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Dr. rer. nat., Dipl.-Psych
Ralf Vogt
Leipziger Straße 36a
D - 04178 Leipzig
Germany
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Book Contents
Ralf Vogt: Psychotrauma, State, Setting
- 1 Introduction 15
- 1.1 Preliminary Note for Colleagues 15
- 1.2 Preliminary Note for
Clients 17
- 1.3 The Complex Importance of a Comprehensive Treatment
and a Reduction of Complex Traumatizations 18
- 2 Theoretical Background
21
- 2.1 Interdisciplinary Connections between Important Fields of
Research and Psychotraumatology 21
- 2.1.1 Preliminary Note Regarding
the Connection between Physical Sciences and Psychotraumatology 21
- 2.1.2
Connections with and Translations from Neurobiology 21
- 2.1.3 Connections
with and Translations from Comparative Psychobiology 27
- 2.1.4 Connections
with and Translations from Prenatal, Perinatal, and Postnatal Birth
Research 31
- 2.1.5 Connections with and Translations from Infant Research
and Attachment Research 34
- 2.2 A Selection of Conceptually Adopted
Constructs, Empirical Interpretations, and My Own Drafts for the
Development of the SPIM-20-CTP 39
- 2.2.1 Preliminary Note Regarding
the Connection with and Importance of Brain-Physiological and Psycho-Dynamic
Traumata Circles 39
- 2.2.2 Regarding the Uniformity and Reciprocity
of Complex Psychotrauma Symptoms, State Appearances, and Shapings
of Settings 40
- 2.2.3 On the Correlation of Transferences, Introjects,
and Implants in Regulation States 44
- Regarding Category 1: Situation-Flexible
States 47
- Regarding Category 2: Elastic Habitual States 49
- Regarding Category
3: Transference States 50
- Regarding Category 4: Introject States 52
- Regarding Category 5:
Implant States 54
- Regarding Category 6: Programming States 59
- 2.2.4 Hypotheses Regarding
the Reciprocity between a Brain-Physiological and Psychological Regulation
Cross-Linking 63
- 2.2.5 On the Position of the Psychotrauma within
the Framework of Psycho-Dynamic Regulation and the Regulation-Specific
Development 67
- 2.2.6 Regarding the Difference between Transference
and Countertransference when Treating Complexly Traumatized Patients
72
- 2.2.7 The Benefit of Psychological Concepts of Externalization
for Psychotrauma Therapy 75
- 2.2.8 The Advantage of Using “Beseelbare” Therapy
Objects within the Framework of Transparent Treatment Structures
in Psychotrauma Therapy 79
- 2.2.9 The Importance of a Fundamentally
Body-Specific and Action-Specific Orientation for Psychotrauma Therapy
83
- 2.2.10 Regard the Terms of Abreaction, Closing of Activity-Specific
Arcs, and Final Physical Actions and Interactions in Psychotrauma
Therapy 86
- 2.2.11 Regarding the Importance of Supporting Touches in
Psychotrauma Therapy 91
- 2.2.12 Regarding the Particular Benefit of
Infantile Play for Psychotrauma Therapy 93
- 2.2.13 How Traumatic is
it to Work Out a Psychotrauma? 96
- 2.2.14 With Which Quality Can a
Psychotrauma be Remembered? 99
- 2.2.15 When and How is a Psychotrauma
Therapy Finished? 101
- 3 Description of the SPIM-20-CTP with Manualized
Materials and Case Vignettes 105
- 3.1 Preliminary Note Regarding the
Development of the SPIM-20-CTP 105
- 3.2 The Current Treatment Criteria
of the SPIM-20-CTP 106
- Criteria of the SPIM-20-CTP 106
- Explanations of the Criteria of
the SPIM-20-CTP 107
- 3.3 The Treatment Phases of the SPIM-20-CTP during
the Whole Therapy Process 112
- 3.4 The Empirical Treatment Phases of
an Individual Session or of a Group Therapy Unit in the SPIM-20-CTP
116
- 3.5 Regarding Psycho-Education in the Therapy Concept of the SPIM-20-CTP
with Case Vignettes 118
- 3.5.1 Preliminary Note 118
- 3.5.2 Catalogue of Terms of the SPIM-20-CTP
118
- Abreaction 118
- Alterego 120
- “Beseelbare” Therapy Objects 120
- Dissociation 121
- Dissociative Identity Disorder 122
- Flashback 122
- Implant 123
- Introject 123
- Introject – Transference Dynamics 124
- Introject – Transference
Reversal 125
- Intrusion 125
- Complex Traumatization – Other Dissociative
Disorders, Not Specified in More Detail 126
- Concentrated Structured
Activity-Specific Performances for Psychotrauma Exposition 126
- Body
Movement Orientation 127
- Victim 127
- Paralysis of the Victim or Victim Behavior 128
- Programming 128
- Setting 129
- State 129
- Switch 129
- Perpetrator 130
- Perpetrator Behavior 130
- Trauma or Psychotrauma 130
- Lifting the Trauma 131
- Trauma Orientation 131
- Trauma Shaping 131
- Triggers 132
- Transference 132
- Transference – Introject Reversal 133
- 3.5.3. Manualized Handouts
for Clients 133
- 3.5.3.1 Preliminary Note on How to Deal with the Handouts
133
- Bulletin for Complex Traumatized Patients 134
- 3.5.3.2. Bulletin
for Complex Traumatized Patients with an Orientation Help for Switching
Exercises 134
- 3.5.3.3 Exercise Leaflet for Psycho-Physical Relief
137
- 3.5.3.4 Trigger Leaflet and Self-Help Leaflet 139
- 3.5.3.5 Curriculum
Vitae and Therapy Reports for Complex Traumatized Patients 142
- 3.5.3.6
Basal Psychodynamics Leaflet 148
- 3.5.3.7 Trauma Maps and Resource
Maps 152
- 3.5.3.8 Relationship Category Leaflet 156
- 3.5.3.9 Structural Graphs
for Internal Parts 158
- 3.5.3.10 Structured Diary 164
- 3.5.3.11 Generation Questionnaire
166
- 3.5.3.12 Introject-Generation Scheme 171
- 3.5.3.13 Play Contract
and Minutes 174
- 3.5.4. Manualized Handouts for Therapists 178
- 3.5.4.1 Preliminary
Note on How to Deal with the Therapists’ Handouts
178
- 3.5.4.2 Psychotherapy Agreement for Individual and Group Therapy
178
- 3.5.4.3 Basal Minutes of Sessions – Individual Therapy 182
- 3.5.4.4
Basal Minutes of Sequences – Group Therapy 186
- 3.5.4.5 Minutes
of the Differentiated Graduated Training of Regulation Scripts 190
- 4
Manualized Representation of Settings of the SPIM-20-CTP with Case
Vignettes 194
- 4.1 Preliminary Note on How to Deal with Setting-Specific
Indications and Instructions 194
- 4.2 Settings of Therapy Phase I: Stabilization
and Psycho-Education 195
- 4.2.1 Basic Settings for Demonstrating the
Psychodynamics 195
- 4.2.1.1 Settings for Establishing a Relationship
with Contact Sticks 195
- 4.2.1.2 Setting for Deepening a Relationship
with the Holding Rocker Rope and the Back Mat 198
- 4.2.1.3 Settings
for Comparison Purposes and Variations of Stages of Regression with
Gymnastic Ball Dialogues and Swing Settings 201
- 4.2.1.4 Settings for
a Restorative and Diagnostic Regulation of Affects with Bags, Clubs,
Blocks, and Other Objects 204
- 4.2.2 Restorative Settings for Enhancing
Insights into Internal Regulation 209
- 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
- 4.2.2.2 Settings for Diagnostic Play with Stuffed Animals, Resource-
and Solution-Orientedly 212
- 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
- 4.2.2.4 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
- 4.2.3 Course Group Settings for an Introduction
to a Joint Development Orientation in the Psychotrauma Treatment
218
- 4.2.3.1 Concept of the Course Group Therapy 218
- 4.2.3.2 Settings
for Establishing a Contact, Deepening a Relationship, and Enhancing
a Regressive Group Work 220
- 4.2.3.3 Settings for a Joint Regulation
of Affects 221
- 4.2.4 Settings for Dealing with Reference Persons at
the Beginning of the Therapy 222
- 4.2.4.1 Inclusion of Every Kind of
Partnership 222
- 4.2.4.2 Dealing with Parents and Other Reference Persons
as Conflict Partners (Letters, Conversation for Establishing Boundaries,
Generation Interview) 223
- 4.3 Settings of Therapy Phase II: Psychodynamic
Work on and Exposition of Psychotrauma 224
- 4.3.1 Advanced Settings
for a Psychodynamic Deepening of the Internal Regulation Work 224
- 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
- 4.3.1.2 Work on Regulation States with a Negative Transference
(Bag-Club Accusation, Phobics’ Tub and Depression Tub) 229
- 4.3.1.3
Work on Individual Regulation States with a Negative Introjection
(Questioning of Introject) 232
- 4.3.1.4 Work on Interlinked Regulation
States with a Negative Introjection (Island Work) 234
- 4.3.1.5 Dealing
with Extreme Affects (Murderous Rage and the Like) in Advanced Psychotrauma
Therapy 237
- 4.3.2 Advanced Settings for Psychotrauma Exposition Work
240
- 4.3.2.1 Concept for a Concentrated, Structured Activity-Related
Performance for Psychotrauma Exposition 240
- 4.3.2.2 Spontaneous Extensions
of Individual Performances 241
- 4.3.2.3 Planned Extensions of Individual
Performances with a Concentrated, Structured Activity-Related Performance
for Psychotrauma Exposition 244
- 4.3.2.4 Combination of Various Exposition
Settings with a Concentrated, Structured Activity-Related Performance
for Psychotrauma Exposition 247
- 4.3.3 Long-Term Group Settings for
Using Joint Development Resources and for Coping with the Psychotrauma
250
- 4.3.3.1 Concept of a Long-Term Group Therapy 250
- 4.3.3.2 Enhancement
of Regulation States with a Positive Transference (Hammock, Hover
Belt, Hands Bed) 252
- 4.3.3.3 Work on Regulation States with a Negative
Transference (Black Giant Bag, Red Giant Block, Tug Rope, and Similar
Objects) 254
- 4.3.3.4 Work on Individual Regulation States with Negative
Introjection (Introject Cage) 256
- 4.3.3.5 Work on Interlinked Regulation
States with Negative Introjection (Introject Kaleidoscope) 260
- 4.3.3.6
Work on Extreme Affects (Murderous Rage and the Like) in an Advanced
Group 263
- 4.3.4 Settings for Dealing with Reference Persons in Connection
with an Advanced Development of the Therapy 264
- 4.3.4.1 A More Intensive
Inclusion of Partnerships and Family 264
- 4.3.4.2 Dealing with Parents
and Other Reference Persons as Conflict Partners (Conversation for
Confrontation Purposes) 265
- 4.4 Settings of Therapy Phase III: Integration
and Farewell 267
- 4.4.1 Preliminary Note on Settings in the Integration
and Detachment Process (Level of Consultation) 267
- 4.4.2 Reality-Oriented
Demand-Specific Settings 268
- 4.4.2.1 Tasks for Self-Balancing (Bodies
of Rules, Self-Epicrisis) 268
- 4.4.2.2 Settings for a Context-Related
and an Inner Strengthening of Modification Successes (Repetitions
of Settings, Self-Direction Settings) 268
- 4.4.2.3 Role Play Training
for Coping with External Demands (Conversations about Professional
Interests and Personal Courage, and the Like 269
- 4.4.3 Self-Help Groups’ Concepts
(Subject Groups, Play Groups, Late Course Groups) 269
- 4.4.4 Dealing
with Reference Persons Towards the End of the Therapy 271
- 4.4.4.1
Inclusion of Partners and the Family (Family Council) 271
- 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
- 4.5 Photographic
Documentation of Case Vignettes 275
- 5 Evaluation of the Treatment
Approach of the SPIM-20-CTP 283
- 5.1 Preliminary Note 283
- 5.2 Investigation Design and Description
of Random Samples 284
- 5.3 Statements Regarding the Movements to be
Noted in Connection with the Random Samples 293
- 5.4 Evaluations with
the BSI of All Points of Measurement 293
- 5.5 Evaluations with the
Satisfaction Questionnaire 296
- 5.5.1 Analyses, on the basis of the
Satisfaction Questionnaire’s
Satisfaction Scales, of All Points of Measurement 296
- 5.5.2 Analyses
in the Diagnosis Groups and Setting Groups 302
- 5.5.3 Categorized Surveys
of Open Response Structures in the Satisfaction Questionnaire (ZFB)
in Connection with the Post-Measurements and Catamnesis Measurements
305
- 5.5.3.1 Regarding the Use of “Beseelbare” Therapy
Objects – the
Importance of Aggression Settings, Dialogue Settings, and Subsequent
Nurturing Settings 305
- 5.5.3.2 Regarding the Experience of Helpful,
Nice, and Terrible Therapy Situations 309
- 6 Summary and Outlook of
the Book 318
- 7 Materials Referring to the SPIM-20-CTP Approach 323
- 8 Further
Training Regarding the SPIM-20-CTP Approach 325
- 9 Translation Glossary
327
- 10 Bibliography 328
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