Ambivalenz in der psychiatrischen Organisation

For the past 100 years Bleuler??s ambivalence terminology has been applied to many aspects of the psychiatric treatment of patients, particularly in the realm of diagnostics and therapy. It has, however, been adopted in an approach mainly limited to psychopathological phenomena. This article discusses whether advanced concepts of ambivalence can facilitate the analysis of current challenges and problems of institutional psychiatry, placing them in a new light. It describes a wide range of psychiatry-specific ambivalence experiences by investigating the field of activity of individual therapists as well as of interdisciplinary therapeutic teams. Particular attention is given to an ambivalence-oriented perspective of clinic management taking uncertainty and complexity into consideration. In such different contexts modern ambivalence concepts give way to a psychodynamic understanding of clinical areas of conflict, thus extending the possibilities of multimodal therapy. When dealing with complex leadership and planning tasks, sensibility and tolerance towards ambivalence phenomena and conflicts prove to be unusual but valuable problem solving resources.