First interview of the psychoanalysis according to Argelander

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The first interview in psychotherapy is structured differently depending on the therapy school and the background of the therapist. A psychoanalytic form is the "first interview of psychotherapy" according to Hermann Argelander , in which the indication for psychotherapy is made, the choice of a specific treatment method is made and the prognosis is assessed.

Preconditions

For the first interview, appropriate framework conditions must be created in terms of time and space. This includes a sufficient time window; enough rest; A room that exudes calm and comfort with the individuality of the interviewer.

A preliminary interview is always possible before the start of the first interview. In the short exploratory discussion, it is checked whether the patient is correctly "addressed". The roles of the people involved in the conversation are clearly defined. On the one hand we see the psychotherapeutic specialist, on the other hand the patient. Both sides are free to choose the interviewer / patient and to protect them from going beyond their innermost relationships.

Data collection

In the initial interview, three forms of data (information) are collected. First the more common personal information. Personal information and biographical facts are collected and certain behaviors or personality traits are observed. These data can be checked at any time. Information can be obtained from this data without having to be present during the conversation. They are ambiguous and their interpretation requires specialist knowledge.

Second, the subjective data must be included. These are less reliable. What matters is the importance that the patient gives them. The data are mostly clear, but difficult to verify. The data can only be recognized by skillfully dealing with the patient. The result is a vivid picture of the patient, which is tied to the current situation and is difficult to compare with other personalities.

Ultimately, the scenic data must also be taken into account. Here the experience of emotions and imagination processes, even if the patient is silent, are taken into account. The information cannot be verified by repeating the situation. The perception of the data depends on the skills of the interviewer and his field of relationship with the patient. All three data levels are included in the assessment of the patient together. This creates its own form of information. The first impression of a patient arises even before the first consultation through so-called "pre-field phenomena ", such as the patient presents when registering; whether he keeps the deadline, etc.

motivation

In order to consider further psychotherapeutic treatment useful, a certain level of motivation must be discovered in the patient . According to Hermann Argelander, four different types of patients can meet the interviewer:

  • The “patient advanced” is often referred to by friends or family members and is often poorly motivated. This patient has to be released from his passive role and he has to accept his own part in the disease.
  • The “demanding patient” has high demands but little personal commitment. Often arouses compassionate reactions that cloud the judgments. These patients do not have the necessary insight into the disease. You flirt with knowledge and have a disturbed sense of tact. The motivation arises from the desire to perfect knowledge.
  • The unproductive patient cannot tie up the interviewer. His expression is inhibited and emotionally rigid. The psychoanalyst has to prepare for resistance in the interview.
  • The informed patient has great prior knowledge of the treatment method. He strives for perfection. The often very differentiated intellectuality is often opposed to a stunted and difficult to access emotional life.

target

The aim of the initial interview is that the patient not only communicates, but also reveals personality disorders. This is required for reaching a judgment. In the interview, the patient's personal ideas and expectations have an impact. This gives the interviewer the opportunity to exert influence. This possibility is included in the investigation plan (which is drawn up during the initial interview).

interviewer

The interviewer should always adopt a calm, wait-and-see attitude and show constant attention and interest. During the conversation, the boundaries should be made clear and attention should be paid to compliance. The interviewer must never get into action (unconscious action according to the patient's wishes). No criticism or judgments are introduced, but only asked about the meaning depending on the situation. Resistance during the conversation should be bypassed, this disrupts the important data collection. For interpretations, the necessary unconscious confirmation must be obtained from the patient as a reflection . It should be noted that the interviewer always knows more than he can put on the record. Only with knowledge and experience can connections be recognized and correctly interpreted.

literature

Hermann Argelander: The first interview in psychotherapy . Wissenschaftlicher Buchverlag, Darmstadt, 1st edition 1970, unchanged 10th edition 2014