Garde T, Erdmann R, Sander H, Drees A
Psychiatr Prax. 1987 Jul;14(4):137-41.
Patients with "early disturbances" partly display considerable resistance to treatment methods that promote regression or aim at uncovering inhibitions, since they themselves lack emotional differentiation. In an inpatient setting such patients are able to transfer their non-experienced share of feelings and references to the treating personnel. If these transferred feelings are not properly processed and managed, therapy blockades and communication blockades arise, resulting in considerable frustrations of all concerned within the therapeutic community. Against the background of these experiences we developed a ward group method inviting both patients and staff to join hands in creative playing (e.g. by acting a fairy tale on the stage); within this framework it is possible to shape latent group, ward and team conflicts on a metaphorical level. As a result we achieve a reduction of the emotional tension level within the ward, a reduction of team conflicts, and hence an improved therapeutical climate and better possibilities to translate into reality appropriate strategies for a fair solution of problems. The overall framework, the therapeutic concept, as well as the individual stages of work-in-progress in the realisation of the fairy-tale drama are described in detail (e.g. phase of birth of the fairy tale, phase of fairy-tale recital, phase of casting, actual performance phase and subsequent discussion phase). These steps are described both as regards their form and their contents; they are compared with other group techniques of a similar nature.
患有“早期障碍”的患者部分表现出对促进退行或旨在揭示抑制因素的治疗方法有相当大的抵触,因为他们自身缺乏情感分化。在住院环境中,这类患者能够将他们未体验到的情感份额和参照转移到治疗人员身上。如果这些转移的情感得不到妥善处理和管理,就会出现治疗障碍和沟通障碍,导致治疗社区内所有相关人员产生相当大的挫败感。基于这些经验,我们开发了一种病房小组方法,邀请患者和工作人员携手进行创造性游戏(例如在舞台上表演童话故事);在此框架内,可以在隐喻层面塑造潜在的群体、病房和团队冲突。结果,我们降低了病房内的情绪紧张程度,减少了团队冲突,从而改善了治疗氛围,并增加了将公平解决问题的适当策略转化为现实的可能性。详细描述了总体框架、治疗理念以及实现童话剧过程中各个阶段的工作进展(例如童话诞生阶段、童话朗诵阶段、选角阶段、实际表演阶段和后续讨论阶段)。这些步骤从形式和内容两方面进行了描述,并与其他类似性质的小组技术进行了比较。