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Abstract

第125巻第9号

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Ernst Kretschmer: Understanding the Soul, Multidimensional Diagnosis, and Psychotherapy
Hiroki HISAE
Sakuragaoka Memorial Hospital
Psychiatria et Neurologia Japonica 125: 808-817, 2023
https://doi.org/10.57369/pnj.23-114

 By introducing the themes of "understanding the soul" and "multidimensional diagnosis" given by Ernst Kretschmer, I would like to discuss key learning based on his contribution to psychotherapy and criticism of his work.
 Kretschmer defined the "soul" (Seele) as a direct experience occurring between the ego and the outside world, and undergoing personality-specific processing. He classified the reactions to the experience (Erlebnisreaktionen) into primitive reactions (Primitivreaktionen) and personality reactions (Persönlichkeitsreaktionen). A key experience (Schlüsselerlebnis) is defined as one that acts on a specific personality and causes a reaction peculiar to that personality. According to Kretschmer, most psychic reactions originate not from a single motive but from a colligation of motives, and there are various components in such colligations. Experiences with strong emotions affect the movement of the soul as a complex, or form an overvalued idea and occupy the core of the personality, resulting in delusions of reference. By understanding the Erlebnisreaktionen, it is possible to know the "movement of the soul" and the pathological development of abnormal psychology.
 Kretschmer said that personality, experience, and environmental factors are involved in the development of sensitive delusions of reference, and they can be understood from the viewpoint of reaction; therefore, psychotherapy can be used for treatment of such delusions. His psychotherapy theory emphasizes that active, positive, and step-by-step efforts should be made, and he suggested yoga, protreptic methods, "fractionated active hypnosis" (fraktionierte Aktivhypnose), and Johannes Heinrich Schultz's autogenic training for treatment.
 Kretschmer's multidimensional diagnostic concept is characterized by relativity. I believe that the reason he continued to hold a significant position despite being criticized for lacking rigor in the systematic theory, was that he was conscious of the purpose of making his theory useful for treatment. If one applies his reaction theory and multidimensional concept to clinical situations, they will realize that they can "understand" the patient better as a therapist. By examining Kretschmer's contribution, it can be understood that multidimensional diagnosis and treatment have their bases in his research.
 Author's abstract

Keywords:Ernst Kretschmer, Erlebnisreaktion (reaction to experience), multidimensional diagnosis, sensitive delusions of reference, psychotherapy>
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