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Personalized treatment-which interaction ingredients should be focused to capture the unconscious

World Journal of Clinical Cases 2022年第7期10卷 2053-2062页

作者： dagmar steinmair Henriette Löffler-Stastka Department of Psychoanalysis and Psychotherapy Medical University ViennaWien 1090ÖsterreichAustria

A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic *** mental health care in physical care services is still ***,interdisciplinary communication across treatment providers is *** standardized language provided by the diagnostic statistical manual favors a clear ***,this approach might not focus on the individual,as thinking in categories might impede recognizing the continuum from healthy to *** theory is concerned with an individual’s unconscious conflictual wishes and motivations,manifested through enactments like psychic symptoms or(maladaptive)behavior with long-term consequences if not *** modifiable internal and external factors often are inadequately ***,together with the physical chronic condition constraints,these factors determine degrees of freedom for a self-determined *** effect of therapeutic interventions,and especially therapy adherence,relies on a solid therapeutic *** and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment *** article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research.A clinical example is ***,further directions for research are *** theoretical frame in psychoanalytic therapies is the affect-cognitive *** affect-perception is enabled via awareness of subjective meanings in oneself and the other;shaping this awareness is the main intervention *** interactional ingredients,the patient’s inherent bioenvironmental history meeting the clinician,are relevant *** intrinsic,subliminal parameters relevant for changing behavior are *** inter

关键词： Chronic disease Psychological impairment Psychoanalysis Facial microexpressions Memory reconsolidation Reflection Relationship Resilience

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Future of processing and facilitating change and learning

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World Journal of Psychiatry 2021年第9期11卷 507-516页

作者： Henriette Loffler-Stastka dagmar steinmair Department of Psychoanalysis and Psychotherapy Medical University of ViennaVienna 1090Austria

The field of the sciences of the mind is evolving *** the diversification of knowledge and accumulation of data,often lacking integration and reproducibility,questions *** role of critical thinking and research is *** the science of the unconscious,psychoanalysis provides a method and theory to understand human minds and mentalities,helping the patient know his mind and transform action into *** activities,including social skills,develop in the social context,depending on the social environment’s demands and resources put onto the *** emotional signals,markers of meaning for the individual,is ontogenetically necessary and has influences on memory *** theoretical understanding,implicit relational knowledge is actualized in the therapeutic *** a strong focus on experiencing emotional reconsolidation of memories,previous relationships’repercussions are enriched with broadening viewpoints in the analytic *** long-term effects of psychotherapeutic treatments have been examined.A sufficient explanation of the specific factors contributing to success or an answer when an impact is lacking is still under *** investigating subliminal and implicit mechanisms leading to memory reconsolidation and the formation of functional object relations and interaction patterns,the focus is set on affective interplay and processing prior/during and after social *** present paper discusses which parameters might contribute to the reshaping of memories and the linkage of memory with the emotional load of *** insights into such dynamic mental phenomena could enhance process research by investigating moment by moment interactions in psychoanalysis,treatment,and learning *** to the research subject’s complexity,different research methods and integration of associated research fields are required.

关键词： Psychoanalysis Hermeneutic circle Evidence-based medicine Bias Affective interplay Micro-process

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Importance of communication in medical practice and medical education:An emphasis on empathy and attitudes and their possible influences

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World Journal of Psychiatry 2022年第2期12卷 323-337页

作者： dagmar steinmair Katharina Zervos Guoruey Wong Henriette Löffler-Stastka Department of Psychoanalysis and Psychotherapy Medical University of ViennaVienna 1090Austria Karl Landsteiner University of Health Sciences Krems 3500Austria Department of Ophtalmology University Hospital St.PöltenSt.Pölten 3100Austria Department of Internal Medicine I KRH Klinikum Robert-Koch-GehrdenGehrden 30989Germany Faculty of Medicine University of MontréalMontréal 2900QuébecCanada

BACKGROUND Healthcare professionals need to be prepared to promote healthy lifestyles and care for *** focusing on what students should be able to perform one day as clinicians,we can bridge the gap between mere theoretical knowledge and its practical *** aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning *** To determine sets of intellectual,personal,social,and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking,in order to identify training *** An analysis of training clinicians’conceptions with respect to optimal medical history taking was *** chosen study design also aimed to assess gender *** interviews with supervising clinicians were carried out in a descriptive study at the Medical University of *** were analyzed by conducting a qualitative computer-assisted content analysis of the *** category formation was *** main questions posed to the supervisors dealt with(1)Observed competencies of students in medical history taking;and(2)The supervisor’s own conceptions of"ideal medical history taking".RESULTS A total of 33 training clinicians(n=33),engaged in supervising medical students according to the MedUni Vienna’s curriculum standards,agreed to be enrolled in the study and met inclusion *** qualitative content analysis revealed the following themes relevant to taking an anamnesis:(1)Knowledge;(2)Soft skills(relationship-building abilities,trust,and attitude);(3)Methodical skills(structuring,precision,and completeness of information gathering);and(4)Environmental/contextual factors(language barrier,time pressure,interruptions).Overall,health care professionals consider empathy and attitude as critical features concerning the quality of medical history *** looking at physicians’theoretical conceptions,more general practitioners and ps

关键词： Medical history taking Attitude Empathy Training Physicians’view

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Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison

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World Journal of Psychiatry 2021年第12期11卷 1328-1345页

作者： dagmar steinmair Guoruey Wong Sophie Frantal Christine Rohm Henriette Löffler-Stastka Department of Psychoanalysis and Psychotherapy Medical University of ViennaWien 1090Austria Karl Landsteiner University of Health Sciences Dr.Karl-Dorrek-Straße 30Krems 3500Austria Department of Ophtalmology University Hospital St.PöltenSt.Pölten 3100Austria Facultéde Médecine Universitéde MontréalMontréal H3C 3J7QuébecCanada

BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently *** of differences between different types of therapies has been *** To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic *** Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were *** regimens were applied according to care as usual/manualized including quality control and supervision as *** to one of the groups was done after baseline *** classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post *** patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent *** action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'*** During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD sy

关键词： Psychoanalysis Psychodynamic psychotherapy Borderline personality disorder Affect regulation Affect regulation and experience Q-sort Transference

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Simulating the mind and applications-a theory-based chance for understanding psychic transformations in somatic symptom disorders

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World Journal of Meta-Analysis 2021年第6期9卷 474-487页

作者： Henriette Löffler-Stastka Dietmar Dietrich Thilo Sauter Martin Fittner dagmar steinmair Department of Psychoanalysis and Psychotherapy Medical University ViennaVienna 1090Austria Institute of Computer Technology TU WienVienna 1040Austria Center for Integrated Sensor Systems Danube University KremsWiener Neustadt 2700Austria University Hospital St.Pölten Karl Landsteiner University of Health SciencesSt.Pölten 3100Austria

With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is *** turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the *** and simulation have a long history in science to gain insight also into complex *** the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process *** models have to fit to the complexity of this disorder *** an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is *** from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process *** psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.

关键词： Psychic transformation Computer-technology Simulation Somatic symptom disorder Bodily distress disorder Mealy model

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