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.     

Angststörungen bei Patienten mit implantiertem Kardioverter-Defibrillator (ICD)

Patients with an implantable cardioverter defibrillator (ICD) often show anxiety disorders as comorbid psychologycal disturbances. In a short review we discuss psychosocial aspects of the ICD-implantation. A case study of a 38 year old patient in inpatient treatment is presented for illustration of a cognitive-behavioral treatment method. The psychotherapeutic treatment was carried out in close cooperation with the clinic for cardiology.     

Fokusbezogene psychodynamische Psychotherapie

The OPD-based diagnostics allows to formulate the psychodynamically significant aspects of the unconscious conflict, of the structural limitations and of the dysfunctional relational dispositions. Considering the relative weight of the conflict- and the structural dynamics we are able to differentiate three types of disturbances: the conflict type, the structural type and the miscellaneous type. For these three types of disturbances the therapeutic consequences for setting and therapeutic attitude, for the hierarchy of the foci, and the working through of dysfunctional relational dispositions and at last for the conflict- vs. structure-related interventions are discussed. The Heidelberger Umstrukturierungsskala enables us to the focus-related documentation and evaluation of the progress and the result of the therapy.     

Freud heute

Zusammenfassung Aus Anlass des 150. Geburtstags von Sigmund Freud untersuchte der Autor in einem Festvortrag in der Universit?t München den Standort der Psychoanalyse in der gegenw?rtigen Kultur und Gesellschaft. Auf der Basis von Das Unbehagen in der Kultur und der Beobachtungen Bions in Gruppen sieht er den Einzelnen in einem Spannungsfeld zwischen individuellem und kulturellem über-Ich. Unbehagen entspringt daraus, dass die Entwicklung des Einzelnen mit den Fortschritten der Kultur nicht Schritt h?lt. Hinzu kommen die Verhei?ungen von Glück und Allmacht, die die Kultur an die Stelle Gottes gerückt hat, und die im Alltag entt?uscht werden. Die Psychoanalyse ist an der Entwicklung des Unbehagens nicht unbeteiligt. Sie strebt nach gesellschaftlicher Anerkennung und steht dadurch in Gefahr, das Unbewusste als ihr Zentrum aufs Spiel zu setzen. Ob sie überleben wird, h?ngt davon ab, ob es ihr gelingt, aus einer Randposition heraus hilfreich für den Einzelnen und die Gesellschaft zu sein.

---

Freud today

Abstract On occasion of the 150th birthday of Sigmund Freud the author elaborated the position of psychoanalysis in the present culture and society in a lecture in the University of Munich. On the Basis of Freud’s “Civilisation and its Discontents” and of Bion’s “Experiences in Groups” he regards the individual within a discrepancy and tension between the personal and the cultural superego. Discomfort arises when the development of the individual subject is no longer in line with the progresses which occur in culture. In addition, the omnipotent promises of happiness and grandiosity, by which culture has replaced God and which are disappointed in the every day life, contribute to contemporary discontents. Psychoanalysis has participated in the development of discomfort and supported it. It has aspired for cultural acceptance and attractiveness and gets by this into danger to loose the unconscious as its center. Whether it will survive depends on whether it is successful in returning to a cultural boundary position where it can be of help for both—the subject and the civilisation.

---

---

Münchener Freud-Symposion, Ludwig-Maximilians-Universit?t München, 5. Mai 2006. Aus dem Englischen übersetzt von Wolf Kohl und Michael Ermann, München. Dieser Beitrag erscheint in ver?nderter Fassung auch in Ermann M (Hrsg) Was Freud nicht wusste. Neues in der Psychoanalyse. Brandes und Apsel, Frankfurt aM (In Vorb.).