Rodhe-Dachser C
Psychiatr Prax. 1979 Nov;6(4):183-94.
The essay outlines the strained situation in which psychotherapeutic training in the Psychiatric Clinic nowadys takes place. First, the official training rules for the intending psychotherapist in the Psychiatric Clinic of the Medical School, Hannover, are described. By that, a series of general structural problems is delineated, which influence the organization of the training in psychotherapy within the broader frame of psychiatry and its different institutions, especially its integration into a hospital with a predominantly social-Psychiatric orientation: Admission of candidates according to the criterion of clinic membership (instead of personal qualification); limitation of the instruction period according to the time of clinic membership (at most three or four years); therefore early start of psychotherapeutic treatment with generally rather difficult, severely disturbed patients; treatment with modified psychoanalytic procedures, which in general presuppose an experience in psychoanalytic treatment of many years; self-experience usually in a psychoanalytic group, without own experience with a therapeutic face-to-face-relation and the therapeutic regression possible in this dyade; finally the strain--felt as a conflict by many candidates--between the pressure for action in the daily practice of social psychiatry, and the rather temporizing and permissive attitude of the psychotherapist, where the reflection of action is most important. The theoretical teaching of psychotherapy as well as supervision have to respond to these structurally defined conditions. The essay describes the hitherto existing experiences in the Psychiatric Clinic of the Medical School, Hannover, in Regard of the difficulties, but also the changes of the transfer of psychotherapeutic theories and methods to psychiatrists and--perhaps--physicians in general. It demonstrates, too, some possible attempts for practicably solving the specific problems of a psychotherapeutic traning which is not oriented toward maximum requirements, but toward realizibility withan an given social frame for the sake of patients who probably would not find treatment elsewhere.
本文概述了目前精神病诊所心理治疗培训所处的紧张局面。首先，描述了汉诺威医学院精神病诊所对未来心理治疗师的官方培训规则。由此，勾勒出一系列普遍的结构性问题，这些问题影响着精神病学及其不同机构更广泛框架内心理治疗培训的组织，尤其是其融入以社会精神病学为主导方向的医院的情况：根据诊所成员标准录取候选人（而非个人资质）；根据诊所成员时间限制培训期（最多三到四年）；因此，早期就开始对一般相当困难、病情严重的患者进行心理治疗；采用改良的精神分析程序进行治疗，而这通常需要多年的精神分析治疗经验；自我体验通常在精神分析小组中进行，而没有与治疗师面对面关系的个人体验以及这种二元关系中可能出现的治疗性退行；最后，许多候选人感受到社会精神病学日常实践中的行动压力与心理治疗师相当拖延和宽容的态度之间的冲突，而行动反思在这里最为重要。心理治疗的理论教学以及督导必须应对这些结构性规定的条件。本文描述了汉诺威医学院精神病诊所在将心理治疗理论和方法传授给精神科医生以及——或许——一般医生方面迄今已有的经验，包括困难以及变化。它还展示了一些可能的尝试，以便切实解决心理治疗培训的具体问题，这种培训并非以最高要求为导向，而是为了那些可能在其他地方无法获得治疗的患者，在给定的社会框架内实现可行的培训。
