Psychiatry and Psychotherapy

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Psychotropic drugs

In medication management we avoid psychotropic drugs as far as possible. If medication is already taken we 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.

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 efficiency of hypnosis does not depend on how deep the trance is. Through the activation of creative searching processes blockages can be solved selectively and sustainably.

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 protocols is a contribution to an extensive behavioural diagnostic, from which solution-oriented models are derived. Role-plays and homework are part of the conventional methods of behavioural therapy. They serve as means for self-assessment and information retrieval, for trying out new possibilities, maintaining progress and for transfer to daily-life.

Cognitive behavioural therapy is relevant to present times and target oriented, structures 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 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. In a preliminary talk the traumatizing key events and the most blocking negative personal statements are determined.

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.