Integrating psychotherapy with obstetrics and gynaecology.

摘要

As a specialist Obstetrics and Gynaecology I then became a specialist also in psychotherapy, including: psychodynamic therapy, group therapy, hypnotherapy, and body-therapy. In the last nineteen years I have been working to integrate the medical and psychotherapeutic approach, including attention to psychosocial factors. After some years, I found our German rate of premature birth to be 7%. This amazed me because prematurity very rarely occurred in my patients, which was down to about 1%. In France they did some surveys and studies. By informing the mothers how to live, and reducing smoking and drugs, they reduced their prematurity rate to about half, but still much above my rate of 1%. I have described my method in articles. This is vital work, because serious prematurity is responsible for most damage and death amongst the children. A mother's complaint may be an early suggestion of danger. We then check it with the regular obstetric assessments. Even before birth symptoms can indicate a problem, such as premature labour, much as postnatal problems while breast feeding are indicated by symptoms. And before birth, as well as after birth stress and emotional problems can be the cause for serious somatic illness. It is really an effect of one relationship on the other. The way a woman relates to her child depends on her feeling of security among all who support her. All her relationships are important: how she grew up with her parents; her work; her other children. Further problems that experience of psychotherapy can help to reduce are: exceeding the estimated date of delivery; pre-eclampsia; HELLP-syndrome (Hemolysis, Elevated Liver enzymes and Low Platelets). The lectures we offer on the subject are also relevant to psychotherapeutic understanding and in guiding to treatment.