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This book by a leading member of the Department of Psychiatry of Tuebingen University (Director: Prof. Ernst Kretschmer) deals with the problems, methods, and results of psychotherapy in an in-patient setting. Special factors inherent in this setting are the sheltered climate of the hospital, the limitation of the treatment period, and the possibility of additional group and drug therapy.
The method of analytic therapy used by the author—he calls it “gezielte Analyse” (aimed analysis)—focuses on the clarification of the actual conflict; but it is based on the analysis of the total personality structure including the aspects of sexuality, aggression, self-evaluation, and interpersonal relationships. It attempts to “anchor” the gained insights in the deeper layers of the personality.
The chief therapeutic factor is the affective contact in the doctor-patient relationship, beginning with the first interview. The therapist varies his technique in accordance with the specific needs of the individual patient; the detached patient, oversensitive to coercion, requires more passivity; the hysterical patient firmness; the compulsive, obsessive patient a very high degree of flexibility on the part of the therapist. Only in a positive doctor-patient relationship are the patient's constructive forces, vitally needed for successful therapy, being mobilized.
In some severe cases, especially the schizoid, the therapeutic process is activated by subcoma insulin, which lessens consciousness and control, and simultaneously intensifies the drives not only of hunger and thirst, but also of aggression and sex, thus leading to a temporary “dissociation of the personality.” This is considered helpful in the initial phase of therapy. The dream-like fantasies which occur in the subcoma are used in the subsequent therapeutic hours. They reflect the main problems of the patient and often show him