Countertransference in Psychotherapy of Paranoid Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s779-s779
Author(s):  
S. Manojlovic ◽  
J. Nikolic-Popovic

The complexity of psychotherapy is based on the very nature of the paranoid process. The therapist must not only have a good understanding of the paranoid process, but also needs to be especially careful regarding the transference-countertransference emotions. Long-standing experience in psychotherapeutic work with paranoid patients, in the individual and group setting, has enabled us to systematize countertransference reactions. Dominant projective mechanisms require a high ability to contain emotions from the therapists. The most prominent is aggression, in regard to which the countertransference feelings appear, ranging from aggression to exposedness, impotence, and victimization. The therapist must constantly separate feelings which represent his “blind spot” from those which he perceives as a patient's part in therapist himself. The latter countertransference enables the therapist to experience the internal object of the patient by the mechanism of projective identification. Beside the aggression, the feelings from the narcissistic spectrum related to topics of value, competence, rivalling, idealization, and devaluation represent a significant countertransference problem. The countertransference feelings in group psychotherapy are of lower intensity, and rarely focused on the therapist himself. In the group, there is also the possibility of significant intensification of the projection of aggression, when the whole group is focusing the projections onto the therapist. In the group milieu, commonly emphasized countertransference feelings are related to the position in the group, competence, autonomy, and dependence. The understandings and way of coping with countertransference emotions determine the potential for creating the safe emotional ground in psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2017 ◽  
Vol 41 (S1) ◽  
pp. s879-s879
Author(s):  
I. Sosin ◽  
Y. Chuev ◽  
A. Volkov ◽  
O. Goncharova

IntroductionModern clinical narcology searches for anti-craving programs to overcome psychoactive substances (PAS) pathological addiction with bio-adaptive regulation of systems (BARS).Aims and objectivesTo develop computer modified biofeedback program integrated with Luscher test.MethodTwenty-two PAS addicts who were undergoing biofeedback modified psycho-training were examined. Computer rheoencephalogram (REG) was used as an external monitoring module.ResultsTechnologically novel biofeedback computer modification was developed with preceding Luscher computer testing for determination of the individual preference colour and the colour producing individual unpleasant associations in respondents. Consequently, biofeedback program was corrected differentially by changing standard colour templates for those personified on monitor. Cerebral hemodynamics condition transferred to individually designed for a particular respondent colour registers is used as a homeostatic parameter reflecting alcohol craving presence/absence: in case of the disordered REG parameters the signal reflects the respondent's unpleasant (negative) colour, and with no craving the screen is filled with positive, pleasant, favourite colour. During BARS auto-training the respondents’ skills to mediate present subjective clinical PAS craving manifestations with unpleasant colour and the experimental auto-training method have been mastered, and those psycho emotional states which displace PAS craving symbolic colour from the screen are selected, and it is substituted with favourite colour (symbol of healthy mode of life motivations).ConclusionsUsage of combined BARS biofeedback improved effectiveness of the training and allowed to objectivize and control the condition of the patient getting reliable visual and digital information about either regress or activation of PAS craving and potential relapse of addictive behaviour.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1970 ◽  
Vol 4 (1) ◽  
pp. 43-48 ◽  
Author(s):  
George L. Christie

Some tentative conclusions about the organization and management of relatively closed psychotherapeutic groups are illustrated by examples culled from private clinical practice. After reviewing the rationale of group psychotherapy and its advantages over the individual form, the paper deals mainly with patient selection, the developmental history of the group and group leader technique.


2017 ◽  
Vol 41 (S1) ◽  
pp. S588-S588
Author(s):  
M. Mezghani ◽  
F. Fekih-Romdhane ◽  
F. El Ghali ◽  
M. Zghal ◽  
G. Jmii ◽  
...  

IntroductionIncest may be defined as sexual relations between close blood relatives. Legally, incest and sexual aggression toward minors are classified as a criminal behaviour. Tunisia is among the countries from which incest cases are rarely reported.Objectives and methodThe aim of this study is to investigate the relationship between the psychotic structure and incest, and to describe the individual, clinical, and criminal traits of the incestuous father through clinical observation.Case reportMr T.G is 46 years old. He is married and has six daughters. His wife appears to be passive, and largely dependent on her husband. Mr T.G has had incestuous relationships, initially, with his two eldest daughters. The acts were followed by the mother's complicit silence and the non-denunciation of the daughters. Two years later, he starts an incestuous behavior with his third daughter. Incest took place in the context of delusion. The patient was convinced that he is responsible of his daughters’ sexuality education. He develops an incoherent theory of purification with a tendency towards morbid rationalism. It is only after four years of insufferable paternal incestuous relationships that the third daughter filed a complaint to the police. A psychiatric expertise concluded that the accused is exempt from criminal responsibility.ConclusionIncest is a multi-faceted phenomenon, which makes its approach, comprehension, and treatment quite complex. For a psychotic patient incest is a means to deny alterity by crushing other. It also allows him to find, in this complete power, control over his annihilation anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S11-S11
Author(s):  
T. Jamieson-Craig

Social psychiatry starts from the position that as social animals, the cause, course and response to treatment of mental health problems are powerfully determined by the social environment. For example, childhood trauma within the home and bullying at school is associated with both internalizing and externalizing disorders and exerts its influence through life-long impacts on the individual's ability to form supportive relationships with others, their self-esteem and their resilience in the face of future adversity. Difficulties forming and sustaining personal relationships are intensified by the emergence of illness, consequent social exclusion and discrimination that in turn intensifies damaging beliefs of low self-worth and rejection. In contrast, we have considerable evidence for the “therapeutic” value of good relationships, notably the role of family and social support in the remarkable resilience shown by those who have come through the most appalling environmental and personal crises. It is therefore surprising that the balance of psychiatric therapeutic effort is stubbornly focused on the individual patient as the problem with less attention paid to developing and implementing social interventions targeted at the family and wider social network to prevent and alleviate mental illness. In this presentation I will argue that psychiatrists should be more active in developing and leading interventions that focus on the social and interpersonal networks of their patients with illustrations from past and ongoing efforts to this end.Disclosure of interestThe author has not supplied his declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S34-S35
Author(s):  
A. Schellekens

Addictive behaviours are highly common (prevalence worldwide about 10%), with major impact on the individual and society (contributing to 5% of overall DALYs and mortality) [1,2]. Though a number of evidence-based treatments are available, relapse rates remain high, up to 50% within one year of treatment [3,4]. Staging of addictive behaviors might contribute to improve this prognosis by indicating which patient could benefit most from which treatment modality.In DSM-5 clinical staging of addictive disorders is limited to grading the severity of the disorder, based on criterion counts [5]. However, addictive disorders are highly heterogeneous, with distinct clinical profiles and neurobiological underpinnings of the disorder. Reward-processing deficits are considered a hallmark of addiction. Several additional neurobiological deficits have been identified in addicted individuals, such as dysfunction of brain stress systems, anterior cingulate cortex and habenula.These neurobiological deficits may identify clinical subgroups of patients with distinct pathophysiology (profiling), or be related to progression of the disorder (staging). This presentation will focus on clinical staging and profiling of addictive behaviors combining neurobiological findings and clinical practice [6].Disclosure of interestThe author has not supplied his declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. 915-915
Author(s):  
Bhugra D.

International medical graduates (IMGs) by definition move from the country in which they received their training to another country in order to train and settle down in. The reasons for migration by IMGs can be political, educational or economic. Each reason brings with it a series of difficulties, both for the individual and for the society to which they move (as well as to the society they leave behind). Acculturation and settling down will raise specific issues in the functioning of the IMGs and to their response to the new country. Certain factorsmaycause stress and othersmaycontribute to the successful adjustment by the IMGs. Suggestions on how to support international medical graduates and how to help reduce their stress will be highlighted.Disclosure of interestThe author has not supplied his declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S723-S723
Author(s):  
S. Färber ◽  
M. Färber

IntroductionPsychiatric disorders may become more severe when the subject is exposed to a hostile environment. Symptoms of mental malaise are expressed by the senses, including speech and language.MethodsThe method is used of semiotic analysis and thanatological movie.ObjectiveTo investigate the limit and death as a trigger of a singular mode of use of the spoken language. The problem presented in this paper is the linguistic system created by Nell.ResultsPartial results show that spoken language in this particular cut, becomes an instrument for dealing with the losses accumulated throughout his life. The life of isolation, restrictions on maternal vocalization, her mother's death and mourning acted as an inhibitor of language.ConclusionThe spoken language works like kaleidoscope of interactions of the individual with their group, with the medium in which it is inserted, with the set of beliefs that nourishes and with the world that she wants there, even if only in your intimate venue. Thus, demonstrating the sociolinguistic approach inalienable role in speech performance.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1991 ◽  
Vol 24 (4) ◽  
pp. 389-407 ◽  
Author(s):  
Alan Prodgers

In the postwar years there has been considerable debate on the use and usefulness of the therapist's countertransference feelings in individual psychotherapy, whereas in group psychotherapy, at least in the UK, there has been comparatively little attempt to address these issues. This paper reviews countertransference in relation to the complexities of the group situation. In particular I argue that for the group the term `countertransference' is itself confusing, and this is reflected in its usage, which creates potential for misunderstanding.


2006 ◽  
Vol 39 (3) ◽  
pp. 390-399 ◽  
Author(s):  
Raymond Battegay

This article analyzes five phases in the group process in which narcissism may, also on an archaic basis, be seen to be present, and its effect both on the individuals and the group process, as well as towards the conductor. The author also refers to the tasks of the therapist in respect of this narcissism, as it affects the individual, the other group members, and the group-as-a-whole.


2017 ◽  
Vol 41 (S1) ◽  
pp. S612-S612
Author(s):  
R. Nagpal ◽  
V.G. Jhanwar

A quaint problem indeed. This is an issue where ethical and practical management issues lock horns. An individual with no insight on a rampage, a threat to self and others cannot be given medicines without consent except in an indoor facility and admitted under a specific provision of the current statute. Contrary to the law, the mental health policy envisages community care of the individual. For a time defined interval, surreptitious medication can be administered providing much needed relief to the caregivers and calms the recipient. Surreptitious medication can of course be an instrument of control and hence would necessitate a system of checks and balances. Surreptitious medication tests legal and ethical boundaries. It offers relief to caregivers but can be an instrument of abuse. The act of administering a drug without the individual's consent is prima facie wrong but if the context is woven in, a whole new dimension arises.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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