Die Übertragung als Matrix der Traumgenerierung

Zusammenfassung  Traum und Übertragung sind die beiden Grundpfeiler der Erkenntnis in der Psychoanalyse. Sie stammen aus einer gemeinsamen Matrix und können als zwei verschiedene Ausdrucksformen des unbewussten Denkens über die analytische Beziehung beschrieben werden. Dieser Beitrag untersucht die Frage, wie die jeweils aktive Übertragungsform sich auf die Art und Weise des Träumens auswirkt. Sie stellt zwei unterschiedliche Übertragungsmodi als Pole in einem Kontinuum dar, die mit zwei unterschiedlichen Modi des Träumens einher gehen, die wiederum mit den beiden Grundformen des Gedächtnisses — explizit bzw. implizit — verknüpft sind. Wenn die Übertragung vorwiegend prozedurales Erfahrungswissen aus dem impliziten Gedächtnis aktiviert, dann enthält der Traumbericht Zeichenträume als Hinweise auf archaische Ich-Zustände. Diese sind sind der Prototyp der niederstrukturierten Träume. Wenn die Übertragung aber außerdem Erinnerungswissen aus dem deklarativen Gedächtnis aktiviert, enthält der Traumbericht Geschichten als unbewusste Kommentare über die psychoanalytische Begegnung. Solche höherstrukturierten Träume sind vor dem Hintergrund der klassischen neurotischen Übertragung zu betrachten.

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Transference as a matrix for dream generationOn high and low structured dreams

Dream and transference are the two substantial ways in psychoanalysis towards the understanding of the unconscious. Both are rooted in a common matrix and can be regarded as two different modes of expressing unconscious thinking about the analytical relationship. This contribution studies the question of how the respectively active form of transference effects the way of dreaming. There are two different modes of transference as the poles of a continuum, which are combined with two different modes of dreaming and which in turn are connected to the two basic forms of memory — the explicit and the implicit memory. If transference mainly activates procedural information from the implicit memory, then the dream report contains sign dreams which indicate digitally computed, presymbolic archaic ego-states. Those are the prototype of lower structured dreams. If transference in addition activates information from the declarative memory, the dream report contains analogically computed, symbolic episodes as unconscious comments on the psychoanalytical encounter. Such high structured dreams are to be regarded on the background of the classical neurotic transference.

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Zum 10-jährigen Bestehen des DPG-Instituts für Psychoanalyse Frankfurt am Main am 25.11.2004.

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Ist es utopisch, sich zukünftige Psychoanalytiker ohne besondere berufliche Identität vorzustellen?

The subject of the Identity of Psychoanalysis and of its representatives belongs to the orthodox psychoanalytic movement. Since about 15 years, under the presidency of J. Sandler, the International Psychoanalytic Association (IPA) has tried successfully to facilitate scientific research and to promote projects. If the resistance of influential analysts against empirical investigations further decreases, psychoanalytic movement and its unfavourable concommitants will be past. The development to a scientific community will no longer be hampered by controversies on professional identity. The question of identity was dominated by the idea of the so-called “strict, untendentious psychoanalysis” (Freud 1909b, S. 104, 1919a, S. 168). It never existed and could never materialise—it was a fiction. The psychosocial dimensions and its normative implications call the concept of identity into question. Instead it is advisable to speak of a pychoanalytic attitude which has to prove its therapeutic value. This “second (professional) self” (Schafer 1983) is closely connected to the “first (personal) self”, but it is necessary and possible to separate the method from the person and to objectify changes in the patient even if taking place in an intersubjective, relational space. For many years Freud defined what Psychoanalysis is about and who is entitled to call himself an analyst. Later on, the psychoanalytic movement and the institutionalised training system fulfilled this role. The training analysis had been at the centre of all curricula. The genealogy of the training analyst determined the membership in the evergrowing family. Dissidents belong to the history of Psychoanalysis. The official acceptance of the pluralisms within the International Psychoanalytical Association demands comparisons between the various schools according to scientific criteria. Modern process and outcome research provides criteria suited to serve as a model for clinical treatment reports.     

Wir Kriegskinder

Roughly six decades after the end of World War II an interest in the destiny of the generations of non-Jewish Germans born during the war has arisen during the last few years. The reason for the long-lasting ignorance toward the early destiny of these war-children, at least in psychoanalytic literature, is supposed to lie in feelings of guilt as a consequence of Holocaust, and in the danger to compare incomparable destinies with each other. Conscious of that danger, the author describes these war-generations in regard to some aspects of their self experience and behaviour. He holds the opinion that the inability of the adults to mourn (Mitscherlich), based on guilt, transgenerationally led with the war-children to an inner ban of feeling themselves. This caused a perversion of the thinking in the war-baby generations by gruesome experiences being declared the normality. Survivor’s guilt and guilt felt over trauma-induced self-hatred were additional psychodynamic factors, all together leading to what he calls “war-children identity”. It is characterized by a lack of self understanding and a distance to the own feelings, a certain toughness in coping with one’s life, and social adaptation. It is based on a strangeness to oneself which results in feeling strange also to others and remaining indeed a stranger to them. The decisive step in psychoanalytic therapy implies that war-children start to accept themselves as traumatized, to give up their denial and to acquire a positive war-children identity. This essentially means to develop the ability to be concerned of oneself, to feel empathy for oneself and to gain self-esteem. The way is leading through mourning over missed life chances and is accompanied continuously by the danger to break off therapy as if everything were not that bad at all.     

Die tiefenpsychologisch fundierte Methodik in der Praxis

Depth psychologically founded psychotherapy (tfPT) is historically a method derived from psychoanalysis. It was introduced in 1967 into the scope of psychotherapy in Germany by the Psychotherapy Guidelines and has developed since then a certain autonomy. This contribution describes its methodical basis and its practical application in the context of the Psychotherapy Guidelines in Germany. A standard tfPT method for the treatment of neurotic conflict disturbances is distinguished from the modified tfPT for the treatment of developmental disturbances and posttraumatic disorders. The method is defined by several characteristics in this paper: Current psychosocial problems of the patients are worked through as re-actualised conflicts or results of structural deficiencies in their actual genetic unconscious dimension. The uncovering and working through of transference in external relationships is of special importance. The therapeutical regression is limited by the setting (one encounter per week in vis-a-vis position, limitation to 50 up to 80 sessions in total), by focusing on the psychosocial reality and by restriction of the transference. Specific intervention forms, particularly interpretations, can be combined with structure oriented interventions or eclectic techniques. The orientation at the unconscious dimension of the disturbance and at the process is the central reference point of the complete therapeutic strategy. This definition allows a clear demarcation against psychoanalytic psychotherapy. The essential difference is to be seen in the focusing on the re-actualised elements of the relevant psychodynamics and in including the external relationships into transference (“Dezentrieren”). The specific methodology requires a special education with a depth psychologically founded self experience as its core.     

Teilstationäre Psychotherapie

Psychotherapeutic day clinics increasingly take over responsibility for the treatment of patients who cannot be cared for satisfactorily, respectively, at all in an inpatient setting. Psychotherapy in a day clinic setting is a treatment in its own right which has progressively established itself between inpatient and outpatient treatment. Empirically raised up to date data prove the efficacy and the efficiency of psychotherapeutic treatment in day clinics. Accordingly, the goal of the present study is to investigate the outcomes of psychotherapeutic treatment in a day clinic with a psychodynamic concept. Since 1996 the psychotherapeutic day clinic Basel empirically assesses the treatment course of all admitted patients. Patients and therapists fill in questionnaires upon admittance, two months into the course of treatment and upon discharge (SCL-90-R, PSKB-Se-R, OPD etc.) Our results indicate that significant improvements of symptoms as well as of socio-communicative competency can be achieved during treatment which remain stable even after discharge (first follow-up three months after discharge). Comparing outcome data of patients treated in full-time inpatient setting and of patients who undergo partial hospitalization we found that outcome was at least equivalent. Additionally we found that the diagnosis of a personality disorder influenced treatment results significantly in some symptom specific spheres.     

Therapiewechsler

At least 30% of the patients, currently in psychotherapy, have been in one or more psychotherapeutic treatments before the beginnig of the actual treatment. A great number of these patients decided as a consequence of their experiences with the former therapeutic treatments to change not only the therapist but also the form of the psychotherapy. The task was to find out the reasons for this. 25 patients who had changed from one of the Guideline Therapies into a client-centred therapy (CCT) were interviewed about their reasons for this change. It was assumed, that the failing of earlier therapies was caused by a lack of matching between patient and therapist, treatment and disorder in the sense of the Generic Model of Psychotherapy (GMP) conceptualized by Orlinsky and Howard. The results support this hypotheses: For most of these patients CCT turned out to be a necessary and successful alternative to the previous treatments. Most of the patients reported that they responded better to the therapeutic offer of CCT. The reasons mentioned for choosing another form of psychotherapy support the necessity of a differential indication for psychotherapy on the basis of the GMP.     

Cross-national comparisons of complex problem-solving strategies in two microworlds

Research in the fields of complex problem solving (CPS) and dynamic decision making using microworlds has been mainly conducted in Western industrialized countries. This study analyzes the CPS process by investigating thinking-aloud protocols in five countries. Participants were 511 students from Brazil, Germany, India, the Philippines, and the United States who worked on two microworlds. On the basis of cultural-psychological theories, specific cross-national differences in CPS strategies were hypothesized. Following theories of situatedness of cognition, hypotheses about the specific frequency of problem-solving strategies in the two microworlds were developed. Results of the verbal protocols showed (a) modification of the theoretical CPS model, (b) task dependence of CPS strategies, and (c) cross-national differences in CPS strategies. Participants' CPS processes were particularly influenced by country-specific problem-solving strategies.