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  • Title: [The "interpretation" principle and the "response" principle in psychoanalytic therapy. Comments on the theoretical foundation of two therapeutic orientations, directed at different patient groups].
    Author: Heigl-Evers A, Nitzschke B.
    Journal: Z Psychosom Med Psychoanal; 1991; 37(2):115-27. PubMed ID: 1853645.
    Abstract:
    The theoretical justification for two psychoanalytic, therapeutic offers, one of them oriented toward the principle of "interpretation" the other toward that of the "answer", is based on the differences in the psychopathology of two groups of disturbances: In the case of classical (transfer) neuroses, conflict pathology is dominant, in the case of preoedipal or ego structure disturbances, development pathology is dominant. The differences in these forms of illness are related above all to the degree of structuring of the patient. Neuroses exhibit a higher degree of structure than ego structure disturbances, if we understand 'structure' as the differentiation of the psychic apparatus in a certain number of systems with certain programs, i.e. fixed forms of organized behavior. Classical neuroses are more highly structured forms of disturbance with an oedipal superego, intra-psychic conflicts, and an ego which, as an organization process, reveals a potential for integration and a greater tolerance for frustration; they stand in contrast to less highly structured preoedipal forms of disturbance with precursors of a superego in the form of an externalization of guilt, the ego as a kind of battlefield between the id and the superego, with a low tolerance for frustration, i.e., an intolerance of failure. Therapy in these two cases must differ according to the differences in the level of organization: In the case of classical neuroses, application of the therapeutic principle of "interpretation" is indicated, in the case of ego structure disturbances, the principle of "answer" should be applied.
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