Confinia psychiatrica. Borderland of psychiatry. Grenzgebiete der Psychiatrie. Les Confins de la psychiatrie最新文献

In the period of acute psychosis the musical compositions were characterized by 'hiatus discursivitatis' and a partial absoluteness, whereas the works of the chronic period are characterized by a sterile, dreary style. The patient's musical compositions and the stagnation they express correspond to his deficient way of living, i.e. his open limitation. The examination of the compositions enriches the psychopathology of creativity with a new dimension: the quality of time inherent in musical works provides a deeper in sight into the creative existence of the patient than the products of visual arts often examined.

The authors report on a case of borderline hysterics with several depressive reactions. The patient was treated by art therapy using the focal conflict model. The psychodynamic background of the disease, i.e. castration anxiety, incestuous tendencies and primary narcissism were revealed. The authors conclude that the use of the focal conflict model in art therapy enhances the patient's chances of working through unconscious conflicts in psychotherapy.

Nosological and pathophysiological aspects of psychiatric syndromes in the work of Emil Kraepelin are discussed. A chronological review shows that through developing his nosology, pathophysiological points of view because more and more prominent and nosological aspects got only a relative weight. Considering this background, the still accepted nosology of Kraepelin seems to have only the character of a typology, i.e. operationalizing symptoms on the psychopathological level in order to improve scientific communication. The pathophysiological aspect of a psychiatric nosology, however, allows us to prove--by means of psychophysiological methods--unspecific pathophysiologic mechanisms. These mechanisms characterize the organism affected by a psychiatric illness as having a lower modulatory capacity of psychophysiological systems in comparison with healthy controls. This is demonstrated in the results of the investigations of the Tübingen research group on depressive as well as schizophrenic syndromes.

The author attempts to uncover the logic behind the various delusion phenomena. Starting from the hypothesis that the paranoic interprets certain I-thou relations exclusively as auto-reference, a new conceptualization of the notion of 'auto-reference' is proposed. On the basis of a reformulated Freudian structure model, auto-reference (id) is defined as physical self-reference. With the aid of a many-valued (transclassical) logic it is shown that delusion phenomena represent mirror-like mappings of certain physical structures of the paranoic. The formal treatment of delusion structures should therefore directly indicate the composition of certain organic structures, especially brain structures, of the paranoic. As this paper tries to show, progress in delusion research can only be achieved by interdisciplinary cooperation.

The way in which the Norwegian artist Edvard Munch conveyed the feeling of tension and anxiety to the viewer is analyzed, taking into account composition, form and characteristics of lines. This is in contradiction to the conventional way of content analysis. It is suggested that such an analysis may contribute to a better understanding of the way in which professional artists as well as emotionally disturbed patients express their emotions and convey them to the viewer. This may probably be used as an additional means for better evaluation of emotions in paintings.

In the light of sculptures by the Canadian Mark Prent a comment is made on the 'Esthetics of Ugliness' from the medical and socio-psychological point of view. The focal point of interest lies in the interaction between the work and the onlooker. The onlooker's concern with the problem of the 'Esthetics of Ugliness' is considered as a possibility of understanding better and, therefore, preventing or as the case may be curing mental disorders of the individual and society as well as the impedding and even disease-causing factors in human relations.

This is a presentation of drawings of encephalopods by a schizophrenic patient of ours, Augustin Wilhelm. They will be compared with works of other patients as well as with encephalopod figures known from the history of art and culture. This comparison should enable a better understanding of the subject known in schizophrenic painting as the 'regressive phenomenon', which until today has been insufficiently grasped.

The relations of the individual to others and family are understood through 'intersubjective' and/or 'interfamiliar' concepts. This 'inter' is always the origin of the relations between subjects; it is a reality which is of an atmospheric pneumatic nature. Its creative power and the uniqueness of the word are clarified by a selection of examples from oriental and occidental cultures. In contrast to it, the relations of the individual are also determined by norms, in which the 'objektive Geist' (Hegel) of a particular time is manifested. The individual is, in this relation, first of all a carrier of roles. A conditional analysis of psychotic disturbances must be based on the concept that the individual's psyche, in both spheres, is not a 'tabula rasa' (Locke), but always conveys a selection of that which has been offered in the situation (Leibniz). Out of this come constellations of a conditional nature conductive to the development of endogenous psychoses which exhibit themselves in the inter-sphere and role-sphere. These can only develop where a coherence of specific personality-structures with specific situations occurs. What makes various situations pathogenic for a particular, predisposed type, is a specific inference of meaning from peristatic precipitations.

This essay deals with Karl Kraus' polemics against psychiatry; not only orthodox psychiatry but also psychoanalysis, which at that time was gaining in importance. The introduction is an appreciation of Kraus' significance for the German speaking civilization. Then the two cases, Louis von Sachsen and Prof. Beer, are discussed in relationship to Kraus' polemics against forensic psychiatry, for in these cases forensic psychiatry was in danger of losing its claim of being scientific and of becoming a supporter of the vested interests or an advocate of sexual repression. It is then attempted to show how aphorisms with universal validity arise out of topical polemics. Kraus' position in relation to Freud and his school is discussed. We try to demonstrate that the similarity in opinion that H. Marcuse assumed about the significance of a sexual economy can only be a superficial one, especially as it relates to sublimation as a mainspring of civilization. Also Kraus' critique of the inferiority complex is delved into. Concluding, we touch upon attempts at interpreting Kraus' work and personality from a psychoanalytical standpoint. Here the term 'narcissistic personality' is discussed.