TREATMENT GOAL BEAUTIFUL LIFE – THE ORPHEUS PROGRAMME
Enabling an independent and joyful, in other words beautiful life is main objective of a therapy programme which has been developed primarily for addicts a few years ago in the Anton Proksch Institute and has become known as the „Orpheus-Programme“. This Orpheus Programme regards itself as wholeheartedly committed to the maxims of a human based medicine. What is important here is to create safe opportunities and an opening ambience to which patients become capable to take their own first steps, were what is attractive and of beauty to them is to be found and were the individual does not suffer such far-reaching harm in case of stumbling and tumbling that it wouldn’t be easily possible again to take further steps towards a joyful life. The Orpheus Programme doesn’t regard itself as an alternative to conventional treatment services, but as a complementary therapeutic approach to pharmacotherapy, psychotherapy and sociotherapy of psychological illnesses. The modalities of this treatment program with a lastly open objective are based on a multidimensional and differential diagnostic process, whereas particular importance is attached to optative and aesthetic resources. Goal is not a predetermined objective given by the therapist, but to enable a potentiality, the path to a joyful life within reach of the individual. Thereby beauty is main focus of therapy as well as self therapeutic agent.
Keywords: addiction, beauty, aesthetics, joy, sensual perception
CONSENT IN ADDICTION
An existential analytical approach
Dependency is obstruction in being person. This exceedingly strong psychological neediness regularly forces the free will to submit itself. The will gives in and plays along. This brings relief. The nasty thing about it: The will acts against one’s own being as a person, the human being against itself. The human has become an enemy of itself, come to a state of self-destruction. – In order to escape this auto-destructive behavior, a systematic reference to one’s own person is helpful in order to anchor oneself again and to gradually live from what is significant. For this purpose, training steps and a method for enforcing personal strengths are presented which starts at the point of acceptance of addiction and this way attempts to provide further scope for the person and overcome dependency from within.
Keywords: addiction, will, freedom, self-acceptance
ADDICTION: IN THE MILD GLEAM OF ILLUSION TO THE ABYSS
While we feel like in paradise intoxicated, experiencing addiction becomes hell. Literary accounts and witnesses of clients describe how it all began so easily: Enticed by the mild gleam of illusion, addicts become slaves to the insubstantiality of existence whilst following the siren-like will-o`-the-wisps. In the estrangement to themselves the voice of conscience fades and having become addicted they drift, apparently helplessly wasting away, towards the abyss. The helpless experience and unauthentic behavior is illustrated on the basis of examples from literature and psychotherapeutic practice. Psychoanalytical theory constructions and the existential analytical perspective enable a therapeutic understanding and indicate first steps out of addiction.
Keywords: addiction, literature, psychodynamics, Existential Analysis
DESPAIR OF SELF
On the deeper existential cause of addiction
Before genetic factors and neuronal patterns become effective or biochemically measurable signs of degeneration manifest themselves and can be diagnosed as the immediate cause for addiction, the addict is existentially marked by the despair of self (Kierkegaard’s „Verzweiflung am Selbst“) and a fallenness onto one (Heidegger’s „Verfallenheit an das Man“) in its various concretions. Seen from a fundamental ontological and existential analytical perspective, the lack of spirit (Kierkegaard’s Geistlosigkeit) becoming apparent therein, which is ultimately self-lessness and self-ishness (self addictedness) rolled into one, as well as the failure in the task to attain authenticity (Eigentlichkeit) for one’s being-in-existence, are merely the indirect but surely the actual and deepest reason for the development of human addictive behavior. This deep existential philosophical structure enables us to understand that and why addictive behavior to a certain extent occurs with nearly all human beings in a usually latent but controllable form. While the purely medical, empiric-psychological, therapeutic perspective principally targets reparation, the existential philosophical understanding of addiction-causes has great value due to its capability to preventively face addiction tendencies.
Keywords: fallenness, (deep) boredom (Heidegger), despair (Kierkegaard)
I ACHIEVE NOTHING BUT WORK
The image of workaholism according to typical symptoms
This case vignette depicts an image of the development from motivated and committed work to work ending in addictive behavior. Intention of this article is to explain to what extent such addictive behavior, infesting everyday working activities, affects physique, emotionality and sociality of the patient. Subsequently, the behavior of the patient is compared with central criteria indicating addiction.
Keywords: workaholic, workaholism, addiction, case vignette
“BUT I DO NOT WANT TO HUNGER!”
Obesity in the context of psychotherapy
Some patients ward off unpleasant feelings. Food intake is one of the means for this purpose amongst other things. On the basis of a case example, the issue of binge eating and subsequent overweight is illustrated. A possible existential analytical approach in the psychotherapy of overweight patients is outlined.
Keywords: eating disorder, obesity, psychotherapy treatment, case report
LOST AT PLAY
The excessive nonprofessional and non-educational use of computer and internet leading to serious disadvantages for the person affected, commonly known as “computer addiction”, is a new cultural and psychopathological phenomenon.
Hence, up to now, there are no diagnostic criteria for the pathological use of computer and internet (or the “internet addiction”) in ICD 10 and DSM 5. The AHG Klinik Münchwies in Germany established a special clinical branch concerning the pathological use of computer and internet. Based on clinical experience and research in this field, phenomenological criteria of diagnosis were defined and therapeutic strategies developed. The pathognomonical dichotomy of the self, concerning reality versus the virtual world, is of special significance in this context.
KeyWords: PC/internet addiction, disorder due to use of internet games, pathological use of PC/internet, diagnostic criteria, treatment, phenomenology
ADDICTION – SHELTER AND FORTRESS
In the past years a multitude of studies have clearly proven the epidemiological connection between traumatization, post traumatic disorders and addiction. It makes sense to treat both illnesses simultaneously and to develop coordinated treatment concepts for this. Crucial in this process is a clear empathetic, trauma sensitive, therapeutic approach as well as goal oriented coordination with the client in therapy. Helping patients to help themselves is an aim, therefore making it also a goal for the patient to become an expert on both disorders.
Keywords: addiction, trauma, epidemiology, simultaneous treatment of addiction and trauma, therapeutic approach
QUALITY OF LIFE BEFORE AND AFTER STATIONARY ADDICTION THERAPY
Quantitative and qualitative research results by comparison
SILVIA LÄNGLE & ASTRID GÖRTZ
In recent years several isolated cases of stationary therapeutic processes in a hospital for patients suffering from addiction, the Carina-Hospital in Feldkirch, were subjected to closer investigation. On the one hand, interviews with patients before and at the end of their therapy stay were carried out and subjected to phenomenological analysis. On the other hand, clinically relevant parameters were measured with various questionnaires (pre/post treatment). A comparison of these methods based on three isolated cases also shows, apart from the interesting insights into therapy effects on addicted patients, the possibilities and limits of the different approaches within psychotherapy research.
Keywords: quantitative research, qualitative research, phenomenological-hermeneutical research, pre/post evaluation, (stationary) addiction therapy, quality of life, empirical study
METHOD FOR HERMENEUTIC-PHENOMENOLOGICAL RESEARCH PRACTICE
Qualitative research is a genuine issue of Existential Analysis due to its centering on the person and essential contents of life (meaning). Aside from a short description of the basics of this research, a hermeneutically oriented approach is presented in particular, with which the responses in interviews can be understood as meaningful expressions of life. The instructions at hand for hermeneutic-phenomenological research are oriented towards the classical philosophical steps of Epoché in phenomenology. These are translated in each step into stages of a psychological process. It is for the researcher to not only put aside prior knowledge, but also affective interpretations and experience-based interpretations, in order to arrive at a phenomenological perception and delineate the essential in the statement.
Keywords: hermeneutic-phenomenological research, qualitative research, phenomenology, phenomenological method
INNER EMPTINESS AND ADDICTION
ELSBETH KOHLER, JOHANNES RAUCH
Inner emptiness is connected to self-affirmation and the relation to one’s own person. Inner emptiness can be felt as extremely painful. Addictive substances and addictive behavior can relieve this pain or distract from it. However, addictive substances can also render better access towards oneself if for example anxiety or aggression is regulated and the person therefore becomes freer. But in dependency inner emptiness increases since failure in relationships, at work etc. amplifies self-devaluation and self-estrangement. Work on developing a positive relationship to oneself and the treatment of addiction take place in parallel.
Keywords: inner emptiness, self-estrangement, addiction
“WHEN ALL IS OVERCOME, IT IS FAR FROM BEING OVER”
Psychotherapy with mature children of alcoholic parents
As an introduction two case vignettes are introduced. Then typical characteristics of a family with at least one addicted parent are described and, implementing the existential analytical structural model according to Längle, the only partially accomplished development of self-esteem and basic value along with resulting problems is outlined. Finally, central aspects of psychotherapy with mature children of alcoholic parents are examined in detail on the basis of a case vignette.
Keywords: addiction, developmental psychology, family members, children, late effects
EXISTENTIAL ANALYTICAL THERAPY OF ANOREXIA AND BULIMIA
Central for the therapeutic approach is the understanding of anorexia and bulimia as a complex illness on a physical, psychological and cognitive level. This leads to the necessity of integrating the treatment of all these aspects into therapy. The present article outlines essential steps in existential analytical therapy. First of all questions referring to the setting are clarified and possibilities of strengthening resources are discussed with the aim to provide patients with a stability allowing the treatment of their profound problems. The main focus of the discussion is on the treatment of deficits – in perception, emotional experiencing, arrangement of relationships, self-worth, thought and attitudes – as well as the treatment of injuries and traumatization in biography.
Keywords: anorexia, bulimia, eating disorder, addiction, PEA, inner child
ADAM, WHERE ARE YOU? EVE, WHAT ARE YOU DOING?
Addiction potential of the romantic relationship ideal and its impact on relationship arrangement and partnership
Focus of this article is the dependency and isolation of couple relationships. The dependency on one another, as well as the latent entanglement generally indwelling (couple) relationships, will be outlined by a free interpretation of the ancient oriental narrative of Adam and Eve. A subjective and modern perspective of the picture puts the spotlight on basic masculine and feminine patterns. Then socio-cultural influence factors on the psychodynamic interaction of couples are outlined. Inspirations for engaged serenity grant an outlook on the possibility of couples being united while preserving authenticity and autonomy.
Keywords: relationship addiction, couple, partnership, encounter, love
The internet today has become indispensible, and sexuality and pornography are firm components of search queries. More than 30% of the worldwide data traffic is pornographic. This phenomenon transforms society, its concepts of sexuality, gender roles and eroticism. Sexuality and zeitgeist cannot be separated. However, excessive consumption is only a symptom which shouldn’t only be taken into account in psychotherapeutic practice but treated as well.
Keywords: pornography, internet, “sex pour sex”, social change – liberation and risk
BACKGAMMON AND POKER INSIDE – RISE AND FALL OF A PROFESSIONAL PLAYER
What makes the difference between a professional and an amateur player? What characterizes a professional player? Which dangers exist to become addicted? And where are these dangers when it comes to online games?
Keywords: professional player, gambling addiction
CONNECTED BUT YET DISCONNECTED
The excessive use of social media applications in the sense of psychologically pathogenic addiction together with their consequences have been barely researched and are difficult to grasp in adolescents due to their rapidly changing media behavior. Experts are divided about the question concerning the effects of virtual social interaction on real-life behavior and on the social and emotional personality development of juveniles. This article describes the factors which fascinate juveniles particularly in social media, the criteria when a person can be classified as dependent and which backgrounds promote addictive behavior. Positive developmental potentials are described, and ideas for treatment are presented.
Keywords: internet addiction, social media, dependency, adolescents
Introduction and location determination
What does a method of psychotherapy have to do with pedagogy? Which aspects of Logotherapy can be employed in the context of education? How can Existential Analysis be applied in the field of pedagogy? A task group within the “Gesellschaft für Logotherapie und Existenzanalyse” is dealing with this issue in connection with the latest Existential Analysis. After the pedagogic direction was seen in the “Personal Pedagogy” for a long time, it now finds its expression in an advanced “Existential Pedagogy”. In this article previous developments and the current concept is presented.
Keywords: Existential Pedagogy, phenomenological approach, personal encounter, educational goal, development, evolvement
ENCOUNTERING ADDICTION WITH ATTENTIVENESS
Workshop on the issue „attentiveness based relapse prevention“
Persons suffering from addictive disorders become ensnared in a disastrous addictive cycle in which they lose their inner freedom. Addiction is characterized by an escape from the present sober condition. The “here and now” is rejected. Attentiveness can help withstand the escape-pressure and craving, rendering it possible to stay, accept it and turn towards what is perceived as unpleasant. In this manner attentiveness can lead to a sensitization of the relapse trigger and its included thinking and feeling patterns, and alternative behavioral options can be recognized.
This article pursues the question to what extent attentiveness enables the recuperation of inner freedom lost in addiction. In particular, the efficacy of attentiveness with regard to the fundamental motivations is illuminated. Elements from the MBRP-Programme (‘Mindfullness-Based Relapse Prevention’) according to Sarah W. Bowen, Neha Chawla und G. Alan Marlatt (2012) are presented, and their application options delineated by the example of a psychotherapeutically supported residential and job project for persons with addiction experience.
Keywords: addiction, attentiveness, self-detachment ability, inner observer, inner freedom, compassion for oneself
OPIOID DRUG ADDICTION AND THE FUNDAMENTAL EXISTENTIAL MOTIVATIONS
This article describes how an opioid-addicted person experiences existential reality on the ontological, axiological, ethical, and context (praxiological) levels of existence. My hypothesis is that in failing to manage their being at each of the four existential levels, the opioid-addicted person, “builds” an alternative “drug world” in which they carry out a ‘pseudo fulfilment’ of their fundamental aspirations and find “meaning”.
Keywords: Fundamental Motivations, Drug Addiction Experience, ‘Drug World’
ADDICTION AND MEANING
Human beings are beings of meaning; we seek meaning in our lives and for our lives. Existential theory and practice proposes that we are beings faced with the responsibility of making free choices, choices designed to support each of us to live an authentic life in relationship with self and other. Those suffering in a life of addiction cannot experience life authentically, and suffer from a loss of meaning. Existential Analysis offers specific treatment methods designed to help individuals, through the activation of will, to be released from the bonds of addiction, so that they can live meaningful lives freely, responsibly and authentically. Two such methods include: the Meaning Searching Method, and the Horizon of Life Problem Method. The case study offered here demonstrates these methods in practice.
Key words: Addiction, case study, meaning, methods, will