The concept topical conflict in the OPD

The conflict model is of fundamental importance for psychoanalytically oriented approaches and supplementally significant for cognitive-behaviorally oriented approaches. The Operationalized Psychodynamic Diagnostic (OPD) distinguishes 7 time continuous unconscious conflicts (for example ''dependence versus autonomy''; ''subjugation versus control'' etc.). These time continuous dysfunctional conflicts are characterized by biographically related repetitive behavior patterns and established patterns of experience in association with a relatively stable ego structure. The OPD further designates the concept of a topical conflict for patients who have reached adulthood labeled ''conflictive external burden.'' Similar to the continuous conflicts, the topical conflict also places the patient in a partially unconscious psychodynamically oriented conflict he is unable to resolve. Topical conflicts can be induced either through acute-traumatic or primary-intrapsychic conflicts brought on by external events or developmental or aging-related processes throughout the life course. Primary symptoms can be expressed either actively or passively. Topical conflicts must be discriminated from consciously experienced but principally solvable internal or external related conflicts and from post-traumatic stress dirorders (as defined by DSM-III-R). The primary pathological characteristic of the topical conflict is that it is subjectively or objectively unsolvable; in relation, the level of awareness as a regulatory factor is qualitatively diminished. In the Current study, a clinically based algorithm is presented comparing the differential therapy indications of psychoneurotic and topical conflicts. The goal of topical conflict psychotherapy is to bring the underlying conflict constellation responsible for symptoms to consciousness or the development of solutions possible within the reality of the situation. If an evaluation of the differential diagnoses within the therapeutic process does not produce recognizable repetitive patterns of conflict, therapy can be directed towards these pathological patterns with patient consent. The concept of topical conflict broadens the current perspective on psychodynamic conflicts and aids in the differentiation of necessary therapy indications for the second half of adult life.