No abstract

The psychopathological condition of Robert Schumann has been a prominent object of study in psychiatry since his hospitalization in 1854. Renowned psychiatrists have diagnosed Schumann with syphilis, schizophrenia, and bipolar and personality disorders. Until today, these analyses of his symptomatology have led to contradictory results. Recent discussion has suggested that his hospitalization was due to professional failure and separation wishes on the part of his wife, her family, and her friends. In line with this hypothesis is the opinion that the separation insisted upon by Clara Schumann was reinforced by the economic interests of the psychiatrist who kept Schumann in custody for 2 years until his death in 1856. In this article, we trace the complex interaction of bipolar vulnerability and pathogenic life events with hypersensitive talent and “creative bipolarity,” defined as the capacity, motivation, and resilience to transform emotional stress and cognitive inconsistency into coherent artistic products. Finally, we present our conclusions about comprehensive psychiatric and psychotherapeutic treatment with respect to “creative bipolarity.”

"Sense of coherence" (SOC) plays an essential role in the maintenance or recovery of health, according to the salutogenetic approach of Aaron Antonovsky. Empirical studies provide evidence of significant links between sense of coherence and different indicators of mental health. In the present study, the effectivity of an integrative counselling concept for the promotion of sense of coherence, reduction of mental distress and improvement of satisfaction with life was tested in a sample of 153 clients and patients. Correlations of SOC with mental distress and satisfaction with life and studies indicate a strong association. After psychosocial counselling according to the integrative ABCDE-model, significant pre-/post- changes with moderate to high effect sizes could be achieved. These findings bring important implications for the modifiability of the sense of coherence and provide evidence that the integrative ABCDE-model of psychosocial counseling might be effective. Correlations between ratings of the dimensions of the model and pre-/post changes are discussed.

Psychotherapy of patients suffering from schizophrenic disorders remains controversial. There are promising descriptions of treatments, and some empirical studies show that different forms of psychotherapy are effective. However, there are few models to combine different psychotherapeutic strategies in a comprehensive way. Here we propose a model of integrative psychotherapy that is based on the therapeutic alliance and the general principles of understanding and communication. It comprises cognitive-behavioral, psychodynamic, and existential elements. These aspects are applied hermeneutically to the narrative of a case of schizophrenia. After remission of the acute symptoms, integrative psychotherapy played the major role in the recovery of the patient. It is shown how therapeutic alliance and understanding and communication in a general sense interacted with behavioral, cognitive, psychodynamic, and existential strategies. The patient himself assessed these strategies and approved his case report. General principles of psychotherapy gain contextual meaning by the analysis of individual narratives. In the case of schizophrenia, the gap between hermeneutics and science can be bridged by an interdisciplinary concept of coherence.