Bad Herrenalber model
The Bad Herrenalber model is a humanistic and depth psychology depth , at the twelve-step program for abstinence against addictive substances orienting, holistic psychotherapy - concept based on a therapeutic community . In the 1970s it was developed by Walther H. Lechler, among others, together with therapists and patients. The Bad Herrenalber model is still practiced in different variations in clinics in the Hochgrat Clinic Wolfsried in Stiefenhofen and the Adula Clinic in Oberstdorf .
concept
As part of an inpatient stay in a clinic, mentally and / or psychosomatically ill people should have the opportunity to reorient themselves. The therapy is intended to encourage.
According to Daniel Casriel, both the disorder and the therapy concept are essentially based on the theory of insufficient satisfaction of children's basic needs, in particular that of physical closeness and emotional openness or the basic conflict , with lack and learning deficit being decisive. The togetherness of the therapeutic community is intended to support a salutary breaking through of this life program, which is regarded as self-destructive. It demands the abandonment of “compromising attempts at coping”, “all self-deception ” and so-called “stabilizing tricks”.
The community should support the patient in the relationship to his own body as well as in the search for a meaning in life and his spiritual orientation. The model assumes that impairing learning experiences have led to a double deficit. Furthermore, it is assumed that deficiencies have arisen due to the non-fulfillment of needs. This is supposed to reinforce each other in the manner of a vicious circle.
The group's supportive and confrontational psychodynamic community should create an atmosphere in which opportunities can be developed to recognize self-destructive behaviors. Therefore, patients who want to treat themselves according to this concept should be motivated to deal critically with their own behavior in a guided group, as well as be very willing to change their personality structure and bring along great spiritual openness.
The clinic is designed as a meeting place (learning-teaching community) and also offers the possibility of involving patients' relatives in the treatment. The model is formative for parts of psychotherapeutic self-help and self-help groups in Germany and beyond.
Five pillars
Therapeutic community
The therapeutic “teaching and learning community” includes the work of all employees and guests of the clinic in a joint process. It serves as a practice field for encounter for authentic and non-violent communication behavior. The employees and the guests address each other with a confidential "you" and their first names. In regular large groups (plenary assembly, committee, plenum), exemplary relationship clarifications, confrontations and relapses are processed in order to change old relationship patterns and to experience and practice new relationship behavior. This anticipated the idea of behavioral therapy-oriented social competence training that was developed later.
Fast
The fasting agreement is a prerequisite and the therapeutic entry into the treatment. Fasting means something different here than in a conventional fasting clinic. It essentially refers to renouncing distraction and emotional manipulation of any kind. Consciousness-altering drugs of all kinds, television, radio, music players, computers, distracting or distracting literature as well as romances and sexual contacts during the stay in the clinic, including not drinking coffee, sweets, are prohibited. Sugar etc., even if there is a dependency or addiction on the latter. The avoidance of distractions and distractions should make it easier to allow feelings that have previously been rejected and to express these in encounters in the therapeutic community. A healthier way of dealing with the previously insufficiently satisfied basic needs, which these feelings indicate, should also be achieved. In addition to the distractions and possible (substitute) gratifications mentioned, fasting also explicitly refers to dysfunctional symptomatic behavior such as over-engaged helping or depressive withdrawal, which has so far contributed to the maintenance of the disorder. In this regard, there is a willingness of all participants in the therapeutic community to make themselves confrontational in order to be supported by others in the process of practicing new behavior.
Casriel Therapy
The Casriel bonding therapy has a decisive influence on the overall atmosphere in the clinic and is intended to promote general therapeutic work in the clinic. It should facilitate access to defended emotions and physical needs.
Body therapy
Body-oriented therapy in connection with regular sporting activities and daily exercise outside in any weather also includes practicing breathing and relaxation techniques as well as meditation.
12-step program
A twelve-step program , which is intended to provide orientation on the path to recovery and to consolidate the spiritual and spiritual basis of the therapeutic process, is implemented in self-help groups. For this purpose, “12-step meetings” are offered in the evening hours, which take place either in the clinic itself or outside of it. Participation in these self-help groups is voluntary.
Other methods
marathon
There are regular 5-day intensive days, for example as a “hut marathon” or “hiking marathon”. Individual patient groups and their therapists spend five days working together 24 hours a day and work on their health.
Creative therapy
Art therapy (painting, pottery, etc.), dance therapy, theater therapy are other forms of therapy that are increasingly used in the Herrenalber model. Mindfulness therapy, meditation, yoga and exercise therapy are also used.
indication
The Herrenalber model for addiction patients is particularly suitable and originally developed for this. Especially for substance-related addictions such as alcohol, drugs, medication, but also for non-substance-related addictions such as gambling, shopping, sex, work, sport, the Internet, etc.
The Herrenalber model is also suitable for relationship disorders, depression, anxiety, post-traumatic stress disorder, psychosomatic disorder, burnout. Correspondingly, “indication groups” are offered in which specific work can be carried out in line with the diagnosis.
Contraindication
As part of the therapy for a borderline personality disorder , bonding is now regarded as contraindicated by some important representatives of the Bad Herrenalber concept. It could possibly lead to a split in personality. More often, however, it was observed in severe borderline personalities who took part in such a strongly emotionally activating and revealing procedure that there was a further unwanted affective destabilization and crisis of the already emotionally very unstable patients. These patients find it difficult to regulate, calm down and stabilize themselves again after bonding, which is usually achieved without major difficulties with other patients who have more ego structure.
history
The Herrenalber model was introduced and developed in 1971 by Walther Lechler in the "Psychosomatic Clinic Bad Herrenalb" in the spa town of Bad Herrenalb . He headed the clinic until 1988. In the 1990s, the clinic was moved to a hotel building in Herrenalb. In December 2011, the new operator, together with the payers, in particular the German pension insurance, abolished the model in this clinic.
The Herrenalber model was carried on and continued by former employees and others: by Konrad Stauss in the "Psychosomatic Clinic Bad Grönenbach", by Georg Reisach in the "Hochgrat Clinic Wolfsried" and the "Adula Clinic Oberstdorf". The clinics around Joachim Galuska in the “Heiligenfeld Clinics” group are at least close to the ideas of the therapeutic community, group therapy and spirituality.
Today the Herrenalber model is still practiced at the following clinics:
- Hochgrat Clinic in Wolfsried, Stiefenhofen
- Adula Clinic in Oberstdorf
Criticism of the Bad Herrenalber model
Occasionally, points of criticism regarding Alcoholics Anonymous (AA), modified self-help groups for other life problems and the twelve-step program are also transferred to the Bad Herrenalber clinic concept, as the recovery ideology of the AA groups is an integral part of the corresponding clinics. However, it is precisely this that is viewed by proponents as an advantage and strength of the Bad Herrenalber model.
Another point of criticism is directed against the extensive non-specificity of the therapeutic community in the original form of the Bad Herrenalber model. This has been and is being countered in various clinics that work and work according to this model by setting up indicative groups for special problems, e.g. B. structure groups, skills groups for borderline personality disorders, food addiction groups or special reference groups for traumatized people.
The concept requires a high degree of personal responsibility and self-regulatory ability on the part of the patient for his healing. The so-called structurally disturbed patients in this group concept repeatedly feel overwhelmed by the high level of emotional activation in the relationship work. It is therefore sometimes suggested that the Bad Herrenalber concept is better suited for neurotic problems and less suitable for structural disorders and personality disorders.
In the course of increasing pressure in the health care system, the concept is repeatedly diluted, weakened or changed in order to maintain the competitiveness of the private clinic by adapting it to the supposed and actual demands of the changed patient clientele and cost bearers. Behind this is the criticism that has been expressed on various occasions, namely that they are too radical, too confrontational and too committed to the humanistic-psychotherapeutic ideal of self-development of the 1970s. Typical stimulus and conflict issues between therapists, clinic operators and representatives of the cost bearers are “therapeutic DU”, unconventional therapy methods such as gestalt therapy, bonding psychotherapy, family constellations and others, human and physical closeness, the high degree of emotional activation, or the desired temporary emotional destabilization within the treatment, the fasting concept in connection with the strict release policy in the event of a break in the fast as well as the proportional weighting of therapy and wellness.
A more recent point of criticism criticizes the insufficient evidence-based nature of the Bad Herrenalber model. On the other hand, there are detailed catamnestic surveys by the quality assurance systems of the clinics.
literature
- Tom John Wolff: Make love with life and become who you are: healing community and biodanza . Verlag Neue Erde, Saarbrücken 2016, ISBN 978-3-89060-686-6 .
- Martin Hambrecht: The teaching and learning community. From psychotherapy to life school. A concept and its realization . Dissertation at the University of Hamburg in 1982.
- Martin Hambrecht: Starting life again - When therapy becomes a school of life. Twelve & Twelve, 1982, ISBN 3-930657-13-9 .
- Hans Praschniker: "Sociodemographic background, alcoholism career, duration of abstinence, self-image and personality of convalescent alcoholics - an exploratory study of alcoholics anonymous in Austria"; Dissertation Uni Graz 1984 Praschniker Abstracts
- Walther H. Lechler: It can't go on like this with me! - New beginning through spiritual experiences in therapy . Kreuz Verlag, 1994, ISBN 3-7831-1305-9 .
- R. Nübling, R. Bürgy, J. Meyerberg, M. Oppl, J. Kieser, J. Schmidt, WW Wittmann: Inpatient psychosomatic rehabilitation as part of a cross-school treatment concept. First results of the 1 year follow-up of the Bad Herrenalber catamnesis study. In: M. Bassler (ed.): Guidelines for inpatient psychotherapy. Psychosozial-Verlag, Giessen 2000, ISBN 3-89806-071-3 , pp. 274-300.
- Mathias Jung, Walther H. Lechler: How Heaven Opens - A Bible Interpretation . EMU-Verlag, 2002, ISBN 3-89189-092-3 .
- Walther H. Lechler: Anyone who can still get sick is healthy. School of life based on the Bad Herrenalber model . Santiago, 2004, ISBN 3-937212-05-1 .
- Walther H. Lechler, Jacqueline C.. Lair: Call it madness for me. Protocol of a cure . Kreuz Verlag, 2005, ISBN 3-7831-2584-7 .
- Walther H. Lechler, Alfred Meier: Wake up and live! - The therapeutic power of biblical stories . Kösel-Verlag, 2005, ISBN 3-466-36677-1 .
- Ambros Wehrli: Introduction to emotional group therapy according to Casriel - Volume 1 - You can do it, but you can't do it alone . Santiago Verlag, 2006, ISBN 3-937212-06-X .
- Ambros Wehrli: Comments on emotional group therapy according to Casriel - Volume 2 - The Santiago School of Life Verlag, 2007, ISBN 978-3-937212-07-4 .
- Walther H. Lechler, Alfred Meier: The Bad Herrenalber Model - A teaching-learning community as a psychosomatic clinic concept . Santiago Verlag, 2007, ISBN 978-3-937212-14-2 .
swell
- ↑ Konrad Stauss: New concepts for the borderline syndrome - inpatient treatment using the methods of transaction analysis. The Grönenbach model. Junfermann, Paderborn 1993, ISBN 3-87387-110-6 .
- ↑ Hochgrat Clinic Wolfsried
- ^ Adula Clinic Oberstdorf
- ↑ a b c cf. Wolff 2016.