Biomedical subjects

M Bürgy

Publications and source records attributed to M Bürgy.

10 recordsLinked to original sources

PubMed2005

Psychopathology of obsessive-compulsive disorder: a phenomenological approach.

Until the beginning of the 20th century, the idea of obsession found in the literature was mostly a broad and unspecific one, and it has, to some extent, persisted in this form until the present day. At the same time, however, Esquirol and Westphal began to develop a concept of obsession in the strict sense, and Jaspers used the phenomenological method as a basis to give it its final form. The concept of obsession in the strict sense represents the formal and nosologically specific core symptom of obsessive-compulsive disorder. In conjunction with the distinction between primary and secondary obsessions, obsession in the strict sense is proving helpful in differential diagnosis, but it can also serve as a guideline in the further phenomenological investigation of obsessive-compulsive disorder. It is shown how the interaction between personality, affect and release situation develops the obsessive-compulsive disorder. The clarification of these aspects with the patient can at the same time be the starting point of psychotherapeutic treatment.

Affect↗

PubMed2005

[Obsessive compulsive disorder and schizophrenia. An attempt at psychopathologic differentiation by focusing on the single phenomenon of obsession].

This paper follows the hypothesis that differentiation between obsessive compulsive disorder and schizophrenia is possible only by focusing on the single phenomenon of obsession. The declaration of a nosological specificity of obsession is set against the current view of ICD-10 and DSM-IV, of obsession as a ubiquitous nonspecific phenomenon appearing with comorbidities. The historic development of these two most different views of obsession and their combination is explained. The distinction between obsessive compulsive disorder and schizophrenia can be made at the psychopathologic dividing line between obsession and delusional thoughts. Examination of the literature on the transition from obsessive compulsive disorder into schizophrenia shows that there is no clear link between obsession and schizophrenia.

Clinical Trials as Topic↗

PubMed2001

The narcissistic function in obsessive-compulsive neurosis.

Freud's intrapersonal concept of anal-sadistic regression is set against the interpretation of obsessive-compulsive neurosis as a structural ego deficit. The interpersonal dimension that comes to the fore as a result of this, becomes clear if we focus on obsessive-compulsive behavioral disorder: Persons suffering from obsessive-compulsive neurosis lack the self-assessment factor. It needs another person as part of their own ego who accepts and supports them in their behavior. A clinical example illustrates this narcissistic function of compulsion together with the changes in the psychodynamic approach and resulting therapy. Against DSM-classification with the concept of obsessive-compulsive disorder, which contains an unspecific symptomatology that occurs both in neurosis, schizophrenia, melancholia, and organic psychosis, this article advocates the specific and differentiated concept of obsessive-compulsive neurosis.

Ego↗

PubMed2000

[The question of the connection between obsessive-compulsive disorder and narcissism].

Freud's psychodynamic concept of the anal-sadistic regression in obsessive-compulsive neurosis is completed with the clinical observation of the structural ego deficit in connection with obsessive-compulsive disorder. Not being able to rely on one's own behaviour, described by Quint, for example, explains that the self-assessing function is lacking in the obsessive-compulsive patient. Such patients need the other person to acknowledge and confirm their behaviour as a self-object, i.e. as a part of his self. The aspect of the narcissistic bond of the obsessive-compulsive patient is emphasised here as a differentiation to the more superficial criteria of narcissism in the DSM-IV. The obsessive-compulsive symptomatology has the function to hold on to his self-object as no autonomy is available and loss of bond is experienced as loss of self. The relation of obsessive-compulsive disorder and narcissism is described on the basis of three case histories and supported by biographic and psychotherapeutic data. Furthermore attention is drawn to the consequences of this opinion for a modified psychodynamic therapeutical approach.

Humans↗

PubMed1999

[Clozapine and obsessive-compulsive symptoms in schizophrenia. A case history of one patient].

In the examination in question, the case history of a patient who had exhibited serious obsessive-compulsive symptoms since the age of 14 is described. It is not an independent obsessive-compulsive disorder, but a case of schizophrenia masked by obsessive-compulsive symptoms. During therapy for the schizophrenic symptoms with clozapine, which set in at the age of 31, neither psychotic symptoms nor obsessive-compulsive symptoms worth mentioning can be found at the 1-year catamnesis. Whereas the literature increasingly points to obsessive-compulsive symptoms being a side-effect of clozapine medication, usually in the clinical indication area of chronic schizophrenic psychoses, as far as the author knows, this describes a rare case of improvement of obsessive-compulsive symptoms using clozapine after first suffering from a schizophrenic disorder. The meaning of differential diagnostics of obsessive-compulsive phenomena for adequate pharmacotherapy is discussed using the example of the individual case.

Adolescent↗

PubMed1998

[Dysmorphophobia. Becoming estranged with oneself as a disorder of communication].

Dysmorphophobia shall be described as an example for a communicative disorder and be deliminated from other syndromes under which it has been subsumed so far. On the background of available literature, the "fear of deformity" is to be elaborated as feeling ashamed of the contemptuous look of another person, whose look has turned into the own view. This results in a discrepancy with the ego and the own self conveyed by others, finally leading to depersonalisation. This basic interpersonal appearance shall be further illustrated by two individual examples.

Adult↗

PubMed1998

[Psychodynamics and therapy of trichotillomania].

After a short review of the literature, some aspects of the psychodynamics and therapy of trichotillomania with an adolescent patient are presented that up to now have not been described in great detail. Against the backdrop of previous fears of being abandoned, the patient feels threatened that while coping with the developmental tasks of sexuality and aggressiveness she will be dropped once again. This psychodynamically oriented therapy makes it possible for the patient to accept and verbalize the corresponding feelings in a relationship that gives a feeling of security. Therefore, the symptoms that previously served the purpose of regulating diffuse inner tensions and fears may be abandoned.

Acculturation↗

PubMed1997

[Self-reflection, interpersonal behavior and psychoanalytic ethics].

In the middle ages, ethical practice included a metaphysical theory of value. In comparison with that, self-reflection and interpersonality should be described as principles of more individual ethics and proceeding from philosophy to psychoanalysis in modern times. Drawing a borderline between human philosophy and metaphysies, Kant defined his so-called categorial imperative as a basic phenomenon of human reciprocity. Ethical relationship to another person, however, requires realization of one's own self, i.e. self-reflection. Hegel's subsequent association of intersubjectivity and selfreflection supplied the basis for Sarte's constitution of consciousness: Existence as existing for the good of the fellow-being. Self-reflection, basing on the sight of one's own self by the other person, leads to Sartre's concept of existential psychoanalysis and to his understanding of ethics. His concept illustrates the decline of significance of philosophy for the analysis of human relationship. Habermas describes self-reflection and interpersonality as fundamental principles of the psychoanalytic therapy and its ethical demands. With the historical concept of the super-ego, Freud established therapeutical one-sidedness and abstinence from ethics; however, as therapeutical interrelationship continued to intensity, ethics of depth psychology also began to develop. This ethical demand was not expressly formulated within the context of psychoanalysis, with the exception of jung and his epigones. Nevertheless, psychoanalytic interaction implies the development of self-reflection, which definitely represents a step forward in the sense of "ethical enlightenment" represented by Kant.

Awareness↗

PubMed1996

[Psychotherapy in psychiatry--an assessment of current status. Report on the DGPPN Status Colloquium "Psychotherapy in Psychiatry" 22-24 February 1996 in Heidelberg].

The German psychiatrists have agreed to new training regulations which now include psychotherapy. On this occasion the German Psychiatric Association organized a symposium "psychotherapy within psychiatry". Psychotherapy researchers of all psychiatric departments in German speaking countries were invited. As a result, a cross-sectional picture of current psychotherapy research within psychiatry showed a great variety of methods and ways of thinking about research on psychotherapeutic process, outcome, and applications. Even non behavioural approaches showed a trend towards operationalized and quantifying, but also standardized qualitative research. All participants agreed on the necessity of better and in comparison with psychopharmacological research more fair financing of psychotherapy research.

Curriculum↗

PubMed1995

[2 basic problems of psychoanalytic psychotherapy and their philosophical revision].

The presupposition of the cartesian cogito provokes a ¿potential decrease of transcendental philosophy,¿ which means, that reevaluation of the scientific reflexive reason leads into a metaphysical evacuation. Original philosophical subjects develop into subjects of a scientific psychology respectively depth psychology. Two fundamental problems, resulting from this historical context of philosophy, should be described: Firstly the consciousness, which is objectivated and hardened as psyche by the influence of reflection. Secondly the unconsciousness, which seems like a hidden psychological entity with an indifferent essence. The effort to revise those two problems should be made by the use of phenomenological and existential philosophy. The intention of this revision is first to reintegrate the isolated reflexive consciousness in a field of consciousness and secondly to replace the confrontation with the unconsciousness by the dialogue with the fellow being.

Consciousness↗