[Some considerations on psychotherapy training for physicians in the psychiatric clinic--demonstrated by the example of the Medical School Hannover (author's transl)].

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.