No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
The initial interview in psychotherapy. (Trans H. F. Bernays).
Abstract
The initial interview is seen as an important tool in the evaluation of directions for treatment, the formulation of specific methodology, and the assessment of prognosis. The first contact with the client is depicted as a kind of rehearsal that provides the therapist with the opportunity to integrate objective, subjective, and situational information from the patient so as to form a new gestalt. A conceptual framework and techniques allowing for maximal utilization of the initial contact are presented from a psychoanalytic orientation for use by both experienced practitioners and students of psychotherapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
From the very first moment of the initial interview to the end of a long course of psychoanalysis, the unconscious exchange between analysand and analyst, and the analysis of the relationship between transference and countertransference, are at the heart of psychoanalytic work. Drawing on initial interviews with a psychosomatically and depressively ill student, a psychoanalytic understanding of initial encounters is worked out. The opening scene of the first interview already condenses the central psychopathology - a clinging to the primary object because it was never securely experienced as present by the patient. The author outlines the development of some psychoanalytic theories concerning the initial interview and demonstrates their specific importance as background knowledge for the clinical situation in the following domains: the 'diagnostic position', the 'therapeutic position', the 'opening scene', the 'countertransference' and the 'analyst's free-floating introspectiveness'. More recent investigations refer to 'process qualities' of the analytic relationship, such as 'synchronization' and 'self-efficacy'. The latter seeks to describe after how much time between the interview sessions constructive or destructive inner processes gain ground in the patient and what significance this may have for the decision about the treatment that follows. All these factors combined can lead to establishing a differential process-orientated indication that also takes account of the fact that being confronted with the fear of unconscious processes of exchange is specific to the psychoanalytic profession.
Examined how much of a consultation case needs to be coded before reliable and accurate estimates of interactionally defined variables are obtained. 10 behavioral consultation cases were coded according to the L. E. Rogers and R. V. France (1975) coding system incorporating W. P. Erchul's (see record
1988-21534-001) modifications. Values for 10 consultants and 10 consultees on the variables dominance and domineeringness were calculated for 12 time samples. Three sampling plans were judged acceptable for dominance, and 9 for domineeringness. For the variables examined, coding only the initial interview proved a viable sampling strategy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Development of therapeutic relational skills is a relatively neglected area of medical education. Conventional teaching techniques are mostly unsuitable for the realization of experience-based learning.
To develop a training method which enables lived self-experiences of the therapeutic relationship in class. To help students understand that illness and the doctor-patient relationship are integrated in the network of life histories and other relationships.
Our Integrated Performative Action Method is based on the elaboration of a short story of an illness in a student group. Through the 5 phases of the process, students write their own version of the story, build up characters, scenarios and enact the play. We have tested the method with 6 groups of students (n = 70) in a 10-week course. Video-recordings and minutes of sessions were analysed by two independent observers.
Through elaborating the characters and playing the roles, students could speak about their own problems and act out feelings in the name of the characters. All groups had strong involvement throughout the process.
The method helps to experience the ways in which therapeutic relationships and professional identities are constructed, reflected upon and communicated in a group of medical students.
What happens when the analyst has the impression of being annihilated by the patient? Analysts have a tendency to use more general, i.e. simplifying, constructions such as destructiveness, psychosis or death instinct as explanatory models. In the authors' view, these constructions in the end evade rather than mirror clinical reality. More recent research points to promising possibilities of differentiation, e.g. psychotic mechanisms which are--as yet undiscussed--based on Freud's notion of the partial 'rent in the relation between ego and external world'. These findings emphasize the restitutive function of a symptom or disturbance, i.e. destruction of a relationship which hinders the therapeutic process and which is not understood initially, instead of solely stressing the destructive meaning in a tabooing gesture. The concept of performance attempts to replace simplifying models with a discriminant process, and will be preliminarily defined and explained in delineation to terms already in use such as acting out, enactment, and role responsiveness. The authors explore the question of how the perception of unthought certainty in the performance can either be recognized as a blueprint, i.e. organizing activity, or as the destruction of the relationship so that a new one can emerge. The evidence from a detailed clinical example shows that many treatments can fail at this point and demonstrates how an understanding of performance in this sense offers a chance for integrating processes that otherwise impede treatment.
ResearchGate has not been able to resolve any references for this publication.