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G Rudolf

Publications and source records attributed to G Rudolf.

88 records · Page 5Linked to original sources
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[The use of evidence-based medicine in psychotherapeutic medicine].

This review article gives an overview of the state of the art of evidence-based medicine (EBM) which is contrasted with some central aspects of current psychotherapy research. In the first part, three meanings of EBM are discussed: EBM as a regulative idea, EBM as a codified method and EBM as a sociopolitical movement; it follows an evaluation of the advantages and disadvantages of randomized controlled trials (RCT). In the second part, the discussions surrounding the meta-analysis of Grawe, the "Consumer Reports" study and the so-called "Empirically Supported Treatments" are touched upon briefly; it follows a discussion of the specific problems of using RCTs in psychotherapy research and of the suggestions for more naturalistic studies in this field.

Evidence-Based Medicine↗
PubMedDate not supplied

[Development of psychogenic disorders: an integrative model].

On the basis of clinical experience and empirically based data an integrative model of how psychogenic disorders develop is described in this article. The development-psychological steps of maturation from the uterine period to adolescence are examined with regard to the respective basic conflict to be derived from the step, and the disorder forms neurotization, structural disorder, and traumatisation are differentiated. Especially the process character of the respective development from the basic conflicts over the different coping strategies up to the symptom outbreak is emphasized.

Adaptation, Psychological↗
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[The Berlin Documentation System for Psychotherapy].

A Berlin Team for Documentation in Psychotherapy has developed an extensive documentation system. It provides data of a social, psychological and life-history nature, refering to computerized dataanalysis, which are pertinent in the psychological assessment of patients with neurotic and psychosomatic symptoms. The instrument which serves in collecting the data--a special type of psychoanalytic interview--has been used routinely in the Berlin-Group since 1951 to diagnose neurotic disturbances and to prognostically assess the chances for treatment. Interest in assessment-procedures which especially take into account the social situation of the patient, and the work on documentation procedures which treat psychological and social factors with equal weight, grew out of the tradition of the Psychoanalytic Ambulance of Berlin in the years between 1920 and 1940. The following report, in treating its historical development, describes the psychoanalytic interview as well as the psychoanalytic institutions whose large amount of experience in the treatment of patients made it possible to construct the documentation system (Institut für Psychogene Erkrankungen der AOK Berlin und Abteilung für Psychotherapie und Psychosomatische Medizin im Klinikum Charlottenburg). The authors present the specific elements of the datasystem: the patient's attitude towards his illness, his actual social environment, his early socialization process, personality structure and prognosis. They discuss the relationship between the documentation on the one hand and the process of psychoanalytic interview on the other, which necessitates both the understanding of the patient's life-history and his pattern of social interaction. The possibilities and limitations of the data evaluation especially in regard to ratings are discussed in its methodological aspects. The most important questions to be answered by this project are: Testing of psychoanalytic hypotheses with help of extensive data from numerous patients, the descriptive differentiation of neurotic personality patterns, the testing of social influences on psychosomatic disorders, and the construction of a short version of documentation with which comparative research on psychotherapy should be possible.

Berlin↗
PubMedDate not supplied

[Development of a model of operational psychodynamic diagnosis].

Since 1992 a working group called "Operationalized Psychodynamic diagnoses" conceptualized a model of operationalized psychodynamic diagnosis in Germany. This model includes the most important diagnostic dimensions from psychodynamic view which are: Axis I: Experience with illness and treatment preconditions. Axis II: Habituated relationships of the patient, Axis III: Intrapsychic conflicts of the patient, Axis IV: the structure of personality development of the patient, Axis V: The level of symptoms or syndromes. This axis is adapted to ICD-10. The development of these axis is done in special subgroups during 1992 and 1994 and in first empirical studies the reliability and other test-related dimensions of the model were proved. In this paper the essentials of the diagnostic model are shown and further developments are discussed.

Humans↗
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[Difficulties of describing human relationships with the help of psychoanalytic descriptive models: a critique of ego-psychology].

Progress of psychotherapy and of related behaviour sciences makes evident the importance of a better understanding of human relations. But psychoanalysis finds it hard to describe interpersonal processes without transference. In order to remain within the conceptional frame of metapsychology it has to see interaction between individuals as the oral, aggressive or sexual cathexis of an object or as satisfaction or denial of the subject by the object. The structure of the "ego", which--in analogy to medical thinking--is conceived as an organ with its functions, is considered to have no interpersonal activities. The "ego" of the classic psychoanalytic theory is chiefly occupied with itself. It has to care for its egoistical interests and to guarantee its self-preservation. As an auxiliary and meanwhile popular concept the "self" has been introduced to describe object-relations. This concept is not sharply defined. Due to its metapsychological implications it produces additional theoretical difficulties. Linguistic studies show that every inventory of words implies a certain insight into reality. For this reason the metapsychological machine-like concept of psychic structures does not permit new ideas about interpersonal relations. If we leave metapsychology and base on colloquial speech we see that the experience of "I" is much more related to persons than the rather autistic concept of the "ego" shows. Further we learn that self-preservation cannot be an egoistical interest; it depends on the attachment to others. All feelings of self-esteem depend much more on interpersonal relations than on "narcissistic regulations". From these experiences three conclusions are derived: a) One of the main qualities of the ego is the relatedness to persons. b) The concept of narcissistic regulation as a successor of primary narcissism is no longer useful. Narcissistic traits develop as the secundary compensations if the individual failed to build up satisfactory interpersonal relations. c) The revision of (a) ego-psychology and (b) theory of narcissism asks for modifications of the therapeutic technique, where now the interest is especially concentrated on interpersonal problems instead on the pathology of the ego.

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