Open Door Review III

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FB7##0$9_!=>_!8$0%1M2_!@>_!IJ7#0<0_!H>_!"2B3*0%_!Q>_!I066<0%_!H>_!K$6Z0&0_!O>_!@T*(0_!">_!5)(#_!S>![+,,b^>! /647#)2*2<460!B*&!a0B%)Z$660*67#2:(0*>!a0B%)3$)<)D$67#0!V0%J*&0%B*D61%)C0660!30$!1647#)2*2<4($67#0*! F0#2*&! 0%#<%+-%)Ba>+*%O&Gb _!]]-E]].>! "2B3*0%_!Q>_!FB7##0$9_!=>_!5B&4M_!5>_!IJ7#0<0_!H>_!F%B*6_!S>![+,-+^>!H)Z!&)06!*0B%)3$)<)D$72! 1-%&/$%#)?@+&N">#+@B&"!&'(A?-"@+@BA()(&bG^&GgdVGegC ! In recent years, human neuroscience has become interested in the investigation of brain changes when patients are under psychotherapy. As this is a complex process that cannot be adequately captured with standard experimental paradigms from neuroscience, new approaches and the inclusion of the subjective, individual perspective have to be applied. Previous studies examining the functional neuroanatomy of psychotherapy in depressed patients have mostly studied interpersonal therapy or cognitive behavioral therapy. The present research from the Hanse-Neuro-Psychoanalysis Study reports on the first fMRI study with recurrently depressed patients treated with long-term psychoanalytic therapy (Buchheim et al. 2008). H&2*Y#! Our study design differed from that of previous studies in the following respects. 1) Neuroimaging studies have examined the effects of short time psychotherapy (e.g. 12-20 weeks), applying cognitive-behavioral or interpersonal therapy in depressed patients. We examined depressed patients during psychoanalytic treatment providing a longer observation window (15 months of therapy). 2) Most studies used more unspecific and non-personal stimuli (e.g. International Affective Picture System or the Ekman faces) to induce certain moods to assess neural changes during therapy. Our research group developed two different fMRI paradigms with an individualized research approach in order to operationalize processes relevant for depression and therapeutic change on different levels: (a) Adult Attachment Projective Picture System to assess representations of significant attachment experiences (e.g. separation, loss etc) and relationships (Part I), b) Operationalized Psychodynamic Diagnosis (OPD-2) as a valid tool to investigate the participant’s dysfunctional interpersonal relationship patterns (see Part II). The OPD paradigm is also applied in the Frankfurter-fMRI/EEG-Depressionsstudie (FRED) (PI: PD Dr. T. Fischmann) in the context of a collaborative study.

In an attempt to bridge the gap between science and clinical practice, a clinical research project was initiated together with the participating psychoanalysts. It investigated the influence of the neuroscientific study on the therapeutic process by regular group meetings of the psychoanalysts, case reflections and self-report data from patients (Taubner et al. 2012).

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