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Www.seminare-ps.net Sensitivity - therapeutic strategies Dr. Samuel Pfeifer Klinik Sonnenhalde, CH-4125 Riehen, Switzerland.

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1 Sensitivity - therapeutic strategies Dr. Samuel Pfeifer Klinik Sonnenhalde, CH-4125 Riehen, Switzerland

2 Therapeutic strategies  Medication  Psychotherapy  Coping behavior

3 Medication  Neurobiology has an important role in sensitivity  Medication (especially antidepressants) stabilizes nervous functions, decreases mood swings and reduces somatic irritability.  This leads to improved general functioning in emotions, work performance and relationships.

4 Medication improves psychotherapy  „I had been in psychotherapy for years before I started taking medication. The painful mood swings, the irritability and the excessive sensitivity have since gone back, enabling me to function almost normally. Only now I have the strength to follow through with the good advice I receive in therapy.“

5 Study results  Continued treatment with antidepressants led to an overall robust and sustained response rate of 76% (N = 32) among dysthymic patients;  in tandem, major depressive episodes and suicidality were prevented in all responders.  some were able to make important decisions for the first time in their lives.  The positive change among dysthymic responders consisted of coping with daily hassles without being overwhelmed, thereby contributing to long-term compliance.  Patients with dysthymia who had required extensive psychotherapeutic attention prior to state-of-the-art pharmacotherapy no longer required such therapy. (J Clin Psychiatry 1999;60:508–518)

6 Conclusions  „With sustained pharmacotherapy and specialized clinical care in a private mood clinic, 3 of 4 patients immersed in gloom for much of their lives achieved for the first time good to superior levels of functioning that were maintained for an average of 5 years. Although the art of clinical management of dysthymia should be fully grounded in understanding the interpersonal context of depression, we submit that SSRIs such as fluoxetine appear broadly efficacious in areas previously deemed to be the domain of formal psychotherapy.“ –(J Clin Psychiatry 1999;60:508–518)

7 Is medication changing personality?  Some patients fear a negative change of their personality as a side effect of antidepressant medication.  Some Aspects: 1.What is the real personality? 2.Lethargy, sullen mood, social withdrawal are pathologic traits. 3.Medication helps to regain the „real“ personality, which were covered by depression. 4.Medication reduces irritability, anxiety, worrying, indecision, pessimism, lack of energy etc. 5.Some are afraid of positive change: „this is not me any more!“ „They will demand too much of me!“

8 Successful Psychotherapy  What are the factors that determine positive outcome in therapy? DISCUSS

9 Common Factors in Psychotherapy  Relationship: warm, intensive and trusting  Explanation for the disorder /complaint  New Information on causes and dynamics as well as new strategies for dealing with problems.  Giving hope: positive expectations  Experience of Success, which supports expectancies, trust and hope.  Concern and warm support by the therapist. J. Frank

10 Conviction ExpectancyRelation common factors in psychotherapy

11 common factors conviction Expectanciesrelationship FAITH LOVEHOPE

12 common factors conviction Expectanciesrelationship FAITH LOVEHOPE

13 Limitations of Psychotherapy  Limitation of the past: You cannot turn back the wheel of your life. Some wounds will always hurt.  The framework of community (family, marriage, work, church). Community can be wonderful, but it can also mean pressure, duties, responsibility  The Limitations of Ethics: frequent conflicts: extramarital relationship, divorce, unwelcome pregnancy, deep seated resentments etc.

14 Limitations of Psychotherapy - 2  Individual Freedom and Responsibility: The therapist cannot take the decisions the individual has to make.  Living with limitations and weakness Even the best therapy cannot fully take away high sensitivity. Counselees have to learn to live with limitations. “My strength is powerful in weakness”.

15 Coping with high sensitivity

16 1. Find a balance between overactivity and regression! 2. Learn to understand your body‘s language! 3. Accept the limitations of your sensitivity! 4. Do not take everything too personal! 5. Take time to relax and to enjoy! 6. Do not take too much responsibility! 7. Explain your condition to others! 8. Recognize your shadow and work at improving your weaknesses. chapter 15 Protecting yourself

17 A prayer for positive sensitivity  Lord, open my mind and fill me with your wisdom and guidance.  Lord, take out all my fussies and frownies and fill me with your love.  Lord, open my eyes to see all the beautiful things you have made.  Lord open my nose Lord, help me to be a sweet fragrance for you.  Lord, help me always speak your words of love and kindness.  Lord, let me be a light to others for you have filled me with your light.

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