Personalized treatment-which interaction ingredients should be focused to capture the unconscious  

作　　者：Dagmar Steinmair Henriette Löffler-Stastka 

机构地区：[1]Department of Psychoanalysis and Psychotherapy,Medical University Vienna,Wien 1090,Österreich,Austria

出　　处：《World Journal of Clinical Cases》2022年第7期2053-2062,共10页世界临床病例杂志

摘　　要：A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions.Implementing mental health care in physical care services is still insufficient.Thus,interdisciplinary communication across treatment providers is essential.The standardized language provided by the diagnostic statistical manual favors a clear conceptualization.However,this approach might not focus on the individual,as thinking in categories might impede recognizing the continuum from healthy to diseased.Psychoanalytic theory is concerned with an individual’s unconscious conflictual wishes and motivations,manifested through enactments like psychic symptoms or(maladaptive)behavior with long-term consequences if not considered.Such modifiable internal and external factors often are inadequately treated.However,together with the physical chronic condition constraints,these factors determine degrees of freedom for a self-determined existence.The effect of therapeutic interventions,and especially therapy adherence,relies on a solid therapeutic relationship.Outcome and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment problems.This article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research.A clinical example is discussed.Additionally,further directions for research are given.The theoretical frame in psychoanalytic therapies is the affect-cognitive interface.Subliminal affect-perception is enabled via awareness of subjective meanings in oneself and the other;shaping this awareness is the main intervention point.The interactional ingredients,the patient’s inherent bioenvironmental history meeting the clinician,are relevant variables.Several intrinsic,subliminal parameters relevant for changing behavior are observed.Therapeutic interventions aim at supporting the internaliza

关 键 词：Chronic disease Psychological impairment PSYCHOANALYSIS Facial microexpressions Memory reconsolidation Reflection Relationship Resilience 

分 类 号：R493[医药卫生—康复医学]