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Biomedical subjects

H Willenberg

Publications and source records attributed to H Willenberg.

6 recordsLinked to original sources
PubMed1998

[Coping with illness in myasthenia gravis in comparison with other chronic neuromuscular diseases].

Seventy-nine patients with chronic neuromuscular diseases were examined by psychodiagnostic tests. The most frequently used coping strategies were "compliance and confidence in the physician", "self encouragement", "to relative by comparison" and "problem-solving". Comparison of the test sample and our total sampling group and the groups divided by diagnosis showed more common features than differences in the coping process. This might be caused by similar general problems in chronic diseases. Less "compliance and confidence in the physician" was the only significant difference between the myasthenic patients and the remaining test group. We supposed less treatment possibilities and/or longer duration of illness (remaining test group) to be responsible for this result. Duration of illness in common seems to have an influence on coping. Patients suffering a longer illness showed reduced values in "self encouragement". Common and specific problems and circumstances of illness seem to be more significant for the coping process than the diagnosis. The patients' mood, which we took as a measure for partial aspects of adaptivity of coping, correlated significantly with the strength of the complaints felt. Classification into adaptive and maladaptive coping forms is not possible.

Adaptation, Psychological↗
PubMed1994

Countertransference in factitious disorder.

In the treatment of patients with factitious disorder it is important to realize that at various levels of their experience these patients are more intimate with death than with life. This requires a particular awareness of resistance mechanisms to countertransference as well as of the importance of clinical procedures, in particular with regard to superego analysis. A requirement for establishing a psychotherapeutic alliance with patients suffering from factitious disorder is a high degree of 'therapeutic eros', hope and trust in one's own capabilities. The emphasis on a 'biophile attitude' does, however, involve the danger that the destructive potential, fantasies of death or killing, but above all feelings of guilt and shame are euphemistically interpreted and played down. A supportive superego analysis is viewed by the patient as playing down her or his 'terror of conscience' and a sense of being left alone. The therapist can be of greater help to the patient by focusing on his or her need and by escorting him or her. This requires that the therapist accept the feelings of relentlessness and hopelessness experienced by the patients in her- or himself. By relinquishing the denial of death-directed tendencies, the therapist is able to establish normality, reality and structure, and is thus in a position to exert a stabilizing effect, initially on her- or himself, but frequently also on the patient, for whom new horizons open.

Adult↗
PubMed1994

[The Repertory Grid as a research instrument in inpatient psychotherapy. Possibilities of semantic construct analysis in patients with psychogenic pain].

The Repertory Grid Technique provides a differential analysis of individual constructs ("hypotheses"), by which we structure the perception of our environment. In our study we investigated 35 psychogenic chronic pain patients at beginning and end of inpatient psychotherapy, whether semantic changes occurred in their construct system. We analysed these semantic changes using a categorial system, which was developed by Landfield (1971). This categorial system consists of 22 different categories, at which a rating system (by use of a manual) evaluates the appropriate semantic attachment of constructs of an individual repertory grid to these categories. Our study shows that contrary to our expectation psychogenic pain patients comparatively often described themselves with constructs, which expressed direct social interactions or emotions. However, this finding must be interpreted with some reservation, as our patient group probably is not representative for most of the chronic pain patients, which usually are hardly to motivate for inpatient (respectively outpatient) psychotherapy. Finally we investigated the semantic changes of the construct system during the course of inpatient psychotherapy--here we assume that the conceptualization of own theory guided categories will provide more clinically relevant or perspective results compared to the original category system of Landfield.

Adult↗
PubMedDate not supplied

[ "Weight phobia". A discussion of the problem of "atypical" and "not otherwise specified" eating and weight disorders].

A number of authors have stated that the problem of classifying patients whose diagnosis does not meet all the criteria of anorexia and bulimia nervosa has not been satisfactorily solved. The question has been asked if it is justified to regard characteristics like "weight phobia" or body image disturbance as valid diagnostic criteria. In the present study the differences observed in three groups of patients with eating and weight disorders (anorexia: n = 42; bulimia: n = 29; atypical group without "weight phobia": n = 14) were compared using the Giessen-Test. The atypical group was shown to be significantly more "tractable" on scale 2 than the main groups, which achieved a higher score on "dominance". Significant differences between the atypical group and the "uncontrolled" group of patients with bulimia were noted for scale 3, with the atypical group showing comparable results to those recorded in the anorexic group on "compulsiveness". The authors discuss the significance of the results under an epistemological aspect. The description and classification of clinical phenomena which is based on the clinical manifestation of the disorder independently of theoretical concepts is therefore indispensible for realising a uniform basis for communication by researchers worldwide. Equally indispensible is the differentiation or "extension" of the classification to allow a more detailed systematic categorisation guided along specific theoretical concepts. This requires the operational definition of psychopathological and psychodynamic criteria as, e.g. "the struggle for identy" or the "relentless pursuit of thinness". The experiences with the OPD (Operationalized Psychodynamic Diagnosis; 1996) have shown this to be a difficult but viable approach.

Anorexia↗
PubMedDate not supplied

[Classification of secret self-injury behavior and development of an alternative proposal].

The existing efforts towards a classification of autodestructive behaviors are critically discussed. In this context the nowadays usual method of operationally defining clinical appearances is confronted with the traditional method of psychopathological phenomenology. Starting from this point of view the author suggests an alternative pattern for the classification of factitious disorders.

Factitious Disorders↗