[Therapeutic insight and tolerance of ambiguity].
The author discusses the implications of the psychoanalytic concept of insight. He refers to it as an "action-steering utopia of the psychoanalytic process".
Biomedical subjects
Publications and source records attributed to R Hohage.
The author discusses the implications of the psychoanalytic concept of insight. He refers to it as an "action-steering utopia of the psychoanalytic process".
The initial phase and the termination phase (8 sessions each) of a psychoanalysis are compared according to changes of emotional insight. Aspects of emotional insight are investigated using contentanalytic rating scales which allow to determine the integration of emotional and cognitive aspects of experiencing. There are significant differences of insight between initial phase and termination phase. Regarding the mean scores of single sessions, we observed in the course of the initial phase a decrease of insight and of the emotional access to experiencing, that is in contrast to the changes described before. A systematic clinical description can explain the contentanalytic results. Obviously the psychoanalytic process is influenced by a complex interaction of different factors.
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For epistemological and empirical reasons, Freud's "evenly hovering attention" has to be understood as an advice that the analyst should remain open for new observation. It is a recommendation against having preconceived ideas and biases. In fact, the analyst's attention is regulated by conscious and unconscious selections. It is subject to considerable changes in the analyst's cognitive processes. His countertransference influences his attention. The patient in turn reacts consciously or unconsciously to the variations of the analyst's attention. It is therefore necessary to interpret those changes and sometimes to admit them. This recognition supports the reality testing of the patient in the analytic situation. Otherwise malign regressions or denials and other defensive processes might occur. We give an example of the changes in the "evenly hovering attention" of an analyst and their handling.
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This paper presenting clinical case material examines the conditions which have to be fulfilled in an analytic session in order for a patient to talk about memories which have so far been repressed. The examples given in this paper are taken from detailed minutes of one session. They were chosen to illustrate the effect of the analyst's decision to apply an active interpretative technique in dealing with a dream that the patient presents. The analyst names that which the dream symbolizes and which the patient does not dare to name himself. By taking such a step the analyst prepares the ground for important memories to emerge once a phase of resistance is overcome.
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This study discusses the first psychotherapeutic-oriented portion of the practical course for psychosomatics/psychotherapy which was held in seminar form in small groups. The material for the course was prepared cuts from vitiotapes of first and second therapeutic sessions conducted in a psychotherapeutic outpatient clinic. To a large extent, the initial experience tends to speak for our teaching plan which basically refrained from initially mediating theory. On the other hand, it was also necessary to cutback the original plan in an attempt to use the "countertransference reactions" of the students to better understand the patients. Special attention was given to the affective reactions of the students in the individual groups since a certain dependency on the specific teaching style of the seminar leader was to be expected. Occasionally, there was danger of overestimating the tolerance of the students to their tensions and fears. This intensified the defense reactions. The experience up until now caused us to modify our plan in a few points.
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