Plassmann R
Burg-Klinik, Stadtlengsfeld, Deutschland, Germany.
Psychother Psychosom. 1994;62(1-2):96-107. doi: 10.1159/000288910.
A favorable therapeutic course is achieved by the combination of an initial clinical psychotherapy and a subsequent analytical long-term treatment implemented as an outpatient therapy or an interval therapy. This form of therapy was offered to all of the patients and was accepted by half of the patient collective, i.e., by 12 out of 24. Only in 1 of these 12 cases, was it possible to dispense with the initial clinical therapy in favor of a primary outpatient therapy. Of these 12 therapies, 2 were terminated by the patients. We were able to continue the other 10 for longer periods, extending up to 4 years. In this setting, a transition from the working phase to the separation phase is possible around the fourth year of therapy. Termination of therapy is almost always based on a negative therapeutic reaction. The patients were generally capable of development, but were not able to take advantage of this opportunity because of the dominance of malignant introjects. In several cases, this pattern has become consolidated on a social as well as an endopsychic level. The therapy is then terminated in favor of a structured mother-child relationship or a similarly structured marriage. In those cases where the therapy was broken off prematurely, the establishment of a sufficiently stable working relationship was prevented by the predominantly negative transference. As a result, it was not possible to conduct a follow-up therapy after the normal end of the clinical psychotherapy, for example. The question remains whether a significant lengthening of the clinical psychotherapy could have changed anything here; in my opinion, this is not the case. In these cases, the inpatient therapy was always terminated by the patients, either by a directly expressed wish or by a symptomatic development making referral or discharge imperative. The 10 cases undergoing long-term therapy all progressed favorably, with a significant, or at least marked, improvement of the symptomatology and the relationship capability. In this context, the results are, in each case, a function of the severity of the illness, the individual capability for growth, and the length of treatment. Even though 6 of the 10 long-term therapies are now in the separation phase, none of them has been finally ended yet. As a result, we have only a small amount of information so far on the possibilities for reaching a final conclusion of the therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
通过初始临床心理治疗与后续作为门诊治疗或间歇治疗实施的分析性长期治疗相结合，可取得良好的治疗过程。这种治疗形式提供给了所有患者，并且被一半的患者群体所接受，即24名患者中的12名。在这12个病例中，只有1例有可能放弃初始临床治疗而选择主要的门诊治疗。在这12次治疗中，有2次被患者终止。我们能够将另外10次治疗持续更长时间，长达4年。在这种情况下，治疗大约在第四年时有可能从工作阶段过渡到分离阶段。治疗的终止几乎总是基于负面的治疗反应。患者一般具有发展能力，但由于恶性内摄物占主导地位而无法利用这个机会。在一些案例中，这种模式在社会层面和内心层面都已巩固。然后治疗终止，转而建立一种结构化的母婴关系或类似结构化的婚姻关系。在那些治疗过早中断的案例中，主要的负面移情阻碍了足够稳定的工作关系的建立。结果，例如在临床心理治疗正常结束后无法进行后续治疗。问题仍然是临床心理治疗显著延长是否会改变这种情况；在我看来，并非如此。在这些案例中，住院治疗总是被患者终止，要么是通过直接表达的意愿，要么是通过症状发展使得转诊或出院成为必要。接受长期治疗的10个案例都进展良好，症状学和关系能力有显著改善，或者至少有明显改善。在这种情况下，结果在每种情况下都是疾病严重程度、个体成长能力和治疗时长的函数。尽管10次长期治疗中有6次现在处于分离阶段，但它们都尚未最终结束。因此，到目前为止，我们关于治疗最终结束可能性的信息很少。（摘要截断于400字）
