More than one way home - Student raters' impressions of interventions and group processes in mentalisation based group psychotherapy and group analytic psychotherapy.

In a study comparing mentalisation-based group therapy (MBT-G) and group analytic psychotherapy (GAP) in a day clinic, both group psychotherapy forms were found to be highly effective. But how did specific interventions and processes in both groups differ? The present article describes student raters impressions. Twelve psychology students listened to 100 audio recordings of 90 minutes group psychotherapy sessions of GAP and MBT-G. Each session was randomly assigned to two student raters, who were asked to write down their impressions. These were analysed. Group conductors in MBT-G used more questions, had short shares of speech, used group dynamics and fostered multiple perspectives on issues discussed. Affect perception was stimulated by asking questions. In PDGT, conductors used more interpretations, confrontations and supportive interventions, and they had longer shared of speech. Handling of affects was based on 'allowing to get infected'. Discussion. It is hypothesized that symptom reduction in both groups occurred via different ways: in GAP the pathic (affective contagion) function of interactions was more relevant, while in MBT-G it was the phatic (contact keeping) function. Results are also discussed in relation to previous findings on group processes and interventions.

Mentalization-Based Treatment in Groups for Adults With Autism Spectrum Disorder.

In order to successfully interact with others in social encounters, we have to be attentive to their mental states. This means, we have to implicitly and explicitly interpret our own actions as well as the actions of others as meaningful on the basis of the ascription of intentional mental states. However, this ability, often referred to as mentalizing, seems to be impaired in autism spectrum disorder (ASD). Individuals with ADS show specific deficits relating to the representation of mental states of others. Especially, the spontaneous, intuitive attribution of and reaction to others' mental states seem to be impaired. Mentalization-Based Treatment (MBT) is a form of psychotherapy in individual and group settings that focuses on the education and enhancement of mentalizing. Although the scope of MBT is broad and MBT has been already proven to be useful in a variety of mental disorders, no attempt has been made to apply MBT in patients with ASD. In our study, we adapted MBT for adults with ASD in a therapeutic group setting to examine the feasibility as well as the effectiveness of the treatment in this patient group. During 15-20 weeks of weekly group therapy, we surveyed the patients' acceptability of the intervention. Additionally, changes in mentalizing difficulties were measured before and after treatment. Results show a high acceptance of the treatment and an improvement in the patients' mentalizing abilities, presenting MBT as a promising treatment option for ASD.

[A forgotten chapter in the prehistory of psychoanalysis in Cologne. The emigration of Hans Erich Haas (1896-1990)]. / Zur (vergessenen) Frühgeschichte der Kölner Psychoanalyse: Das Emigrationsschicksal von Hans Erich Haas (1896-1990).

Haas was the first medical doctor from the Rhineland who was trained at the Berlin Psychoanalytic Institute and established himself as a "specialist for psychoanalysis" in Cologne. For nearly ten years he had a flourishing practice there with a particular interest in the treatment of schizophrenia. He was Jewish and in 1936 he emigrated to England where he was the first and for a long time only psychoanalyst in Birmingham. He specialised in treating patients with personality disorders and psychosomatic diseases and was increasingly consulted as a forensic expert. As a result of his association with a hospital and with the university, he was instrumental in the foundation of the West Midlands Institute for Psychotherapy. At the time of his death in 1990, the psychoanalytic study group of Cologne lacked any knowledge of his life or work.

Magical ideation -- defense mechanism or neuropathology? A study with multiple sclerosis patients.

BACKGROUND: The major psychological stress factor in multiple sclerosis (MS) is loss of control of life. In MS patients with impaired cognition, magical ideation might be a characteristic way of thinking. Proof for this may be the high frequency of alternative treatments used by individuals with MS. The study investigates whether the level of magical ideation in MS patients is higher compared to healthy control subjects and, in case of positive confirmation, with which somatic and psychological features it is associated. Moreover, it is aimed to discuss the modalities of magical ideation in general. SAMPLING AND METHODS: A German version of the Magical Ideation Scale was validated with a group of 69 healthy subjects. Ninety-four MS patients were additionally assessed with the Dissociative Experience Scale, the Symptom-Check-List-90-Revised and 5 neuropsychological tests. RESULTS: The Magical Ideation Scale did not reveal a significant difference between MS patients and healthy controls (p = 0.968). Among the MS patients, magical ideation shows a correlation neither with age nor with disability, but a positive correlation (p = 0.007; r = 0.329) with the grade of neuropsychological deficiency. Among the psychological parameters, the highest positive correlation with magical ideation was found in dissociation (p = 0.000; r = 0.520). DISCUSSION: Magical ideation, sharing common features with dissociation, can be viewed as an early defense mechanism when perceiving a loss of control of life, particularly in early stages of MS. In late stages, when developing neuropsychological deficits, it may occur as a substitute for cognitive coping. The data may encourage clinicians to identify magical ideation. In young and previously diagnosed patients, it is important to acknowledge helplessness and support a rather rational way of coping. Training cognitive skills could be crucial to prevent older patients from losing touch with reality. More generally, the occurrence of a significant amount of magical ideation is discussed both as a psychological and a neurophysiologic regression of thinking.

Looking back on back pain: trial and error of diagnoses in the 20th century.

CONTEXT: The societal costs of low back pain and associated disability are immense. However, very little is known about the etiology of low back pain. Lumbar disc disease was discovered in the last century and became the predominant etiology for back pain. Today we know that for the majority of low back pain cases, a specific etiology cannot be determined. OBJECTIVE: To analyze the evolution of the "disc paradigm" and to compare our contemporary understanding to the scientific discussion in the beginning of the last century. DESIGN: Survey of the highest ranked German medical journal from 1900 to 1999. DATA EXTRACTION: The indexes of 5185 journal issues of the Deutsche Medizinische Wochenschrift were reviewed for articles about low back pain. DATA SYNTHESIS: For each article, the etiologies were identified, categorized, and counted per decade. In addition, each important etiology was described. CONCLUSIONS: In the beginning of the last century, many heterogeneous etiologies coexisted. In the second half of the century, the theory of disc degeneration took over almost the entire literature about low back pain. Pre-existing theories disappeared, but re-entered the discussion in the last decade. Two factors seemed to influence this development: 1) a tendency to prefer organic, visible abnormalities as etiologies; and 2) an inclination to trust technical diagnostic results more than clinical judgment.

Dissociative and associated psychopathological symptoms in patients with epilepsy, pseudoseizures, and both seizure forms.

PURPOSE: A controversy currently exists regarding the significance of dissociation and conversion in the pathogenesis of pseudoepileptic seizures. After the abolition of the term "hysterical neurosis" from the current diagnostic systems, these seizures were diagnosed as either Dissociative Disorders (ICD-10) or in the DSM IV as Somatoform disorder, most often of conversion type. Recent studies of patients with Dissociative Disorders found that most patients also had conversion symptoms. METHODS: In the present study, 60 patients of an outpatient clinic for epilepsy were assessed for the presence of dissociative symptoms and general psychopathologic symptoms by using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R). RESULTS: The patients with pseudoepileptic seizures showed a significantly higher incidence of dissociation (p < 0.0098) and general psychopathologic symptoms (p < 0.0083). Depression, anxiety, and obsession were dominating psychopathologic symptoms in all patients. CONCLUSIONS: The significantly higher incidence of dissociation in the patients with pseudoepileptic seizures suggests dissociation in the pathogenesis of these seizures.