients completed two questionnaires, the Symptom Check List Revised 90-R (SCL-90) for the severity of symptoms and the Assessment of DSM-IV Personality Disorders Questionnaire (ADP-IV) for personality disorders.

Results

Body and art therapy psychotherapists expressed more positive, protective and involved countertransference feelings whereas psychotherapists for single and group therapy expressed more aggressive and hopeless feelings. Countertransference has an impact on therapy outcome and feelings of a lack of interest, aggression and resignation at the beginning of therapy can point to a poor outcome. Patients with personality disorders activate more negative countertransference reactions than patients without personality disorders but at the same time they may also evoke parent-like feelings of protection.

Conclusions

Using the CTQ it is possible to differentiate countertransference phenomena in a team of psychotherapists treating inpatients with psychodynamic psychotherapy. The timely perception and integration of countertransference feelings has a positive influence on the therapeutic process and therapy outcome.     

New biographical research on the members of the psychoanalytic movement in vienna 1902-1938

Abstract

The paper presents Elke Mühlleitner's Biographisches Lexikon der Psychoanalyse (Biographical Lexicon of Psychoanalysis) and comments on her first evaluations of this comprehensive data. It illustrates, by reference to the early members of the Psychologische Mittwoch-Gesellschaft (the Wednesday Psychological Society), the heuristic value of the collected material for dealing with the issues and hypotheses related to the history of science.     

Self-regulation and protective health behaviour: How regulatory focus and anticipated regret are related to vaccination decisions

Objective: We examined how individual motivational orientations and anticipated regret are related to the protective health decision of vaccination behaviour.

Design: The proposed relations were examined in a large-scale sample (N = 3168) and three medium-sized samples (N = 151, N = 194, N = 208). Questionnaires were applied to assess regulatory focus, anticipated regret and vaccination behaviour.

Results: Increased prevention-focused self-regulation – which is represented by concerns about security-related goals, responsibilities and obligations – was related to a greater likelihood of vaccination. Prevention-focused individuals’ higher likelihood of getting vaccinated seems at least in part to be a consequence of anticipated regret for not vaccinating. Study 3 suggests that regulatory focus is less related to vaccination decisions when regret is increased by the decision-making context; that is, when information highlighting vaccination effectiveness and a low likelihood of adverse responses is provided.

Conclusion: Prevention-focused self-regulation is related to a greater likelihood of engaging in health-protective behaviour. This can be explained by prevention-focused individuals’ greater tendency to anticipate regret about getting ill as a consequence of not adopting protective measures. If people perceive a protective measure such as a vaccination as highly effective, anticipated regret for not adopting it is generally increased, and individual differences in regulatory focus no longer predict the decision.     

Essentialism goes social: belief in social determinism as a component of psychological essentialism

Individuals tend to explain the characteristics of others with reference to an underlying essence, a tendency that has been termed psychological essentialism. Drawing on current conceptualizations of essentialism as a fundamental mode of social thinking, and on prior studies investigating belief in genetic determinism (BGD) as a component of essentialism, we argue that BGD cannot constitute the sole basis of individuals' essentialist reasoning. Accordingly, we propose belief in social determinism (BSD) as a complementary component of essentialism, which relies on the belief that a person's essential character is shaped by social factors (e.g., upbringing, social background). We developed a scale to measure this social component of essentialism. Results of five correlational studies indicate that (a) BGD and BSD are largely independent, (b) BGD and BSD are related to important correlates of essentialist thinking (e.g., dispositionism, perceived group homogeneity), (c) BGD and BSD are associated with indicators of fundamental epistemic and ideological motives, and (d) the endorsement of each lay theory is associated with vital social-cognitive consequences (particularly stereotyping and prejudice). Two experimental studies examined the idea that the relationship between BSD and prejudice is bidirectional in nature. Study 6 reveals that rendering social-deterministic explanations salient results in increased levels of ingroup favoritism in individuals who chronically endorse BSD. Results of Study 7 show that priming of prejudice enhances endorsement of social-deterministic explanations particularly in persons habitually endorsing prejudiced attitudes.     

Retraining automatic action tendencies changes alcoholic patients' approach bias for alcohol and improves treatment outcome

This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements (pushing a joystick) in response to alcohol pictures, or to one of two control conditions, in which they received no training or sham training. Four brief sessions of experimental CBM preceded regular inpatient treatment. In the experimental conditions only, patients' approach bias changed into an avoidance bias for alcohol. This effect generalized to untrained pictures in the task used in the CBM and to an Implicit Association Test, in which alcohol and soft-drink words were categorized with approach and avoidance words. Patients in the experimental conditions showed better treatment outcomes a year later. These findings indicate that a short intervention can change alcoholics' automatic approach bias for alcohol and may improve treatment outcome.     

CHRM2, parental monitoring, and adolescent externalizing behavior: evidence for gene-environment interaction

Psychologists, with their long-standing tradition of studying mechanistic processes, can make important contributions to further characterizing the risk associated with genes identified as influencing risk for psychiatric disorders. We report one such effort with respect to CHRM2, which codes for the cholinergic muscarinic 2 receptor and was of interest originally for its association with alcohol dependence. We tested for association between CHRM2 and prospectively measured externalizing behavior in a longitudinal, community-based sample of adolescents, as well as for moderation of this association by parental monitoring. We found evidence for an interaction in which the association between the genotype and externalizing behavior was stronger in environments with lower parental monitoring. There was also suggestion of a crossover effect, in which the genotype associated with the highest levels of externalizing behavior under low parental monitoring had the lowest levels of externalizing behavior at the extreme high end of parental monitoring. The difficulties involved in distinguishing mechanisms of gene-environment interaction are discussed.     

Langzeituntergebrachte in der Sicherungsverwahrung

Due to the decision of the European Court for Human Rights, up to mid-2010 the courts of execution had to decide about the release of offenders who had been imprisoned for more than 10 years in preventive detention. This in fact was problematic because preventive detention was limited to a maximum of 10 years at the time of conviction. In all of these cases preventive detention persisted due the assumed high dangerousness of those affected. Regarding the 11 cases that had to be decided by the provincial High Court of Hamm, Germany in 2010, the completion of the detention has been concluded in all cases. The majority of these cases will be described briefly in order to illustrate the different case constellations which led to long-term detention. Moreover these cases serve to demonstrate the difficulties which can arise when trying to evaluate or predict future dangerousness.     

An investigation of brain processes supporting meditation

Meditation is an ancient spiritual practice, which aims to still the fluctuations of the mind. We investigated meditation with fMRI in order to identify and characterise both the “neural switch” mechanism used in the voluntary shift from normal consciousness to meditation and the “threshold regulation mechanism” sustaining the meditative state. Thirty-one individuals with 1.5–25 years experience in meditation were scanned using a blocked on–off design with 45 s alternating epochs during the onset of respectively meditation and normal relaxation. Additionally, 21 subjects were scanned during 14.5 min of sustained meditation. The data were analysed with SPM and ICA. During the onset of meditation, activations were found bilaterally in the putamen and the supplementary motor cortex, while deactivations were found predominately in the right hemisphere, the precuneus, the posterior cingulum and the parieto–temporal area. During sustained meditation, SPM analysis revealed activation in the head of nucleus caudatus. Extensive deactivations were observed in white matter in the right hemisphere, i.e. mainly in the posterior occipito–parieto–temporal area and in the frontal lobes. ICA identified 38 components including known baseline-resting state components, one of which not only overlaps with the activated area revealed in the SPM analysis but extends further into frontal, temporal, parietal and limbic areas, and might presumably constitute a combination of frontoparietal and cinguloopercular task control systems. The identified component processes display varying degrees of correlation. We hypothesise that a proper characterisation of brain processes during meditation will require an operational definition of brain dynamics matching a stable state of mind.