[Psychotherapy with the unwilling patient]

By means of the residential motivation therapy of addicts we discuss ways of dealing with the specific problems, that arise in psychotherapy of character disordered, who are not suffering psychically. The - in the view of the addict patient - often unvoluntary referral to the hospital provokes the patient's refusal of cooperation. The greatest therapeutic challenge is the ego-syntonicity of the character disorder and the rigid defense structure of overcompensation, projection and denial, covered up by rationalizations. This defense system serves to avoid closeness and contact with the original emotions. In our group setting we use mini-contracts, reality-oriented confrontation of behavioral issues in order to make the addict aware of his desperation and lack of fullfilment in life, and offer attractive models of living and the experience of warmth and bondedness in the group. Our main techniques are non-verbal. Body experience and full-body-expression of emotions mediate self-experience which is then integrated verbally. The goal of this psychoanalytically based psychotherapy is to bring about by working through resistances, the attitudes which are a precondition for continuing with a personality-changing psychotherapy.