62nd Lindau Psychotherapy Weeks 2012: A mysterious mechanism

62nd Lindau Psychotherapy Weeks 2012: A mysterious mechanism

All intuition - or what? was the motto of the first week of the traditional scientific conference in Lindau on Lake Constance. Exciting lectures were hidden behind the somewhat flippant headline.

It is possible that intuition is currently so en vogue because it threatens to get lost in disorder-specific, manualized psychotherapy. In any case, this year in Lindau the concern of only training “reproductive therapists” was met with conscious turn to the intuitive and creative side of psychotherapy.

data of the unconscious

That intuition is an ancient human ability, that our unconscious has more data than our consciousness, so we can make complex decisions better, is undisputed. The brain researchers António Damasio and Gerhard Roth see their basis in earlier conscious and unconscious experiences. According to Damasio, intuition is "a mysterious mechanism that allows us to solve problem without thinking about it." How can intuition be used sensibly without falling into arbitrariness?

Several speakers approached the topic under the heading of “clinical view”. According to the Brockhaus Lexicon, intuition is "direct experience of facts" without intervening testing methods, as Prof. Dr. med. Gerd Rudolf, Heidelberg, carried out. This is reminiscent of the concept of evidence used by Martin Heidegger - he uses it to describe what is “glowing from within”. But for two people, different aspects of situation may shine from within, so that it is difficult or impossible for them to agree. Sometimes intuition is an expression of an attachment style. If, for example, woman in mountain village gets stuck with her car in the snow and intuitively “knows” that farmer with his tractor will free her from her predicament, that may also be “female intuition” according to Rudolf, but above all the result is more certain Attachment experiences. Rudolf is skeptical about the proximity of intuition to meditative techniques in the service of "healing". According to him, therapists should develop their own intuitive skills, but should limit themselves to the improvement of psychological symptoms and functions in treating patients.

For Rudolf, intuition is “special form of mindfulness” in which cognitive-rational and intuitive aspects are interlinked. This becomes clear using the example of the initial interview. = = "" / src alt images / d70536fe4dee562e74cc643e1cd369db.png ">

Photo: Fotolia / XtravaganT

All intuition - or what? was the motto of the first week of the traditional scientific conference in Lindau on Lake Constance. Exciting lectures were hidden behind the somewhat flippant headline.

It is possible that intuition is currently so en vogue because it threatens to get lost in disorder-specific, manualized psychotherapy. In any case, this year in Lindau the concern of only training “reproductive therapists” was met with conscious turn to the intuitive and creative side of psychotherapy.

data of the unconscious

That intuition is an ancient human ability, that our unconscious has more data than our consciousness, so we can make complex decisions better, is undisputed. The brain researchers António Damasio and Gerhard Roth see their basis in earlier conscious and unconscious experiences. According to Damasio, intuition is "a mysterious mechanism that allows us to solve problem without thinking about it." How can intuition be used sensibly without falling into arbitrariness?

Several speakers approached the topic under the heading of “clinical view”. According to the Brockhaus Lexicon, intuition is "direct experience of facts" without intervening testing methods, as Prof. Dr. med. Gerd Rudolf, Heidelberg, carried out. This is reminiscent of the concept of evidence used by Martin Heidegger - he uses it to describe what is “glowing from within”. But for two people, different aspects of situation may shine from within, so that it is difficult or impossible for them to agree. Sometimes intuition is an expression of an attachment style. If, for example, woman in mountain village gets stuck with her car in the snow and intuitively “knows” that farmer with his tractor will free her from her predicament, that may also be “female intuition” according to Rudolf, but above all the result is more certain Attachment experiences. Rudolf is skeptical about the proximity of intuition to meditative techniques in the service of "healing". According to him, therapists should develop their own intuitive skills, but should limit themselves to the improvement of psychological symptoms and functions in treating patients.

For Rudolf, intuition is “special form of mindfulness” in which cognitive-rational and intuitive aspects are interlinked. This becomes clear using the example of the initial interview.The opening scene and psychodynamics, for example, require intuition, while capturing the clinical symptoms tends to require “judging, distanced response”. This is surprising: according to studies, the personality trait “emotionally distant” is clearly correlated with the ability to intuition. Rudolf suspects the psychological mechanism of "projective identification" here.

"Container" concept

Dr. Annemarie Laimböck, Innsbruck, asked whether so-called early disturbances, i.e. memories that have not yet been promised, are accessible to intuitive recording and refers to Wilfred Bion's “container” concept. The therapist's task here is to offer himself as “container” with the help of which unconscious, “raw” parts can be digested. In contrast to later “neurotic” disorders, there is no ego as director, “sense” is initially not discernible. With the help of language, diffuse, undirected force finally becomes “force that knows somewhere”. For Laimböck, intuition is nothing metaphysical, but rather "mind game that is based on perceptions", i.e. ultimately hermeneutic procedure.

Dr. med. Claudius Stein from the crisis intervention center in Vienna referred to the Chinese character for “crisis”, which is made up of the characters for “danger” and “opportunity”. When accompanying people in crisis situations, intuition plays an essential role as “quick cognition”. Here therapists are regularly reliant on making decisions, even though they do not have all the necessary variables at their disposal. This is also where the limits of intuition become apparent. Like any other cognitive process, it can be wrong. Unreflected size and saving fantasies, prejudices, the overlook of problematic transference and countertransference phenomena, personal stress, fear and concern after patient's suicide, as well as personal values ​​influence perception and intuition. According to Stein, the “ideology of the facility” also plays role: if, for example, it is important to prevent suicide in any case, in case of doubt, patient is more likely to be admitted to hospital and not trusting his intuition, which may make outpatient support justifiable lasts.

In 1983 Philip Goldberg summarized the different phases of intuition as follows: A "lightning-like understanding" is followed by "creative impulse", from which, after being "attracted to certain option", an "impulse to act" results. Prof. Dr. phil. Martin Grosse Holtforth, Zurich, points out that the five phases of intuition according to Hans Welling (2005) find their equivalent in model of cognition.The opening scene and psychodynamics, for example, require intuition, while capturing the clinical symptoms tends to require “judging, distanced response”. This is surprising: according to studies, the personality trait “emotionally distant” is clearly correlated with the ability to intuition. Rudolf suspects the psychological mechanism of "projective identification" here.

"Container" concept

Dr. Annemarie Laimböck, Innsbruck, asked whether so-called early disturbances, i.e. memories that have not yet been promised, are accessible to intuitive recording and refers to Wilfred Bion's “container” concept. The therapist's task here is to offer himself as “container” with the help of which unconscious, “raw” parts can be digested. In contrast to later “neurotic” disorders, there is no ego as director, “sense” is initially not discernible. With the help of language, diffuse, undirected force finally becomes “force that knows somewhere”. For Laimböck, intuition is nothing metaphysical, but rather "mind game that is based on perceptions", i.e. ultimately hermeneutic procedure.

Dr. med. Claudius Stein from the crisis intervention center in Vienna referred to the Chinese character for “crisis”, which is made up of the characters for “danger” and “opportunity”. When accompanying people in crisis situations, intuition plays an essential role as “quick cognition”. Here therapists are regularly reliant on making decisions, even though they do not have all the necessary variables at their disposal. This is also where the limits of intuition become apparent. Like any other cognitive process, it can be wrong. Unreflected size and saving fantasies, prejudices, the overlook of problematic transference and countertransference phenomena, personal stress, fear and concern after patient's suicide, as well as personal values ​​influence perception and intuition. According to Stein, the “ideology of the facility” also plays role: if, for example, it is important to prevent suicide in any case, in case of doubt, patient is more likely to be admitted to hospital and not trusting his intuition, which may make outpatient support justifiable lasts.

In 1983 Philip Goldberg summarized the different phases of intuition as follows: A "lightning-like understanding" is followed by "creative impulse", from which, after being "attracted to certain option", an "impulse to act" results. Prof. Dr. phil. Martin Grosse Holtforth, Zurich, points out that the five phases of intuition according to Hans Welling (2005) find their equivalent in model of cognition.A “perception” is followed by “dichotomous awareness”, which can be verbalized through sentences such as “Something is wrong” and “The solution is near”. This is followed by specific “object reference” and “metaphorical solution”. Ultimately, an “explicit verbal understanding” results. Using the example of man who talks about his relationship with his wife in therapy, Grosse Holtforth showed the object reference “marriage”, followed by the metaphorical solution “prison”. Only in the fifth phase can the problem be explicitly verbalized. Information and accuracy therefore increase over the course of the phases.

Positive mood favorable

All speakers agreed that experienced people benefit more from intuition than beginners and that intuition can be trained. It is best used if one applies rational-analytical and intuitive thinking flexibly (Caspar 1997). A positive mood improves intuition, because then weak associations are also accessible to consciousness (Bolte et al. 2003). People with alexithymia (difficulty identifying their own feelings) also struggle with intuition. But the more people trust their intuition, the more they are “at peace” (Jordan et al. 2007).

Intuition as special form of mindfulness is also helpful in the treatment of traumatized patients. 15 years ago he gave lecture on post-traumatic stress disorder and trauma therapy for the first time in Lindau, reported Prof. Dr. med. Ulrich Sachsse, Göttingen. Since then, the “trauma” concept has been booming. Sachsse and Priv.-Doz. Dr. med. Martin Sack, Munich, asked about new findings and fruitful controversies. At the beginning there is an attempt to clarify the concept: not every danger to life is trauma, but rather challenge for our stress management systems, i.e. flight or fight and the ability to bond. Every threat activates our “prime memory” and leads to sensitization: In similar situations, we react quickly with increased vigilance.

According to Sack, there is actually no trauma therapy because the trauma cannot be treated. He advocated the somewhat cumbersome, but more precise term, trauma treatment. Because this therapy has little to do with the past and lot to do with the present. Memories are always present reconstructions - the aim of treatment is therefore present “adaptive reconstructions”. Based on Thomas Hensel's stressor-based concept of the etiology of mental disorders, mild stressor in “stress-trauma continuum” leads to an adjustment disorder, severe one to post-traumatic stress disorder and very severe one to “complex trauma-related disorder”. But whether you need these terms is controversial.A “perception” is followed by “dichotomous awareness”, which can be verbalized through sentences such as “Something is wrong” and “The solution is near”. This is followed by specific “object reference” and “metaphorical solution”. Ultimately, an “explicit verbal understanding” results. Using the example of man who talks about his relationship with his wife in therapy, Grosse Holtforth showed the object reference “marriage”, followed by the metaphorical solution “prison”. Only in the fifth phase can the problem be explicitly verbalized. Information and accuracy therefore increase over the course of the phases.

Positive mood favorable

All speakers agreed that experienced people benefit more from intuition than beginners and that intuition can be trained. It is best used if one applies rational-analytical and intuitive thinking flexibly (Caspar 1997). A positive mood improves intuition, because then weak associations are also accessible to consciousness (Bolte et al. 2003). People with alexithymia (difficulty identifying their own feelings) also struggle with intuition. But the more people trust their intuition, the more they are “at peace” (Jordan et al. 2007).

Intuition as special form of mindfulness is also helpful in the treatment of traumatized patients. 15 years ago he gave lecture on post-traumatic stress disorder and trauma therapy for the first time in Lindau, reported Prof. Dr. med. Ulrich Sachsse, Göttingen. Since then, the “trauma” concept has been booming. Sachsse and Priv.-Doz. Dr. med. Martin Sack, Munich, asked about new findings and fruitful controversies. At the beginning there is an attempt to clarify the concept: not every danger to life is trauma, but rather challenge for our stress management systems, i.e. flight or fight and the ability to bond. Every threat activates our “prime memory” and leads to sensitization: In similar situations, we react quickly with increased vigilance.

According to Sack, there is actually no trauma therapy because the trauma cannot be treated. He advocated the somewhat cumbersome, but more precise term, trauma treatment. Because this therapy has little to do with the past and lot to do with the present. Memories are always present reconstructions - the aim of treatment is therefore present “adaptive reconstructions”. Based on Thomas Hensel's stressor-based concept of the etiology of mental disorders, mild stressor in “stress-trauma continuum” leads to an adjustment disorder, severe one to post-traumatic stress disorder and very severe one to “complex trauma-related disorder”. But whether you need these terms is controversial.Do you understand the borderline-type emotional unstable personality disorder better if you view it as complex trauma-related disorder? Although 60 to 90 percent of borderline patients show trauma, causality is not generally accepted. This may be because it cannot be an “if-then” relationship, as 80 percent of people who were sexually abused in their childhood do not have borderline personality disorder. As expected, the diagnoses borderline personality disorder and complex trauma-related disorder overlap by about 80 percent. The characteristics “violent anger” and “unstable relationships” contribute to the differentiation. They are typically found in borderline patients, while they are not found in people with complex trauma-related disorders. In contrast, somatoform physical complaints, lack of future prospects and loss of basic convictions are more likely to be found in people with complex trauma-related disorders.

What's new in treatment? According to Sachsse and Sack, the classic phase model of psychotrauma therapy consisting of stabilization, confrontation and integration is outdated. A new model contains both from the start - “stabilization through confrontation and confrontation through stabilization”. This combination proves to be the most effective in comparison with stabilizing and supportive as well as confrontational and supportive treatment (Cloitre et al. 2010). It is disputed when to start confrontation. The speakers recommend “gentle confrontation based on everyday situations”. The prerequisite for successful treatment is the “willingness to learn to treat yourself and others with care”. The sufferer's ability to suffer is an essential prognostic factor. Sachsse sees suffering as human condition and not symptom that must be treated away at any cost. Treatment reaches its limits when external stress factors or bitterness and hopelessness persist, or when those affected struggle above all for recognition and compensation. According to Sack, “significant improvement in everyday functionality” is usually achieved after about year.

Intuition plays an essential role in painting and art, music and poetry therapy. Prof. Dr. Dr. According to Ingrid Riedel, Konstanz, intuition means “asking the right questions”. It is "phenomenon of resonance and feeling for the coherence of an atmosphere, even if not all information is available yet".Do you understand the borderline-type emotional unstable personality disorder better if you view it as complex trauma-related disorder? Although 60 to 90 percent of borderline patients show trauma, causality is not generally accepted. This may be because it cannot be an “if-then” relationship, as 80 percent of people who were sexually abused in their childhood do not have borderline personality disorder. As expected, the diagnoses borderline personality disorder and complex trauma-related disorder overlap by about 80 percent. The characteristics “violent anger” and “unstable relationships” contribute to the differentiation. They are typically found in borderline patients, while they are not found in people with complex trauma-related disorders. In contrast, somatoform physical complaints, lack of future prospects and loss of basic convictions are more likely to be found in people with complex trauma-related disorders.

What's new in treatment? According to Sachsse and Sack, the classic phase model of psychotrauma therapy consisting of stabilization, confrontation and integration is outdated. A new model contains both from the start - “stabilization through confrontation and confrontation through stabilization”. This combination proves to be the most effective in comparison with stabilizing and supportive as well as confrontational and supportive treatment (Cloitre et al. 2010). It is disputed when to start confrontation. The speakers recommend “gentle confrontation based on everyday situations”. The prerequisite for successful treatment is the “willingness to learn to treat yourself and others with care”. The sufferer's ability to suffer is an essential prognostic factor. Sachsse sees suffering as human condition and not symptom that must be treated away at any cost. Treatment reaches its limits when external stress factors or bitterness and hopelessness persist, or when those affected struggle above all for recognition and compensation. According to Sack, “significant improvement in everyday functionality” is usually achieved after about year.

Intuition plays an essential role in painting and art, music and poetry therapy. Prof. Dr. Dr. According to Ingrid Riedel, Konstanz, intuition means “asking the right questions”. It is "phenomenon of resonance and feeling for the coherence of an atmosphere, even if not all information is available yet".

Christof Goddemeier

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