Neurobiological and psychological changes in dreams
A psychoanalytic outcome criteria in comparative treatment studies?
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The question of whether and how psychoanalysis should get involved in comparative therapy outcome studies remains controversial within the psychoanalytic community. One of the main objections of clinicians on such studies is that mainly symptom reduction has to be chosen as the main outcome criteria in order to be accepted in the world of evidence-based medicine. This was one reason why we compared symptomatic with so-called structural changes of the patients, measured with the Heidelberg Structural Change Scales in the LAC Study (a large outcome study comparing cognitive-behavioral (CBT) with psychoanalytic long-term psychotherapies (PAT) with chronic depressed patients). In fact we were able to show statistically significantly more frequent structural changes in PAT than in the CBT groups. Another more psychoanalytical perspective was investigated in the so-called FRED (Frankfurt EEG/Depression) study. In this substudy of the LAC Study we tried to use an outcome criterion that had been shown to be suitable in several previous studies to investigate changes in psychoanalysis: the changes of dreams. Dreams are still considered to be one of the via regiae to the patient’s unconscious in contemporary psychoanalysis. Changes in dreams are plausible clinical indicators for psychoanalysts that the unconscious world of inner objects and associated fantasies and conflicts might have been modified. Indeed, in the FRED study, we were able to demonstrate systematic changes in the neurobiological reactions of significant dreams after 1½ years of psychoanalytic treatment. This motivates us to use this criteria in the ongoing replication study of the LAC Study, the Multimodal Outcome Study of Psychoanalyses of Chronically Depressed Patients (MODE) as will be discussed in this presentation.
Marianne Leuzinger-Bohleber, Prof. Dr. phil, director in charge of the Sigmund-Freud-Institut in Frankfurt a.M., Germany (2001-2016), professor em. for psychoanalysis at the University of Kassel, senior professor at the IDeA Excellency Center in Frankfurt a.M. and the Universitymedicine in Mainz. She is training and supervising analyst of the German Psychoanalytical Association (DPV) and the International Psychoanalytical Association. She is chair of the Committee for Research and Universities of the (DPV). She received the Mary Sigourney Award 2016 and the Haskell Norman Prize for Excellence in Psychoanalysis 2017. Her research fields are clinical and extraclinical research in psychoanalysis, psychoanalytical developmental research, prevention studies, interdisciplinary dialogue between psychoanalysis and literature, educational sciences and the neurosciences.
2001-2009 Chair of the Research Subcommittees for Conceptual Research of the IPA(2001-2009), since 2010: Vice Chair for Europe of the Research Board der IPA. 2018/19 she was chair of the IPA Subcommittee for Migration and Refugees.
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