The Current Situation of Psychosomatic Medicine in Germany(The Current Trends of Psychosomatic Madicine in Other Countries)

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  • ドイツ(各国の心身医学の現状)
  • ドイツ

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Abstract

The present conditions of psychosomatic medicine in Germany are outlined. In Germany each of the university faculties of medicine has the departments of psychosomatic medicine and/or those of psychotherapy, where they are engaged in studies and education of psychosomatics and medical psychology. At the lectures of medical psychology students learn about personalities, developments, doctor-patient relationship, coping with the disease, movement of population and diseases, and so on. In 1992 the further education system of psychotherapeutic medicine was established. The first level of this system is the education of basic psychosomatic health care. The second level is the education in psychotherapy and psychosomatics after having been qualified as a specialist in the other medical field. At the third level the doctors who have completed the second level can be a specialist in psychotherapeutic medicine after at least 5 years training. There are many societies of psychosomatics or psychotherapy m Germany and "The German Society of Psychosomatic Medicine (Das deutsche Kollegium ftr Psychosomatische Medizin : DKPM) " plays the central role of German psychosomatics since 1974. Many journals of psychosomatics are also published, for example, "Journal of Psychosomatic Medicine and Psychoanalysis". The Bad Neustadt Psychosomatic Hospital, which has 340 beds, is the biggest psychosomatic hospital in Germany. At this hospital the patients of neurosis, borderline and narcissistic personality disorders, eating disorders, obesity, pain disorders, alchoholism, morbid gambling and psychosomatic diseases in a narrow sense, for example, gastroduodinal ulcer, essential hypertension, ulcerative colitis, Crohn's disease, and so on, are treated according to the idea of "depth-psychological psychosomatics". For all the patients personal psychotherapy, grou.p psychotherapy and body therapy are done. Especially this hospital obtains good results with the origimal body therapy or "body related psychotherapy" which prompts the psychosomatic patients to recover their own body sensations through verbalisation of the feelings during physical exercises. The history of German psychosomatics has many physicians who constructed unique psychosomatic theories. Georg Groddeck was a general practitioner who treated incurable patients with balneotherapy, diet, massage and psychotherapy and who was therefore called as "father of psychosomatics". Under the influence of psychoanalysis Groddeck insisted that each symptom can be interpreted as a symbol and created the original word "It (Es) " which controls both body and mind. Viktor von Weizsacker constructed "the medical anthropology". He insisted the importance of "introducing the subject" into the medicine and proposed "the structual cycle (Gestaltkrers) theory" Thure von Uexkull, the present leader of German psychosomatic medicine, created the situation cycle (Situationskreis) model which explains the mechanism of symptom formation and the relationship of doctor and patient. And now a new medical concept "salutogenesis" is one of the topics in German psychosomatics. Under this concept they don't attach importance to the pathogenesis of the diseases but the patient's potential to be healthy. To respect the theories and to construct indispensable systems steadly is the style of psychosomatic medicine in Germany.

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