Abstinence rule

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The rule of abstinence is a term from psychoanalysis . It describes the treatment-technical principle of the greatest possible unsatisfaction of the feelings and desires caused by the transference in the analysand in relation to the therapist, as well as his obligation to abstain in the context of the countertransference .

In addition to the principles of neutrality and equal attention , the rule of abstinence is a cornerstone of psychoanalytic treatment technique . It serves to work through and to raise awareness of conflicting (libidinal or aggressive) efforts of the analysand within the framework of the therapeutic working alliance . By repeating and remembering in the (protected) framework of psychoanalytic treatment, an abolition of the unconscious repetition compulsion and a psychological reintegration and restructuring by strengthening the conscious ego of the patient should be achieved.

Details

The rule of abstinence applies to the analyst and the analysand at the same time, in that it obliges both sides "(...) not to express their relationship fantasies and wishes in action ." As a basic, "common orientation", it provides an essential framework for therapy and "protects (so) the psychoanalytic situation".

Laplanche and Pontalis define psychoanalytic abstinence as follows:

“Principle according to which the psychoanalytic treatment is carried out in such a way that the patient finds the least possible substitute satisfaction for his symptoms. For the analyst it includes the rule of denying the patient the satisfaction of his desires and actually taking on the role that the patient seeks to impose on him. "

The analytical treatment concept justifies the frustration associated with the rule of abstinence and the creation of artificial suffering through a libido - economic strategy:

“Cruel as it sounds, we must see to it that the patient's suffering does not come to an early end to any effective degree. If it has been diminished by the decomposition and devaluation of the symptoms, we must restore it somewhere other than a delicate deprivation. "

- S. Freud

The libidinal energy built up by denial is to be made therapeutically usable; The goal is the libidinal cathexis of the analytical situation itself. With the help of the psychological stress sustained by the therapeutic refusal, the tendency to act as an expression of the bias in unconscious (passionate) patterns through consent to methodical renunciation and verbalization (as a purely linguistic confrontation of conscious and unconscious ) be replaced. Interpretation and insight as a deepened and improved self-image supplement or ultimately replace the immediate satisfaction claim. The rule of abstinence requires and thus creates a constitution of consciousness that is called “ therapeutic ego splitting ” in post-Freudian theory : the subject divides in the analytical process into an (re) experiencing and an observing entity.

The status of the abstinence rule, its artistic definition and practical application are meanwhile controversial between the psychoanalytic schools and individual authors. Originally intended by Freud to protect the therapist from the libidinal attacks of his "hysterical" patients, abstinence in the more recent discussion primarily serves the patient himself. What is required is a basic attitude that is aware of the dangers that threaten if the abstinence requirement is exceeded: “The therapist has to ensure that he is in a condition that protects him from being linguistically or physically undisciplined, transgressive, tactless or offensive. The analyst is obliged not to abuse his therapeutic role, power and authority to satisfy his own aggressive, erotic and narcissistic needs. "

Violations of therapeutic abstinence

A violation of the abstinence rule endangers or destroys the basis of the therapeutic relationship and can lead to trauma for those affected. Sexual acts are therefore classified as “ sexual abuse taking advantage of a counseling, treatment or care relationship ” and since 1998 punished with up to five years imprisonment according to the Criminal Code ( Section 174c StGB ).

In addition to the establishment of a manifest sexual relationship, the typical violations of the rule of abstinence according to Giulietta Tibone include:

  • Establishing other private relationships with the patient
  • Exploiting the patient as a private service provider or therapist for the therapist
  • Breach of confidentiality (e.g. in the case of publications)
  • Disregard of the duty of neutrality in the form of aggressive devaluation and denigration of the patient

Violations of the abstinence rule and its sometimes serious consequences have recently also been discussed within the institution of psychoanalysis for its training company, the so-called training analysis : Here it is the training analyst who abuses his exclusive position of power over the candidate without adequate processing and coping options consist. The abuse of power thus becomes a taboo tradition for generations of therapists, whose content is denied and covered up.

See also

Web links

Individual evidence

  1. ↑ See Jürgen Körner, article: Abstinenz ; in: Handbook of basic psychoanalytic concepts, Ed. W. Mertens, B. Waldvogel, Stuttgart (Kohlhammer) 2008, p. 1: s. a. Web links.
  2. ^ Jean Laplanche / Jean-Bertrand Pontalis: The vocabulary of psychoanalysis. Frankfurt am Main 1984, first volume p. 22 ff.
  3. ↑ Freud, S. Ways of Psychoanalytic Therapy, 1918. GW, XII, 188. Quoted from Laplanche, Pontalis ibid. P. 23.
  4. ↑ The discussion about abstinence, neutrality and anonymity of the therapist is given by Jens León Tiedemann: The intersubjective nature of shame . Dissertation. FU Berlin, 2007; here part II, chapter 8. Neutrality, anonymity and abstinence . , Pdf (129 kB)
  5. ↑ Giulietta Tibone, Brunhilde Schmieder-Dembek: abstinence and abstinence violations in psychoanalytical training . (PDF file; 82 kB)
  6. ↑ Deutsches Ärzteblatt 2003 (accessed on July 2, 2011)
  7. ^ Professional regulations of the Chamber of Psychotherapists NRW. (PDF; 16.21 MB) from November 12, 2004. In: Bound inserts for North Rhine-Westphalia in the Psychotherapists Journal 1/2005. Federal Chamber of Psychotherapists, March 24, 2005, p. 113 , accessed on October 19, 2013 .
  8. ↑ "What do patients complain about? An experience report " ( Memento from February 18, 2017 in the Internet Archive ), Pdf (16.5 kB)
  9. ↑ Giulietta Tibone, Brunhilde Schmieder-Dembek: abstinence and abstinence violations in psychoanalytical training . (PDF file; 82 kB)