Tress W, Ehl M
Psychiatr Prax. 1987 Jul;14(4):115-20.
Highlighting the development of in-patient psychoanalytical therapy the insufficiency of traditional therapeutical conceptions ("out-patient psychoanalysis in the hospital", "bipolar model of in-patient psychotherapy") in view of increasing numbers of patients with ego-structural disorders in psychosomatoses and borderline pathologies become clear. Their manifold splitting tendencies toward any conceptual distinction of the psychoanalytical session with its transferential processes on the one hand and the "actual" milieu of the ward on the other hand. This fact will be taken into account only by the integrative inpatient psychoanalytical therapy which contrasts the group of patients with the therapeutical team. Only this theoretical constellation may grasp the dynamic processes which the individual patient as well as the whole group of patients but also the individual therapist and his team are undergoing. On this basis interventions will become particularly effective. - The method is illustrated by a description of the setting and a casuistry. A necessary broadening in view of the patients' environment outside the ward and of the bounds of the procedure are described. - Summing up we can say that the integrative inpatient psychoanalytical treatment for the first time provides an approach to the group of severe personality disorders which up to now could not be treated and at best were exposed to an expert rating.
随着心身疾病和边缘性病变中自我结构障碍患者数量的增加，传统治疗观念（“医院门诊精神分析”、“住院心理治疗的两极模式”）的不足凸显了住院精神分析治疗发展的必要性。患者存在多种分裂倾向，一方面是将精神分析疗程及其移情过程与另一方面病房的“实际”环境进行任何概念上的区分。只有将患者群体与治疗团队相对照的综合住院精神分析治疗才能考虑到这一事实。只有这种理论架构才能把握个体患者以及整个患者群体，还有个体治疗师及其团队所经历的动态过程。在此基础上，干预措施将变得尤为有效。——通过对治疗环境的描述和一个病例说明来阐释该方法。还描述了鉴于病房外患者环境以及治疗程序范围而有必要进行的拓展。——总而言之，我们可以说，综合住院精神分析治疗首次为严重人格障碍群体提供了一种治疗方法，这类患者迄今为止无法得到治疗，最多只能接受专家评估。
