Neurological dysfunction, psychic conflict, and psychotherapy

Clinical experience of psychotherapists is getting more and more circumscri bed by the boundaries of theoretical references. The Freudian "psychic trea tment" for neurosis got its impetus from the friendship between Sigmund Fre ud and Ludwig Binswanger, the phenomenological psychiatrist. This relations hip laid the foundation for the references of psychoanalytic psychotherapy in Europe. Then, the Freudian conception of actual neurosis led to a psycho somatic approach. Later the study of narcissistic neurosis opened up to bor derline patients. Teddy, scientific and medical progress greatly influence psychopathological research and the way we look at our patients and their r equests. These changes come from the patients' sayings and their expectancy of well-being. At the same time psychotherapists have to take a new look a t their theoretical references. On the one hand, a dynamic concept for psyc hotherapy is necessary for integrating the phenomenologic approach into psy choanalysis, and providing the understanding of situations emerging in neur ological dysfunction. On the other hand, psychotherapists pay more attentio n to the different actors contributing to a pathology (Who is suffering? Wh at about the life-partner or the relatives?). These changes lead to a new l ook into the processes of identification as well as the notion of identity. This article discusses these influences on psychotherapy and clinical rese arch showing how clinical situations get ahead of theoretical references.