Psychiatry and Psychotherapy

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Psychotropic drugs

In medication management I avoid psychotropic drugs as far as possible. If medication is already taken I analyse the interactions and risks, simplify the intake and reduce, when indicated, the number and dosage of the medication. Elements of integrative medicine prove to be an alternative.

Clinical Hypnosis

Clinical hypnosis as psychotherapeutic measure has nothing in common with show-hypnosis. By means of modern clinical hypnosis after Milton Erickson, an altered state of consciousness called trance is induced. It enables access to intuition and the subconscious and for this reason could also be called emotional therapy.

Hypnotic trance is defined by various subjective changes which can also be obtained through different methods such as autogenic training, meditation, guided imaging and katathym imaginative psychotherapy to name but a few. However, the way in which hypnosis is applied in the clinical context is unique.

Clinical hypnosis refers to the mental and spiritual resources of a human being. The client’s attention is directed away from every-day life and drawn to the inside. Through this a number of characteristic phenomena appear like narrowing of attention, change of body awareness, trance logic, an improved visualization of imaginations, a distorted time perception, greater emotionality, improvement of dissociative processes, an increased suggestibility, decrease of the sympathic irritability level.

The effectiveness of hypnosis does not depend on the level of trance depth. Through the activation of creative searching processes blockages can be solved selectively and sustainably.

Modern hypnosis is a highly effective method which can be applied in an extremely customised and targeted manner.

Through harmonising the inner milieu, increasing suggestibility, changing perception, activating the creative thought processes and intuition and implicit knowledge, inner barriers can be overcome in a highly targeted and sustainable manner.

Cognitive Behavioural Therapy (CBT)

The cognitive behavioural therapy, which goes back to Aaron Beck, focuses on the observable behaviour of the client and their attitude and beliefs. In this the desired behaviour is achieved by re-learning wrongly adapted behaviour or learning not yet adapted behaviour. The cognitive behavioural therapy is based on insights from the learning theory and the psychology of thinking and feeling.

Self-perception in the form of documenting reports is part of the general behavioural diagnostics and also problem solving oriented models which apply the concept of self-control. Role-play and exercises are key elements of classical behavioural therapy, allowing the client to assume and develop an active role in the therapy. This encourages self-assessment and enlightenment, trying new possibilities, sustaining progress that has already been achieved and transferring it successfully into everyday life.

Cognitive behavioural therapy is relevant to present times and target oriented, structured and interactive.

Depending on the situation, stress management, communication and competence training, training of mindfulness, psycho-education, couple- and family sessions are included. The dialectic behavioural therapy (DBT) by Marsha M. Linehan was developed from CBT and is especially applied in cases of borderline-personality disorders.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a psychotherapy method developed by Francine Shapiro to work on traumas. It is the therapy method with the most studies regarding effectiveness in posttraumatic stress disorder (PTSD). It even enables treating complex trauma related diseases. In the last years the indication spectrum was enhanced to include fear, depression, addiction and pain.

EMDR encompasses the findings of various bodies of neurophysiological research and many lessons from both psychodynamic and cognitive behavioural therapy. It is based on the insight that psychological stress reduces when both hemispheres of the brain are stimulated alternating, while the client is thinking about the traumatizing event. Through this, information is processed at a greater speed and cognitive restructuring happens. Sleep researchers assume that through the bilateral stimulation in waking state the same mechanisms as in information processing during sleep are stimulated. When applying bilateral stimulation a relaxing reaction is induced.

The therapy plan development seeks to determine which traumatising events are especially typical for the overall traumatic experience and which negative self-conclusions present the greatest stumbling blocks on the road towards healing.

A few EMDR treatment sessions are usually sufficient to treat patients suffering from a single traumatisation event, if the client is not strongly susceptible due to past experiences. In cases dealing with a sequence of repeated exposure to traumatic events over a long period of time, depending on the degree of damage sustained, it may take a longer to reach stability.

Enactive Trauma Therapy

Enactive trauma therapy was developed by PhD Ellert R.S. Nijenhuis for the treatment of trauma-related dissociation of personality.

Enactivism assumes that organisms are physically trained and embedded in their environment. To be more precise: your brain, your body and your environment constitute and refer to each other, are interdependent and always appear together. In constant interaction, a self, a world and a self emerge as part of this world.

Traumatized individuals are also considered as an organism-environment system. Because of the difficulty in integrating painful memories, a dissociative organization of the personality develops in order to ensure the survival of the person. This means a division into at least two dissociated personality parts. The majority of severe dissociative disorders occur most frequently in the first six years of life. Dissociation is the underlying cause of many trauma-related symptoms: e.g. flooding with trauma memories, avoidance behavior or self-harming actions. The integration of traumatized parts of the personality into the overall personality of people with complex trauma and dissociative disorders requires a gradual and regulated approach within a safe therapeutic relationship.

This creates an interaction similar to a dance.

Trauma therapy with attention to structural dissociation is increasingly oriented towards the subjective truth of those affected. Dealing with a split in personality requires intensive communication, coordination and cooperation between the various parts of the personality, as well as communication of the parts with the therapist.