Therapists' responses during psychotherapy of holocaust survivors and their second generation. (17/803)

Human personality contains three layers of identity: the collective, the familial, and the individual, intra-psychic. All three have been directly traumatized and damaged in Holocaust (Shoah) survivors and indirectly through overt and covert transmission in their children. Survivors and the second generation usually contain a few of these identity components in a state of fragmentation, which become central in the therapeutic dialogue between therapists and the patients. When the therapist belongs to the same traumatized population there exists a unique complexity of an a priori countertransference. Sharing the same traumatogenic reality that the patient seeks to alleviate through therapy poses unique difficulties and challenges for the therapist. In working with survivors, pre-war intra-familial traumatizations are of little significance in the face of the massive traumas and death suffered in the Holocaust. In the case of the second generation, "ordinary" developmental impairments and difficulties cannot be fully understood without knowledge of the parents' war experiences and the resultant family atmosphere. Thus, every therapist has to examine both his knowledge and especially his responses not only about the Shoah as a massive trauma but the specific war history of both parents families. Self-knowledge and awareness are necessary to a far greater extent than usual if one is not to be shocked or surprised into acting out. The depth and degree of openness which therapists need when dealing with Holocaust survivors and their children are at least as important as clinical skills.  (+info)

Aftermath of war experience: impact of anxiety and aggressive feelings on the group and the therapist. (18/803)

AIM: Analysis of some anxious and aggressive features stemming from the highly traumatic war experiences and having as a consequence chronic posttraumatic stress disorder (PTSD). METHOD: Group psychotherapy was applied as a therapeutic approach of choice. RESULTS: During the psychotherapeutic process, the possibility to name and express anxiety and aggressiveness was uncovered not only as the sequels of highly traumatic war experiences but even the transgenerational transmission of frustrations and aggressive feelings. These features have constantly very strong influence on the therapist's countertransference. Some of the most prominent characteristics of these processes are described through clinical vignettes. CONCLUSION: Longer group psychotherapy is required for patients suffering from serious PTSD to develop the possibility to externalize their deep traumas and to work them through in order to reestablish connections with everyday life. During that process, the countertransferential issues disclose the most important traumatic features and encapsulations, and indicate the main topics to be addressed in patients and the therapist as well.  (+info)

Countertransference problems in the treatment of a mixed group of war veterans and female partners of war veterans. (19/803)

AIM: Analysis of countertransference problems in the treatment of a heterogeneous group of war veterans. METHOD: The method used in this work was psychodynamic clinical observation and analysis of countertransference phenomena in group therapy. RESULTS: In the beginning of our work, we faced with a regressive group, which was behaving as it was re-born. The leading subject in the group was aggression and the need for hospitalization to protect them and their environment from their violence. With the development of group processes, a feeling of helplessness and lack of perspective appeared, together with suicidal ideas, which, because of the development of group cohesion and trust, could be openly discussed. With time, the group became a transitional object for its members, an object that gave them a feeling of safety but also a feeling of dependence. CONCLUSION: The role of the therapist is to support group members in becoming independent. The therapist's function is in controlling, containing, and analyzing of the destructive, regressive part and in encouraging the healthy parts of the patient. With the integration of good therapeutic process, the healthy parts of the patient gain control over his or her regressive parts.  (+info)

Psychoanalytic psychotherapy with migrant war victims: transference and countertransference issues. (20/803)

This report raises questions about the relevance of the psychoanalytic theory and method with migrant war victims, and addresses the issue of personal limits of the psychotherapist who treats these often very ill patients. A clinical vignette and its psychoanalytic understanding introduce the question of transference and counter- transference in the therapeutic work with traumatized war victims. Psychological treatment of war victims is a very important issue. On the one hand, patients who have been tortured or otherwise traumatized are often considered to be reluctant to accept psychological help, even if they are severely disturbed. On the other hand, the psychotherapists who agree to work with such patients must be prepared to face very specific difficulties. Psychoanalytic psychotherapy may be very efficient in treating war victims, but requires not only motivated but, above all, well-trained therapists. Otherwise, the therapist may become the next victim of the patient's trauma and, for his or her own sake, work towards immediate repression instead of working through the traumatic event ending up in the repetition compulsion.  (+info)

Complexity of therapist's feelings in the work with war-traumatized patients. (21/803)

AIM: To present the complexity of therapist's feelings and emotions in the work with war-traumatized persons and the importance of psychological mechanisms taking place in such circumstances. METHODS: The method of psychoanalytical psychotherapy was used, adapted to the work with war-traumatized persons. The therapy sessions were held once a week and lasted for 50 minutes. The patients were given transference interpretations differing from customary transference interpretations. They were modified to provide support, aiming at overcoming of the feelings overwhelming each patient. RESULTS: The diversity of the therapist's feelings amalgamated into countertransference was one of the most important psychological mechanisms in the therapy procedures, and served as an indicator of the patient's feelings in the procedure. It was related to the processes of projective identification as a framework of the complex patient-therapist relationship CONCLUSION: + In the work with a war-traumatized patient, it is inevitable that the patient's feelings are partly shared by the therapist through projective identification. This can lead to the "burnout" syndrome and threaten the boundaries of the therapist's psychological system. The role of the therapist includes not only knowledge but also the personal experience of work on himself. Through the process of therapy and by using interpretations as the powerful tool, the therapist is capable to accept such traumatic feelings and help the patient overcome them, but also to remain within the framework of his role.  (+info)

Graffiti - visual memory of Croatian history. (22/803)

Throughout the Middle Ages a unique Croatian Glagolitic script co-existed with Latin and western Cyrillic scripts, thus creating an open, large, and tolerant cultural environment. Many works common to European cultural heritage were translated into Croatian (Church Slavonic) language and preserved in the Glagolitic script. Among the oldest preserved Glagolitic monuments carved in stone are the so-called tables from Baska on the island Krk and Valun (11th-12th century) containing not only many names and church dedications but also valuable historical data. For centuries this script also provided a vehicle of transferring and preserving medical knowledge.  (+info)

Countertransference and empathic problems in therapists/helpers working with psychotraumatized persons. (23/803)

Countertransference in therapists working with patients with posttraumatic stress disorder (PTSD) differs from countertransference in other psychotherapeutical settings. In this article we discuss the specificities of counter- transference in treating PTSD patients and its relation to empathy. The most difficult countertransference problems occur in treating multiply traumatized patients. Countertransference may occur towards an event (e.g., war), patients who have killed people, as well as to colleagues who avoid treating PTSD patients, or towards a supervisor who avoids, either directly or indirectly, supervision of therapists working with PTSD patients. Our recommendation for the prevention of problems in treating PTSD patients include : 1) careful selection of the therapist or helper, both in the personality structure and training; 2) prevention by debriefing and team work and peer supervision; and 3) education - theoretical, practical, and therapeutical.  (+info)

Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies. (24/803)

The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress the worst effects of conflict and to contribute to the consolidation of peace. Such periods of political transition, and associated aid inflows, constitute an opportunity to improve health services in countries whose health indicators have been among the worst in the world and where access to basic health services is significantly diminished by war. This paper analyzes the particular constraints to effective coordination of health sector aid in situations of 'post'-conflict transition. These include: the uncertain legitimacy and competence of state structures; donor choice of implementing channels; and actions by national and international political actors which served to undermine coordination mechanisms in order to further their respective agendas. These obstacles hindered efforts by health professionals to establish an effective coordination regime, for example, through NGO mapping and the establishment of aid coordinating committees at national and provincial levels. These technical measures were unable to address the basic constitutional question of who had the authority to determine the distribution of scarce resources during a period of transition in political authority. The peculiar difficulties of establishing effective coordination mechanisms are important to address if the long-term effectiveness of rehabilitation aid is to be enhanced.  (+info)