Time for change
Basic thoughts on psychotherapy research
This paper deals with the topical controversy over the prevailing research paradigm in psychotherapy. To that end, the relevance of the concept of man, the relation between symptom and person, the problem of comorbidity and the purpose of manualized psychotherapy will be examined. The randomized controlled trails (RCTs), which are still accepted as best practice today, turn out to be insufficient when dealing with the complex field of psychotherapy research. Hence, they should be rejected. Along with the principles of practice-based evidence, a naturalistic research design (effectiveness studies) combining different methodological approaches, is deemed to be indispensable for future research on psychotherapy.
Key words: psychotherapy research, practise-based evidence, effectiveness study, RCT, EST
Four phenomenal categories – Concept of a phenomenological heuristic
Phenomena are experienced through their aspects and in their meanings. In this article an interaction of perceived aspects and realized meanings is describes, enabling the differentiation of four categories for the manner a phenomenon appears: representation, symbol, illusion and chaos. As a heuristic concept, this systematization could contribute to a better understanding of disorders concerning the perception of the “outer” and “inner” world. This should support a phenomenological approach in psychotherapy.
Key words: phenomenology, representation, symbol, illusion, chaos
Encounter with nothingness – Inner emptiness and addiction
Elsbeth Kohler, Johannes Rauch, Oliver Bachmann
Newest neurophysiologic knowledge of inner emptiness is presented in this article, followed by an existential analytical approach towards the phenomenon. The connection between inner emptiness and addiction, as well as its inpatient treatment are described. Therapeutic treatment bases both on newest results of research in neurobiology and on the fundaments of existential analysis. Personal relationship and the methods of existential analysis constitute the basis for the methods of trauma therapy, dialectical behavior therapy, and addiction treatment.
Key words: inner emptiness, personality disorder, treatment
“And heroin cloaked her in a protective mantle”
Trauma and Addiction – a case vignette
By means of a case vignette the intertwining of post-traumatic stress disorder and addiction is described in pathology and treatment. The treatment of PTSD and addiction must be well coordinated in order to prevent them from destabilizing one another. Phenomenological procedure and addiction treatment with trauma therapy were combined in this case. The addictive substance heroin appears in the function of a life sustaining coping strategy in the case vignette.
Key words: in-patient addiction treatment, trauma therapy, existential analysis, case vignette
Short-term therapy in addiction aid work – a case report
Inpatient alcohol addiction treatment
The purpose of this study is to present a facility for the treatment of alcohol addiction and pharmacomania and a specific short-term psychotherapy (existential analysis) used therein. Their specific understanding of addiction is described and the theoretical approach in practical psychotherapeutic work is shown and subsequently reflected by means of a case description. Psychotherapeutic inpatient treatment gives special attention to a multidisciplinary approach, by integrating medical, creative-, ergo- and socio-therapeutic propositions.
Key words: Existential analysis, short-term therapy, psychotherapeutic inpatient treatment, therapy of addictions
Achievement, drinking and nothing else. Or something else after all?
It is known that alcoholics need a solid crisis to undergo detoxification treatment. The following case study describes a therapy proceeding through two phases. In the first phase the fundamental motivations where primarily worked on, but at that time in was not possible to take a position yet. An interruption in therapy then followed, in which an even greater crisis came up than the one which led to detoxification. This prompted the patient towards confrontation. In the second phase of therapy, an authentic position could be achieved, which finally led to content abstinence.
Key words: alcohol addiction, fundamental motivations, grieving process, taking position
Substance abuse as co-morbid disorder
The present article deals with the problem connected to substance abuse as co-morbid disorder. It focuses on the influence of psychoactive substances on development, course and treatment of mental disorders. In concrete terms, the question being looked into here is, in which patients in common psychiatric and psychotherapeutic practices substance abuse as co-morbid disorder develops within the period of one year, and which substances are abused. Case descriptions link the abuse to the patient’s personal history. They serve to illustrate the problematic and enable understanding of derived therapeutic approaches.
Key words: substance abuse as co-morbid disorder, case descriptions, substance abuse
Bulimia – the deceived promise
Phenomenological understanding and existential approach
Alfried Lӓngle, Barbara Jöbstl, Ruth Kathan-Windisch, Claudia Klun, Silvia Längle, Christa Lopatka, Christian Probst, Michaela Probst †, Daniel Trobisch, Paul Wyckoff, Hans Zeiringer
In accordance with the personal orientated procedure of existential analysis, the approach towards bulimia is attempted by phenomenology, which means with reference to the essence on the experiential level. Therein bulimia shows as symptom of a double existential deficiency: on the one hand, a lack of turning towards oneself (corresponding to the second existential fundamental motivation), and on the other hand, bulimia seems to derive from difficulties in finding and retaining the self, and the linked necessity of setting one`s borders. Therefore, in accordance with the third existential fundamental motivation, access to that what is one`s own (being oneself as a person) is aggravated. – Following a description of the psychological significance of eating, a bridge is established to eating (and vomiting) as a means for easing the characteristic bulimic pathology. In this context, bulimia also proves to be a manifestation of specific personal process blockades. Psychopathogenetically, bulimia occurs within diffuse and disappointing relationships, in which rejection, packaged as turning towards, is seen as the specific source of distress. – In conclusion, therapeutic approaches deriving from this phenomenological understanding are presented.
Key words: Existential Analysis, phenomenology, bulimia, existential fundamental motivations
From an empty plate towards a covered table
Following a brief overview of eating disorders (without reference to adipositas) a case history and therapy of a client suffering from bulimia nervosa (Ess-Brech-Sucht) is described. Even though illness started with anorexia nervosa and anorexic phases repeatedly occurred, the focus lies on the current and dominant diagnosis „Ess-Brech-Sucht“. Sequences of sessions and interventions elucidate the therapeutic work. In summary, origin and effects of the disorder are described, and co-morbidities such as compulsion and depression examined.
Key words: eating disorders, fundamental motivations, PEA
Feelings don‘t kill
In this contribution a phenomenological path is described for extricating painful feelings from inertia allowing them to flow once again. Such “emotional thawing” renders it possible to deal with the underlying pathology. This kind of work makes it obvious, that the person – the personally own – only becomes visible when the experienced and experience are connected.
Key words: eating disorder, case report, phenomenology, emotion
Existential analytical teamwork on personality-development and self-help for eating disorders
The following contribution subdivides into two chapters which build upon one another thematically. The first part provides a theoretical outline of existential causes of eating disorders, serving as a basis for a better understanding of this illness. With this in mind, the second, practical part of the essay deals with carrying out the teamwork on personality-development and self-help for eating disorders.
Key words: eating disorders, teamwork, fundamental motivations
What is “borderline”?
Lucio Demetrio Ragazzo, Alfried Längle
The nosologic definition of the borderline syndrome is in many ways problematic due to the respective classificatory perspective. Therefore, the most relevant forms of description are summoned (the structural, the categorical, the dimensional and the aetiopathogenetical), and their points of views are critically examined. Further, main concepts of Psychoanalysis, Cognitive behavioral therapy, and Existential Analysis are delineated. In conclusion, subjective accounts of borderline patients respectively their partners are presented.
Key words: pathology, borderline disorder, classification, psychopathogenesis, Existential Analysis
Disorders of the self of children at pre-school age
This article deals with the causes of the affinity of conflicts of pre-school children and firstly provides a phenomenological description of conflict-laden interpersonal relationships between pre-school children (aggressiveness, sensitivity, shyness, demonstrative behavior). Subsequently, a connection is established between the educational methods of the parents (values in the education, style of upbringing) and the different forms of conflict-laden relationships.
Key words: relationship, dialogue, empirical research, person, disorder of self
Analysis of the phenomenon of forgiveness
Phenomenological access to research of experience: Individual case studies and method of empirical-phenomenological research
Svetlana W. Krivtsova
In this article, different cases of existential analytical therapy of wounds caused by offence are described. The analysis enables the observation of certain aspects of the phenomenon of forgiveness. The phenomenon is also delineated according to A. Längles point of view. For sake of compa rison, an overview of research approaches towards the phenomenon of forgiveness as well as their results by means of phenomenological interviews with American psychologists such as Row et al. and Fow is presented.
Key words: empirical-phenomenological research, case studies, phenomenology, forgiveness
Living today. Existence within the horizon of time
Human existence is bound to time which depicts itself in our experience as something passed, something present and something in the future.
We live in development and change over the course of time and cannot avoid acting according to time in all issues of daily life. Time is the medium of our being: In it we unfold our essence which gains concrete shape in all references to the world and to time.
Within the horizon of time we confront the existential question of meaning about the wherefore and whither, which, in awareness of finitude, often demands a course-setting and decisive response.
But because we are solely capable to arrange our lives in the presence, we are challenged to perceive, select and realize the essential and valuable of each situation.
It is only today, with our life as we live it, that we can answer the question concerning what we want to stand up and be here for.
Key words: lived time, acceleration, boredom, fear, finitude, kairós, presence, existence
I will succeed – calm and relaxed
On the topic test anxiety in preparation for A-level exams
Many pupils suffer from anxiety within the context of their schooling. Some of them find it particularly frightening when the A-level exam season approaches. Being able to share experience on “exam nerves” assisted by different methods with a group of like-minded pupils, brings relief and offers possibilities for problem-solving.
The article outlines the course of A-level preparation seminars (six meetings), in which the pupils learn to understand themselves better in their dealing with fears.
Key words: (examination-) anxiety, adjuvant methods, Theme Centered Interaction