Treatment

The unconscious fulfils the function of giving orientation to our thinking and actions and manoeuvring us safely through everyday life. If these manoeuvres are determined by painful injuries from the past it is difficult for us to come to terms with them. Psychoanalysis supports the process of leaving the past behind and starting something new. However, this process cannot be set in motion simply through rational insights. In the opinion of the renowned brain researcher Gerhard Roth, only those thoughts that are associated with strong emotions have a healing effect. Such connections between thoughts and strong, unconsciously formed feelings can only be achieved through repetition. Pacifying the unconscious therefore takes time.

I work with three forms of treatment, all of which are based on psychoanalysis and focus on unconscious interrelationships:

• Analytical psychotherapy (psychoanalysis)
  Classical psychoanalysis looks at a person’s whole personality along with its history and underlying problems of relationships and self-esteem. It provides the patient with a secure framework for him to communicate to the therapist the experiences of the relationships that frighten and hurt him and to analyze them together with him. This enables these experiences to be subsequently understood and processed.
  Setting: 3-4 sessions per week over several years; lying position on couch

• Depth-psychologically based psychotherapy
  This psychoanalytical technique focuses on conflicts and crises that arise in the patient’s current life situation. Here too, the therapist and patient search together for the unconscious interrelationships of the current problem. However, they concentrate on the central aspects of the problem without analyzing the whole personality.
  Setting: 1-2 sessions per week over 1-1½ years; seated position

• Psychoanalytically oriented focal therapy
  This is a psychoanalytical brief therapy which focuses on the current problem. It can only be used if this problem is caused by a conflict that can be isolated.
  Setting: 1 session per week over ½ year; seated position

If you are interested, I will work with you in one or more preliminary sessions to clarify your complaints and their possible connections. With this information and my experience, together we will choose a form of therapy for you that fits the framework of your life.

An important topic in the context of psychotherapy is the question of the effectiveness of psychotropic drugs. This is a very complex topic, where I would like to point out only one issue: the problematic effectiveness of a certain group of antidepressants: the SSRI Selective Serotonin Reuptake Inhibitors. These SSRIs are also called second-generation antidepressants, and they are supposed to have significantly fewer side effects than the older antidepressants (e.g., tricyclic and tetracyclic antidepressants). However, the entire SSRI group is highly problematic and efficacy is virtually nonexistent compared to placebos. A group of researchers around Irving Kirsch has done very convincing meta-analyses here. If you would like to read the original article by Irving Kirsch on this very exciting meta-study, please click on the following link: Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al. (2008) Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration. PLOS Medicine 5(2): e45.

Very recently, there is a very nice summary presentation by Dipl.-Psych. Thorsten Padberg from Berlin. In 2018, he presented the current research situation on antidepressants and especially considered the contrast to the public perception of SSRIs. He clearly shows how low the pharmacological efficacy of SSRI antidepressants is to be assessed. If you would like to read the actual article by Thorsten Padberg, please click on the following link: Padberg, T. (2018) Placebos, Drogen, Medikamente Der schwierige Umgang mit Antidepressiva

Depression is one of the most common mental illnesses and affects around 8% of the German population. However, there are considerable deficits in the care of these patients: Only 6% of these people with depression receive psychotherapy, but 42% take antidepressant medication. In addition, over half of the patients are diagnosed by general practitioner and only a very small proportion by psychotherapists. These are the findings of a study conducted by AOK Niedersachsen in 2022. To read and download the original study, please click on the following link: Stahmeyer, J. T., Märtens, C., Eidt-Koch, D., Kahl, K. G., Ziedler, J. & Eberhard, S. (2022). Versorgungssituation von Menschen mit Depressionsdiagnose. Deutsches Ärzteblatt, 119 (26).

The German Federal Chamber of Psychotherapists has developed a brochure that clearly explains the different ways of psychotherapy and provides important background information. Please click on the image of the brochure below. It will open in your web browser in a new window and you can read the file. Of course, you can also download the file to your computer first and then read it with a PDF program such as Adobe Reader.