Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Faculty of Medicine, University Leipzig, Leipzig, Germany.
Psychopathology. 2022;55(3-4):143-155. doi: 10.1159/000522345. Epub 2022 Mar 15.
The COVID-19 pandemic and the measures to protect the physically vulnerable may disproportionately affect people with mental health vulnerabilities, who receive psychotherapeutic inpatient treatment, as many of these measures impact the (inter)subjective space crucial to psychotherapy.
We investigate how people with pre-existing mental health conditions and healthcare professionals experienced changes linked to the COVID-19 pandemic.
During the first COVID-19 outbreak and lockdown in spring 2020, we conducted semi-structured interviews with patients and healthcare professionals at a clinic for psychosomatic medicine in Germany and analyzed them following the principles of descriptive phenomenology focusing on social interactions, intersubjectivity, and the therapeutic space.
We conducted a total of >30 h of interviews with 19 patients and 17 healthcare professionals. Analyses revealed that the COVID-19 pandemic and the related measures have led to a sudden loss of a sense of normality. Participants experienced changes in the perception of time, space, self, and embodied interaction with others, resulting in a profound feeling of alienation and "unhomeliness" which seemed to magnify pre-existing psychopathology. The inpatient psychotherapeutic environment provided safety by offering spatial and temporal structures and opportunities for social interaction, supporting people to find new ways to be in a changed world.
Our study shows that despite the threat of infection, it is vital to continue to provide people with psychological vulnerabilities with a safe therapeutic space in which to regain a sense of safety in a changed world. This is particularly important, as those people seem to suffer intensely from the collateral measures of a pandemic.
COVID-19 大流行和保护身体脆弱人群的措施可能会不成比例地影响到有心理健康脆弱性的人，他们接受心理治疗住院治疗，因为这些措施中的许多措施都会影响到对心理治疗至关重要的（主体间）空间。
我们调查了有预先存在的心理健康状况的人和医疗保健专业人员如何经历与 COVID-19 大流行相关的变化。
在 2020 年春季 COVID-19 爆发和封锁期间，我们在德国的身心医学诊所对患者和医疗保健专业人员进行了半结构化访谈，并按照关注社会互动、主体间性和治疗空间的描述现象学原则对其进行了分析。
我们共对 19 名患者和 17 名医疗保健专业人员进行了 >30 小时的访谈。分析表明，COVID-19 大流行和相关措施导致了正常感的突然丧失。参与者经历了时间、空间、自我和与他人身体互动的感知变化，导致了一种深刻的异化和“不适居”感，这似乎放大了预先存在的精神病理学。住院心理治疗环境通过提供时空结构和社交机会提供了安全性，帮助人们在一个变化的世界中找到新的生存方式。
我们的研究表明，尽管存在感染的威胁，但继续为有心理脆弱性的人提供一个安全的治疗空间，在这个空间中重新获得在一个变化的世界中的安全感是至关重要的。这一点尤为重要，因为这些人似乎会因大流行的附带措施而遭受强烈的痛苦。
