Dr. rer. nat., Dipl.-Psych
Ralf Vogt
Leipziger Straße 36a
D - 04178 Leipzig
Germany














 

Book Contents

Ralf Vogt: Psychotrauma, State, Setting

  1. 1 Introduction 15
    1. 1.1 Preliminary Note for Colleagues 15
    2. 1.2 Preliminary Note for Clients 17
    3. 1.3 The Complex Importance of a Comprehensive Treatment and a Reduction of Complex Traumatizations 18
  2. 2 Theoretical Background 21
    1. 2.1 Interdisciplinary Connections between Important Fields of Research and Psychotraumatology 21
      1. 2.1.1 Preliminary Note Regarding the Connection between Physical Sciences and Psychotraumatology 21
      2. 2.1.2 Connections with and Translations from Neurobiology 21
      3. 2.1.3 Connections with and Translations from Comparative Psychobiology 27
      4. 2.1.4 Connections with and Translations from Prenatal, Perinatal, and Postnatal Birth Research 31
      5. 2.1.5 Connections with and Translations from Infant Research and Attachment Research 34
    2. 2.2 A Selection of Conceptually Adopted Constructs, Empirical Interpretations, and My Own Drafts for the Development of the SPIM-20-CTP 39
      1. 2.2.1 Preliminary Note Regarding the Connection with and Importance of Brain-Physiological and Psycho-Dynamic Traumata Circles 39
      2. 2.2.2 Regarding the Uniformity and Reciprocity of Complex Psychotrauma Symptoms, State Appearances, and Shapings of Settings 40
      3. 2.2.3 On the Correlation of Transferences, Introjects, and Implants in Regulation States 44
        1. Regarding Category 1: Situation-Flexible States 47
        2. Regarding Category 2: Elastic Habitual States 49
        3. Regarding Category 3: Transference States 50
        4. Regarding Category 4: Introject States 52
        5. Regarding Category 5: Implant States 54
        6. Regarding Category 6: Programming States 59
      4. 2.2.4 Hypotheses Regarding the Reciprocity between a Brain-Physiological and Psychological Regulation Cross-Linking 63
      5. 2.2.5 On the Position of the Psychotrauma within the Framework of Psycho-Dynamic Regulation and the Regulation-Specific Development 67
      6. 2.2.6 Regarding the Difference between Transference and Countertransference when Treating Complexly Traumatized Patients 72
      7. 2.2.7 The Benefit of Psychological Concepts of Externalization for Psychotrauma Therapy 75
      8. 2.2.8 The Advantage of Using “Beseelbare” Therapy Objects within the Framework of Transparent Treatment Structures in Psychotrauma Therapy 79
      9. 2.2.9 The Importance of a Fundamentally Body-Specific and Action-Specific Orientation for Psychotrauma Therapy 83
      10. 2.2.10 Regard the Terms of Abreaction, Closing of Activity-Specific Arcs, and Final Physical Actions and Interactions in Psychotrauma Therapy 86
      11. 2.2.11 Regarding the Importance of Supporting Touches in Psychotrauma Therapy 91
      12. 2.2.12 Regarding the Particular Benefit of Infantile Play for Psychotrauma Therapy 93
      13. 2.2.13 How Traumatic is it to Work Out a Psychotrauma? 96
      14. 2.2.14 With Which Quality Can a Psychotrauma be Remembered? 99
      15. 2.2.15 When and How is a Psychotrauma Therapy Finished? 101
  3. 3 Description of the SPIM-20-CTP with Manualized Materials and Case Vignettes 105
    1. 3.1 Preliminary Note Regarding the Development of the SPIM-20-CTP 105
    2. 3.2 The Current Treatment Criteria of the SPIM-20-CTP 106
    3. Criteria of the SPIM-20-CTP 106
    4. Explanations of the Criteria of the SPIM-20-CTP 107
    5. 3.3 The Treatment Phases of the SPIM-20-CTP during the Whole Therapy Process 112
    6. 3.4 The Empirical Treatment Phases of an Individual Session or of a Group Therapy Unit in the SPIM-20-CTP 116
    7. 3.5 Regarding Psycho-Education in the Therapy Concept of the SPIM-20-CTP with Case Vignettes 118
      1. 3.5.1 Preliminary Note 118
      2. 3.5.2 Catalogue of Terms of the SPIM-20-CTP 118
        1. Abreaction 118
        2. Alterego 120
        3. “Beseelbare” Therapy Objects 120
        4. Dissociation 121
        5. Dissociative Identity Disorder 122
        6. Flashback 122
        7. Implant 123
        8. Introject 123
        9. Introject – Transference Dynamics 124
        10. Introject – Transference Reversal 125
        11. Intrusion 125
        12. Complex Traumatization – Other Dissociative Disorders, Not Specified in More Detail 126
        13. Concentrated Structured Activity-Specific Performances for Psychotrauma Exposition 126
        14. Body Movement Orientation 127
        15. Victim 127
        16. Paralysis of the Victim or Victim Behavior 128
        17. Programming 128
        18. Setting 129
        19. State 129
        20. Switch 129
        21. Perpetrator 130
        22. Perpetrator Behavior 130
        23. Trauma or Psychotrauma 130
        24. Lifting the Trauma 131
        25. Trauma Orientation 131
        26. Trauma Shaping 131
        27. Triggers 132
        28. Transference 132
        29. Transference – Introject Reversal 133
      3. 3.5.3. Manualized Handouts for Clients 133
        1. 3.5.3.1 Preliminary Note on How to Deal with the Handouts 133
        2. Bulletin for Complex Traumatized Patients 134
        3. 3.5.3.2. Bulletin for Complex Traumatized Patients with an Orientation Help for Switching Exercises 134
        4. 3.5.3.3 Exercise Leaflet for Psycho-Physical Relief 137
        5. 3.5.3.4 Trigger Leaflet and Self-Help Leaflet 139
        6. 3.5.3.5 Curriculum Vitae and Therapy Reports for Complex Traumatized Patients 142
        7. 3.5.3.6 Basal Psychodynamics Leaflet 148
        8. 3.5.3.7 Trauma Maps and Resource Maps 152
        9. 3.5.3.8 Relationship Category Leaflet 156
        10. 3.5.3.9 Structural Graphs for Internal Parts 158
        11. 3.5.3.10 Structured Diary 164
        12. 3.5.3.11 Generation Questionnaire 166
        13. 3.5.3.12 Introject-Generation Scheme 171
        14. 3.5.3.13 Play Contract and Minutes 174
      4. 3.5.4. Manualized Handouts for Therapists 178
        1. 3.5.4.1 Preliminary Note on How to Deal with the Therapists’ Handouts 178
        2. 3.5.4.2 Psychotherapy Agreement for Individual and Group Therapy 178
        3. 3.5.4.3 Basal Minutes of Sessions – Individual Therapy 182
        4. 3.5.4.4 Basal Minutes of Sequences – Group Therapy 186
        5. 3.5.4.5 Minutes of the Differentiated Graduated Training of Regulation Scripts 190
  4. 4 Manualized Representation of Settings of the SPIM-20-CTP with Case Vignettes 194
    1. 4.1 Preliminary Note on How to Deal with Setting-Specific Indications and Instructions 194
    2. 4.2 Settings of Therapy Phase I: Stabilization and Psycho-Education 195
      1. 4.2.1 Basic Settings for Demonstrating the Psychodynamics 195
        1. 4.2.1.1 Settings for Establishing a Relationship with Contact Sticks 195
        2. 4.2.1.2 Setting for Deepening a Relationship with the Holding Rocker Rope and the Back Mat 198
        3. 4.2.1.3 Settings for Comparison Purposes and Variations of Stages of Regression with Gymnastic Ball Dialogues and Swing Settings 201
        4. 4.2.1.4 Settings for a Restorative and Diagnostic Regulation of Affects with Bags, Clubs, Blocks, and Other Objects 204
      2. 4.2.2 Restorative Settings for Enhancing Insights into Internal Regulation 209
        1. 4.2.2.1 Symbolizing Gestalt Therapeutic Work Settings With Regard to External Persons and Parts of the Internal Structure with Drawings, Sculptures, Stuffed Animals, and “Beseelbare” Objects 209
        2. 4.2.2.2 Settings for Diagnostic Play with Stuffed Animals, Resource- and Solution-Orientedly 212
        3. 4.2.2.3 Settings for a Diagnostic, Resource and Solution-Oriented Representation of and Work on the Internal Structure in the Form of Introject-Transference, Regulation Script-Differentiation, and Introject-Generation Schemes 214
        4. 4.2.2.4 Settings for a Regulation of Affects with Statements of “Beseelbare” Therapy Objects (Black Giant Bag, Red Giant Block, White Wall, Yellow Bag, and Similar Means) 216
      3. 4.2.3 Course Group Settings for an Introduction to a Joint Development Orientation in the Psychotrauma Treatment 218
        1. 4.2.3.1 Concept of the Course Group Therapy 218
        2. 4.2.3.2 Settings for Establishing a Contact, Deepening a Relationship, and Enhancing a Regressive Group Work 220
        3. 4.2.3.3 Settings for a Joint Regulation of Affects 221
      4. 4.2.4 Settings for Dealing with Reference Persons at the Beginning of the Therapy 222
        1. 4.2.4.1 Inclusion of Every Kind of Partnership 222
        2. 4.2.4.2 Dealing with Parents and Other Reference Persons as Conflict Partners (Letters, Conversation for Establishing Boundaries, Generation Interview) 223
    3. 4.3 Settings of Therapy Phase II: Psychodynamic Work on and Exposition of Psychotrauma 224
      1. 4.3.1 Advanced Settings for a Psychodynamic Deepening of the Internal Regulation Work 224
        1. 4.3.1.1 Enhancement of Regulation States with a Positive Transference (Subsequent Nurturing with Mother’s Womb Tub, Sick Persons’ Tub, Nest Bag, Throne Bed, Horse To Cling To, Hammock, Cuddling Egg, Cave) 224
        2. 4.3.1.2 Work on Regulation States with a Negative Transference (Bag-Club Accusation, Phobics’ Tub and Depression Tub) 229
        3. 4.3.1.3 Work on Individual Regulation States with a Negative Introjection (Questioning of Introject) 232
        4. 4.3.1.4 Work on Interlinked Regulation States with a Negative Introjection (Island Work) 234
        5. 4.3.1.5 Dealing with Extreme Affects (Murderous Rage and the Like) in Advanced Psychotrauma Therapy 237
      2. 4.3.2 Advanced Settings for Psychotrauma Exposition Work 240
        1. 4.3.2.1 Concept for a Concentrated, Structured Activity-Related Performance for Psychotrauma Exposition 240
        2. 4.3.2.2 Spontaneous Extensions of Individual Performances 241
        3. 4.3.2.3 Planned Extensions of Individual Performances with a Concentrated, Structured Activity-Related Performance for Psychotrauma Exposition 244
        4. 4.3.2.4 Combination of Various Exposition Settings with a Concentrated, Structured Activity-Related Performance for Psychotrauma Exposition 247
      3. 4.3.3 Long-Term Group Settings for Using Joint Development Resources and for Coping with the Psychotrauma 250
        1. 4.3.3.1 Concept of a Long-Term Group Therapy 250
        2. 4.3.3.2 Enhancement of Regulation States with a Positive Transference (Hammock, Hover Belt, Hands Bed) 252
        3. 4.3.3.3 Work on Regulation States with a Negative Transference (Black Giant Bag, Red Giant Block, Tug Rope, and Similar Objects) 254
        4. 4.3.3.4 Work on Individual Regulation States with Negative Introjection (Introject Cage) 256
        5. 4.3.3.5 Work on Interlinked Regulation States with Negative Introjection (Introject Kaleidoscope) 260
        6. 4.3.3.6 Work on Extreme Affects (Murderous Rage and the Like) in an Advanced Group 263
      4. 4.3.4 Settings for Dealing with Reference Persons in Connection with an Advanced Development of the Therapy 264
        1. 4.3.4.1 A More Intensive Inclusion of Partnerships and Family 264
        2. 4.3.4.2 Dealing with Parents and Other Reference Persons as Conflict Partners (Conversation for Confrontation Purposes) 265
    4. 4.4 Settings of Therapy Phase III: Integration and Farewell 267
      1. 4.4.1 Preliminary Note on Settings in the Integration and Detachment Process (Level of Consultation) 267
      2. 4.4.2 Reality-Oriented Demand-Specific Settings 268
        1. 4.4.2.1 Tasks for Self-Balancing (Bodies of Rules, Self-Epicrisis) 268
        2. 4.4.2.2 Settings for a Context-Related and an Inner Strengthening of Modification Successes (Repetitions of Settings, Self-Direction Settings) 268
        3. 4.4.2.3 Role Play Training for Coping with External Demands (Conversations about Professional Interests and Personal Courage, and the Like 269
      3. 4.4.3 Self-Help Groups’ Concepts (Subject Groups, Play Groups, Late Course Groups) 269
      4. 4.4.4 Dealing with Reference Persons Towards the End of the Therapy 271
        1. 4.4.4.1 Inclusion of Partners and the Family (Family Council) 271
        2. 4.4.4.2 Dealing with Parents, Relatives, or Other Important Reference Persons as Conflict Partners (Optional Visits, Conversation about Adult Needs, Guardianship and Death, Multi-Generation Conversation) 271
    5. 4.5 Photographic Documentation of Case Vignettes 275
  5. 5 Evaluation of the Treatment Approach of the SPIM-20-CTP 283
    1. 5.1 Preliminary Note 283
    2. 5.2 Investigation Design and Description of Random Samples 284
    3. 5.3 Statements Regarding the Movements to be Noted in Connection with the Random Samples 293
    4. 5.4 Evaluations with the BSI of All Points of Measurement 293
    5. 5.5 Evaluations with the Satisfaction Questionnaire 296
      1. 5.5.1 Analyses, on the basis of the Satisfaction Questionnaire’s Satisfaction Scales, of All Points of Measurement 296
      2. 5.5.2 Analyses in the Diagnosis Groups and Setting Groups 302
      3. 5.5.3 Categorized Surveys of Open Response Structures in the Satisfaction Questionnaire (ZFB) in Connection with the Post-Measurements and Catamnesis Measurements 305
        1. 5.5.3.1 Regarding the Use of “Beseelbare” Therapy Objects – the Importance of Aggression Settings, Dialogue Settings, and Subsequent Nurturing Settings 305
        2. 5.5.3.2 Regarding the Experience of Helpful, Nice, and Terrible Therapy Situations 309
  6. 6 Summary and Outlook of the Book 318
  7. 7 Materials Referring to the SPIM-20-CTP Approach 323
  8. 8 Further Training Regarding the SPIM-20-CTP Approach 325
  9. 9 Translation Glossary 327
  10. 10 Bibliography 328
 
       
       
   
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