THE REFUSAL OF PSYCHOTHERAPEUTIC HELP - E MPIRICAL OUTLINES OF A DESTRUCTIVE-NARCISSISTIC PHENOMENON - EMPIRICAL-DATA ON THE REFUSAL OF AN OFFER OF PSYCHOTHERAPY

Besides numerous other factors influencing the acceptance of psychothe rapy non-utilization of indicated psychotherapy can a so be considered as acting out of destructive narcissistic conflicts. The author tries to join aspects of narcissism and object relation theory with empiric al findings on the acceptance of psychotherapy. 100 probands (from an epidemiological field survey, not a patient sample) who suffered from medium psychogenic impairment received an offer of psychodynamic psych otherapy. 33% accepted immediately or after a few informative talks wi thin one year. In contrast only 3% of the investigated sample had soug ht psychotherapeutic help on their own initiative within one year befo re the offer. The 67 refusers of the psychotherapy offer were compared to the accepters with regard to sociodemographic, psychometric, and c linical variables (including interaction). A stereotype of attraction, conveyed by sociodemographic variables, analogous to the wellknown Ya vis pattern could not be proved statistically in this field survey. Ho wever, on the basis of certain personality characteristics the group o f therapy accepters could be differentiated significantly from the ref users. A satisfactory interaction between proband and interviewer is a n essential point for the establishment of a positive psychotherapy ac ceptance. In particular, self-esteem and offence protecting factors se em to encourage the probands to accept the offered psychotherapy. Thes e findings seem to be important for the pre-therapeutic process of att achment, motivation and the treatment especially of narcissistically d isturbed patients.