[Crisis and crisis therapy (author's transl)]

A psychic crisis is defined as a reaction to external events where the individual is unable to cope with these events by means of his usual adaptive mechanisms and earlier experiences. Examples of a traumatic crisis is the death of a near relative, the sudden onset of a severe illness, a sudden infidelity in marriage etc. So called transitional life situations may also elicit crisis reaction, i.e. the birth of a first child, retirement from work etc. A psychic crisis is often overdetermined from experiences in early childhood. The more "pure" crisis reactions are often seen in medical or surgical clinics while the psychiatrists usually meet the overdetermined crisis reaction. Four different phases of the crisis reaction are described. The goal of crisis therapy is to support the individual's and his surroundings own resources. It is not to replace the loss or to help the individual deny the emotional impact of what has happened. The function of the therapist can often be described in terms of "containing function" and "vicarious hope". Listening to a client in acute crisis often evokes feelings of anxiety and helplessness in the therapist. He often feels seduced to behave omnipotently, helping the patient to suppress the feelings of sorrow and anger. He may also be overprotective or may avoid discussing the pertinent feelings. The antitherapeutic risks of crisis psychotherapy are discussed and also illustrated with examples from the author's research on reactions of mothers to the birth of stillborn children.