DIAGNOSIS AND PSYCHOTHERAPY OF NEUROTIC WORKING DISTURBANCES

There are only a few publications on working disturbances and their origins. To understand these disorders, it is necessary to differentiate more clearly between disturbances in working and in performance. The act of working requires the ability to attune oneself to the subject and to postpone the self in the service of the task. In patients suffering from working disturbances this ability is restricted, because they have too many problems with their self or their identity. The patients react to their failure by activating specific coping mechanisms, but this way cannot regain their self-esteem. On the other hand, disturbances in performance arise out of specific unconscious meanings of performance within a conflictual relationship. Psychotherapy of working disturbances must follow the line from the surface to the depth. Therefore the pathogenic coping mechanisms or the unconscious meanings of performance have to be treated first. It is likely that the inability to work or to be successful enters into the transference and influences the therapeutic relationship.