a professional journal of practice based on psychotherapeutic methods
Pszichotherapy during the pandemic
29th year, special edition, June 2020
Noémi Berger, László Bokor
Preliminary research study
Dénes Szemán, Felícia András, Gábor Imre, Vera Muth, Judit Vágó, Boglárka Nyúl: The impact of the COVID-19 pandemic on the decision-making process of psychotherapy and counselling professionals
László Bokor: Psychotherapeutic journal during the pandemic
Gábor Szőnyi: Weighing up the options: assessing changes in approach due to Covid-19. Dilemma of a therapist
Questions of practice
Merav Roth: Transference in the time of Corona. Translated by Mária Barna
Questions of practice
Enikő Váradi, Anikó Horváth: The safety of relationship, safe relationship. Therapeutic experience with psychotic patients during the coronavirus outbreak
and what’s your way?
Adrienn Kelemen-Szilágyi: The inner world healing even in COVID
István Soós: I don’t exaggerate when I say it was drastic, nearly surrealistic at the beginning….
Dóra Lőrik: The pain of the freedom to decide
Association of Active Analytic Psychotherapists (Csilla Bodnár) ♦ Group Analytic and Training Society (Zoltán Terenyi ) ♦ Dynamic Short Therapy Association and Workshop (Judit Sári ) ♦
Hungarian Association for Expressive Arts and Dance Therapy (Réka Révay) ♦ Hungarian Family Therapy Association (Katalin Barát ) ♦ Hungarian Association of Hypnosis (Szilvia Sümeg) ♦ Hungarian Association for Movement- and Dancetherapy (Zoltán Csontos) ♦ Hungarian Psychoanalytic Society (Ágoston Schmelowszky, Anett Felházi, Ildikó Ledniczki) ♦ VIKOTE Cognitive and Schematherapy Centre (Emese Kovács, Lajos Simon)
BAZM KK EOK Semmelweis Hospital Psichotherapeutic Rehabilitation Division,”Csanyik” ( Ildikó Cs. Tóth, Judit Erős, János Kocsis, Ágnes Orbán, Ildikó Zivák) ♦ Debreceni Egyetem Clinical Centre Psychiatric and Psychotherapeutic Clinic (Anikó Égerházi) ♦ Nyírő-OPAI Pszichotherapeutic Department (Katalin Csigó ) ♦ SE-PPK Pszichotherapeutic Division (Gergely Biró) ♦ SZTE ÁOK Psychiatric Clinic and Psychotherapeutic Department (Ildikó Kovács, Zoltán Terenyi, Erika Tóth) ♦ OORI Tündérhegy Psyschosomatic and Psychotherapeutic Rehabilitation Division (Mária Barna) ♦ „Thalassa House- Budatétény” Psychotherapeutic and Psychiatric Rehabilitation Institute(Zsolt Zalka)
Bizalom Private Psychotherapeutic Practice (Amaryl Árkovits) ♦ Dr 24 Psychotherapeutic and Psychosomatic Practice (Györgyi Kovács, András Spányik) ♦ Ménesi Psychotherapeutic Practice (Klára Horváth) ♦ Tér Psychotherapeutic Practice (Anett Felházi, Éva Gyomlai , Judit Petró, Katalin Szőke, Mária Tari)♦ Foundation of Drug abuse prevention (Mónika Varga ) ♦Experiences from the „Pedagógiai Szakszolgálat” (Monika Artai , Enikő Cserges, Marianne Rácz)
Conferences – Ágnes Fazekas
Literature in pandemic
Anna Mécs: Selection
Preliminary research study
Dénes Szemán, Felícia András, Gábor Imre, Vera Muth, Judit Vágó, Boglárka Nyúl
The impact of the COVID-19 pandemic on the decision-making process of psychotherapy and counselling professionals
This paper reviews the impacts of the pandemic situation caused by SARS-CoV-2 on the decision-making process in psychotherapy and counselling services. Our research focuses on changes in the setting and the internal, external and relational factors influencing them. The questionnaire used in the survey was developed based on an expert-empirical basis, sent to communities of psychotherapy and counselling professionals, applying the snowball method. The results suggest that the sample mainly consists of professionals with significant experience in their field representing the middle generation, predominantly psychotherapists with a psychodynamic approach (231 people). The majority felt themselves and their patients at risk. Most of the colleagues considered the political and social events when introducing changes and precautionary measures. Directives of the employers and clinics or the opinion of the professional community were considered when making decisions. Personal health status was also a significant influencing factor. When considering the return to the original setting, also these factors are kept in mind. In general, the opinion of professional communities and colleagues are considered especially important, and many participants were afraid of judgement or expected a decline in their professional relations in line with their decisions. The majority made their decisions as a result of rapid assessment and made a transition to remote therapy. Regarding the changes caused by the pandemic situation, the ongoing therapies were perceived as unchanged. During the change in the setting, the health risk of the therapist and the patient induced a quick decision (1 day), though the adaptability of the methods into the online space was still questionable for the participants of the survey. Finally, concerns around adaptability were not confirmed, the change in the setting brought about no alteration in the therapeutic goal. A strong intention seems to be present to keep the therapeutic process unchanged.
Keywords: psychotherapy – counselling – pandemic situation – setting change – decisions
Psychotherapeutic journal during the pandemic
Based on the Hungarian experiences of the two months March-April 2020 period, this paper aims to analyze the impact of COVID-19 pandemic on psychotherapeutic processes. In this period therapists have switched most of the psychotherapies to remote therapy all at once, within a few days. The study reveals the effects of this suddenness on the therapeutic relationship, emphasizing that, due to the challenging social crisis, therapeutic processes had already stopped, making the original therapeutic goal unsustainable. The author makes suggestions on the expedient steps of the change, which frequently condensed in the practice due to the limited opportunities.
The number of remote therapies has skyrocketed. Besides the benefits of this method, the study provides an overview of the not necessarily obvious, but significant limiting factors.
Based on neurobiological studies the difficulties of attunement in the therapy are pointed out. The overview of the negative aspects of setting aims to promote primarily the optimum compensation of them.
The pandemic is a significant burden for the whole society. The pervasive anxiety caused by critical social situations narrows the therapist’s reflectivity. The therapist and the patient are exposed parallelly to the same situations. The therapeutic relationship goes under the effect of external processes, actually they incorporate it. Due to the sudden unexpected critical social situation, the therapeutic relationship could get into a crisis. The therapy itself is prone to be traumatized. External objective factors can mask, that the mediator of the trauma is the therapist his-/herself. The reflection of it is burdensome, but an important component of the mutual trauma processing at the same time.
Keyword: a switch of settings – remote psychotherapy – social crisis – crisis of therapy – trauma
Weighing up the options: assessing changes in approach due to Covid-19. Dilemma of a therapist
The author reviews the decision points which arise due to the virus pandemic. His work hypothesis relies on the differentiation between dangerous situations and a case of emergency. The epidemic threatens the patient, the therapist, their personal surroundings, the organization in which the therapy is running, the functioning of the whole of society, and all those points together threaten the therapy and the psychotherapeutic relationship. It is central to consider how the patient and the therapist feel about the situation and the inherent dangers. This dictates whether there will be sufficient space to assess and prepare a change of setting for the therapy. We should consider that the therapist might become overburdened and that any response to the threat contains individual, relational, group and organizational defences in an intertwined way.
The author reviews and assesses possible variations of the therapeutic setting. He illustrates via his own practice, the choice of applications, and highlights those options which are beyond his competence. He also calls attention to the fact that redemption means another setting switch – “new therapy with the same actors”.
The change in therapeutic practice, due to the epidemic, brings a lot of new experiences, broadens the competencies of the therapist, and inspires experimentation. The same is true for psychotherapeutic organizations.
Keywords: dangerous situation – disastrous situation – change of setting – crisis management – institutional trauma-elaboration
Questions of practice
Transference in the time of the Coronavirus
Dr Merav Roth is an Israeli psychoanalyst with Hungarian roots. Her paper gives a powerful, emotional and personal view on why, and how should psychotherapists and psychoanalysts continue their work in the time of the current pandemic. When „a wall comes down” between patient and therapist, and they became overshadowed by the same, threatening reality, the therapist might feel to have lost the security of their professional framework. Moreover, given the overwhelming outside danger, it might seem that inner work, or the analysis of the unconscious processes is simply impossible. The paper invites all those working with patients to overcome these doubts. It presents transference and countertransference patterns characteristic of the current crisis situation, and through them, it makes the point that the multitude of how we react to the outside danger is endless, and the relationship patterns, transgenerational links emerging in these reactions lead us to the discovery of patients’ unique, individual inner world – just as it always did.
Keywords: psychotherapy in crisis – transference situations – retrospective reparation – common threat
Questions of practice
Enikő Váradi, Anikó Horváth
The Safety of Relationship, Safe Relationship – Therapeutic Experience with Psychotic Patients during The Coronavirus Outbreak
The therapeutic alliance is crucial for our psychiatric and psychotherapeutic practice. Beyond the tragic loss, it is actually the most efficient anti-epidemic measures, i.e. social distancing and isolation, as well as the new rules for human relations which have had the most profound and severe consequences on society, the economy, institutions and individuals. In this situation of distancing, the sustainability and safety of relationships became the greatest challenge for psychiatric and psychotherapeutic practice. In addition to being at higher risk from several medical, existential and psychic aspects during the COVID-19 crisis, psychotic patients are particularly fragile in their social relations. Therefore, the maintenance of the relationship, as well as its safety, always constitute a central issue in therapy. In our study, we will introduce special methods that we have been applying over the outbreak, the challenges that we have encountered, the solutions that we found and the successes that we achieved while protecting the safety of our patients, team and therapeutic alliance.