Biomedical subjects
Publications and source records attributed to H Strotzka.
The development of psychotherapy is outlined very briefly. The dangers which arise from the pluralism of methods are shown. A uniform basic education in medicine is striven for, covering both the biological and the psychosocial domains. The author is of the opinion that psychotherapy should be practiced in institutions in which several methods are represented. The reasons are discussed.
A distinct separation between a pathological grief reaction and "psychosomatic" depressive syndromes is suggested, which would offer the possibility of selecting a specific psychotherapeutic method. The so-called regrief therapy (Volkan) is recommended for the treatment of the pathological grief reaction and supportive and expressive psychoanalytical methods for the "psychosomatic" depressive syndromes.
The reasons for the reluctance of psychotherapists against empirical research are the following: (1) psychotherapy is a 'hermeneutic' process which cannot be measured (basic argument); (2) empirical research interferes in the process (technical argument); (3) it contradicts the specific private working contract of psychotherapy (ethical argument); (4) in comparative psychotherapy research we compare not systems, but individual therapists (personal argument), and (5) in many institutions, care has a higher priority than documentation (pragmatic argument). These arguments are mainly rationalizations. Empirical research is necessary for the survival of psychotherapy as a respected discipline in medicine.
The question, whether the term neuroses and the term psychoreactive crisis are quantitatively or qualitatively different is not yet unanimously agreed upon. Phenomenologically identical disturbances are presented. Some differences in the course of development are presented. Furthermore the concept of "crisis" is depicted . Definitions, course, social situation and the technique of crisis intervention are covered briefly. Great importance have special short-term psychotherapy techniques and also the organization of self-help groups and the mobilization of the natural network which all are for an optimal management of the crisis.
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Sociogenesis is divided into primary sociogenesis (direct connection between social conditions and mental disorders), secondary sociogenesis (indirect connection), and tertiary sociogenesis (social consequences of a disorder according to the degree of acceptance). It has to be interpreted in a system network with organo- and psychogenesis. Social therapy is, according to that, an integration of social work, psychotherapy and pedagogics. Its main instrument is the therapeutic community.
Psychotherapeutic theories and techniques are multiplying explosively. However, the newer developments are reducible to a few basic concepts, namely 1. training, learning, conditioning and information, 2. suggestion, 3. persuasion, 4. counselling, 5. insight (making conscious), 6. group-effects, 7. cartharsis, ecstasis and acting-out. In the present situation a therapeutic schedule based entirely on methods and theories is no longer acceptable and has been replaced by a patient-centred approach, i.e. the method is chosen on a pluralistic basis according to optimum fulfilment of the requirements of patient, therapist and institution. Apart from psychotherapy in the narrower sense, a psychotherapeutic attitude is recommended as an essential method of secondary prevention in all health and social services.
An analysis of the concept of crisis cannot ignore that it is often used in a highly suggestive way, nor should it neglect to look at its historical roots. The psychosocial crisis concept as it is used in psychiatry, psychotherapy, social work, etc. has two historic roots: one root lies in the medical-natural-sciences tradition; the other in the dramaturgical i.e. healing tradition, and they both flow together in the concept as commonly used. At present, there are numerous crisis definitions each of which emphasizes a different aspect. Greater precision, models and operational definitions are indispensable for exact research. Crisis precipitation, disposition (crisis proneness) of the system, environment and reaction of the system are discussed as separate aspects of a crisis. Finally, the innovative and constructive role is stressed which the crisis concept plays in research and practice.
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