With a multi-professional treatment team, we offer our patients disorder-orientated inpatient or day-clinic treatment. The accommodation of inpatients in our building on the edge of the forest is of hotel standard in single and double rooms.
A total of up to 45 patients can be treated on a day-clinic and inpatient basis.
Both inpatient and day-clinic treatment places are available in all disorder-orientated treatment groups. This makes it easy to switch between these forms of treatment within a treatment group.
Our profile
In the mentalisation-oriented treatment unit, we focus on treating patients who suffer from a structural disorder (restrictions in the shaping and functioning of the self in relation to others). Due to insufficiently supportive conditions in their life history, they have not yet been able to learn sufficiently to perceive and think about themselves, to control their own feelings, desires and impulses, to keep their mental balance stable through defence mechanisms, to differentiate between themselves and others as independent persons, to communicate with others and to form stable relationships. This is particularly the case with personality disorders (e.g. borderline personality disorder), but also with some forms of depression, obsessive-compulsive disorder, anxiety and eating disorders.
Focal points
The focus of treatment is on group therapies. Verbal and non-verbal (music and art therapy, relaxation training) methods are combined. Using treatment techniques from mentalisation-based psychotherapy according to Fonagy and Bateman (MBT), we promote mentalisation, i.e. the ability to think what others may be feeling and thinking and to relate this to what one feels and thinks oneself, thereby "understanding others and oneself" (Allen & Fonagy 2009). As a basis for affect regulation and impulse control, team members "label" and mirror affect states, allowing them to be better integrated (Fonagy et al. 2004).
Mentalisation-based psychotherapy (MBT)
Mentalisation-based psychotherapy (MBT) is a form of psychodynamic psychotherapy. It was developed by the English psychiatrist and psychotherapist Anthony W. Bateman and the English psychologist and psychoanalyst Peter Fonagy in the 1990s. In a London day clinic, they combined helpful attitudes and therapeutic strategies from psychoanalysis and depth psychology psychotherapy for patients with severe borderline personality disorder who could not be helped with social psychiatric treatment alone. The detailed and manualised treatment concept (Bateman & Fonagy 2007) has proven its effectiveness in randomised and controlled studies (Bateman & Fonagy 1999, 2001, 2003, 2008, Bales 2012). These studies have enabled MBT to achieve the status of an evidence-based treatment for borderline personality disorder as a psychoanalytically orientated treatment approach in the USA.
Initially developed for borderline disorders, MBT is now also successfully used for other psychosomatic and psychiatric disorders, such as dissocial personality disorders, depression, anxiety and somatisation disorders, eating disorders, addictions, psychoses and autism spectrum disorders.
The mentalisation model is a modern psychological construct developed by Peter Fonagy and the psychologist and psychoanalyst Mary Target. They summarised the latest findings from cognitive science, psychoanalysis, affect research, attachment research and the attempt to develop a coherent picture of ourselves and our relationships with others. Because we cannot see into other people and do not see their thoughts in thought bubbles like in comics, we use our ability to mentalise to make assumptions about what may be going on in others.
On the one hand, mentalising means putting ourselves in someone else's shoes. If our colleague doesn't greet us at work, for example, we can ask ourselves, "Does this really have something to do with me?" or, "How might my colleague be feeling right now and what might he have experienced that is causing him to behave so dismissively?"
On the other hand, mentalising means seeing ourselves through someone else's eyes. We mentalise when we ask ourselves, "What am I feeling right now and where is this coming from?", "What am I thinking and what does this have to do with my living conditions?", but also, "How does what I am doing right now affect others?"
We often consciously (explicitly) mentalise, asking ourselves, for example, "What could be the reason that he was so unkind to me today? Could it be because I forgot to call him yesterday?". We always consciously mentalise when we wonder about our own actions, e.g. "How come I got so upset with my colleague?"
However, when we are dealing with others, we also mentalise intuitively (implicitly), similar to the way we ride a bicycle. For example, if we see someone at a crossroads with a city map and a furrowed brow, we might spontaneously go up to them and ask them where they want to go because we suspect they are looking for an address. If the encounter with others goes smoothly, we usually don't have to think about ourselves and our counterpart first.
Mentalising is the basis for the feeling of being alive and enables us to form meaningful and lasting relationships with other people. Through mentalising, misunderstandings and conflicts can be recognised and resolved.
Mentalising is also the key to controlling yourself. Mentalising makes it possible to endure feelings that are difficult to bear, such as disappointment, hatred, anger, fear, sadness or infatuation, but also stressful physical sensations, without getting into a fight with others or ourselves or taking flight.
How well a person can mentalise depends on genetic factors and relationship experiences in childhood and adolescence. As with sport or learning to play a musical instrument, practice is very important. The ability to mentalise is lost in everyone to the extent that they are under stress or become emotionally agitated. This can happen, for example, in intense relationships with other people, when anxiety arises about an important relationship or when someone feels misunderstood.
When mentalising breaks down in attachment-relevant situations or has not yet been sufficiently learned, so-called pre-mentalistic modes occur as an expression of the threatened cohesion of the self, which are also found in children in terms of developmental psychology:
In terms of developmental psychology, the teleological mode is the earliest mental state that precedes mentalising. Only actions that have physical consequences are ascribed the ability to change the mental state of oneself and others. An infant cannot yet mentalise its diffuse physical-affective state of distress. Calming down is only possible through concrete "physical" actions. In teleological mode, a borderline patient can, for example, be firmly convinced that his partner only loves him if she calls him on her mobile phone at the usual time.
In equivalence mode, the inner psychological world and the outer reality are experienced as identical. As a result, there is no possibility of imagining a different way of seeing and experiencing things. For example, a small child may be terrified at night and insist that there is a ghost in their room until their parents manage to make it possible for them to see that it was only the white curtain through sufficient empathic attention. Even as adults, we are always in equivalence mode when we cannot imagine any other possibility than our own way of seeing and experiencing things. Depressed patients, for example, can be convinced in equivalence mode that they are guilty and worthless and patients with personality disorders are sometimes certain under stress that the therapists have something against them and feel attacked.
The as-if mode is closely linked to play in terms of developmental psychology. Children's play serves to test behavioural patterns, but has no direct impact on the outside world and vice versa. For adults, the as-if mode becomes problematic when the inner world remains completely disconnected from the outer world and ideas and feelings no longer form a bridge between the inner and outer reality. This is the case, for example, when people speak emotionlessly in psychologising language, which is also known as pseudo-mentalising ("psychobubbling"). Clinically, this mode can also manifest itself in dissociative phenomena in which a patient is unreachable as if isolated.
Limitations in the ability to mentalise are often both the cause of mental and psychosomatic illnesses as well as their consequences. As a result, negative experiences with others and unsuitable attempts to cope with them can perpetuate each other in a vicious circle.
At our clinic, we offer treatment techniques of mentalisation-based psychotherapy (MBT) with a focus on patients with personality disorders, depression, anxiety and somatisation disorders as well as eating disorders. All MBT interventions are aimed at (re)establishing or improving shared mentalisation. The therapists ask curious questions, especially about feelings, based on the conviction that they themselves cannot know what exactly is going on in another person (basic attitude of not knowing). This is intended to arouse interest in oneself until a patient, with the support of others, can differentially mentalise their bodily sensations and feelings. Similar to "Inspector Colombo", the therapists ask sometimes unusual questions in order to improve access to feelings and the ability to mentalise. Through irritating questioning ("challenging"), combined with humour and the unexpected, they try to shake up entrenched views and pre-mentalistic modes in order to open up new, more helpful perspectives. They do not give advice, tips or homework, but endeavour to help people find out what suits them best in an encounter at eye level.
Many patients who come to us are initially afraid of group therapy. Possibly because they have had bad experiences in groups in the past, e.g. as a child in their own family or at school. At the beginning of treatment, they are therefore often convinced that the really difficult issues can only be discussed in individual therapy and are afraid of being criticised, shamed or rejected in the group or of overburdening others. Group therapy, however, offers a great opportunity to make new experiences, leave these fears behind and become more satisfied in everyday relationships. This is one of the reasons why we only offer individual therapy sessions in the first two weeks of treatment in our structured setting, in order to facilitate the start in the group.
Group psychotherapy offers particularly good opportunities to learn to mentalise, especially through the social network. The opportunity to explore the experience of oneself and others together in the group is unrivalled. Group therapy offers particularly rich opportunities to examine the influence of one's own behaviour on others, which raises awareness both for oneself and for others.
As a training space for mentalising, group therapy in particular offers the opportunity to practice maintaining the ability to mentalise even under the stress of increasingly difficult feelings.
In group therapy, everyone is invited to express everything that is on their mind, what they are feeling and thinking. We humans develop further when we dare to do something we are afraid of. The recommendation is therefore to talk in the group about what you would rather not talk about in the group.
However, the group can only be conducive to exploration and experimentation if the participants feel safe and accepted in it. Everyone therefore has the right to decide for themselves when and how much they want to contribute to the group. This also applies to questions, which are always welcome without any obligation to answer them. Conflicts that arise within the group are helpful because we can learn from them. However, the group leaders ensure that the discussion remains constructive and interrupt it if necessary in order to protect the individuals and the group. All participants undertake to maintain confidentiality towards outsiders, including patients from other groups here at the clinic.
All group sessions are recorded on video for quality assurance purposes. The recordings are subject to internal data protection, are used exclusively for supervision and are subsequently deleted.
Our profile
In addition to other psychogenic disorders, our depth psychology-orientated treatment unit focuses on treating patients with physical complaints.
A significant risk factor for the development of physical complaints, behind which mental stress is concealed, is an impaired or even absent perception of feelings. In order to support our patients in developing access to their inner life, we place particular emphasis on non-verbal methods such as art, music, relaxation and movement therapy in addition to individual and group therapies in our multimodal therapy programme. Accompanying physiotherapy measures also play an important role.
Patients with physical illnesses or eating disorders in which psychological and social factors play a significant role in triggering or maintaining them also benefit from our therapeutic services, as a deeper understanding of bio-psycho-social interactions and the resulting behaviour can make a stabilising contribution to the course of the illness and to maintaining a physical and psychological balance.
Our profile
In the "Work and Health" setting, we treat patients with a wide range of mental illnesses. We work with behavioural therapy in individual and group therapies. We often integrate schematherapeutic models and interventions. Specialised therapies (art therapy, concentrative movement therapy) and nursing therapy sessions (daily morning rounds, relaxation techniques, individual interventions) are supplemented by depth psychology and other perspectives. We work closely with our in-house social counselling service.
One thematic focus is on dealing with conflicts relating to work (e.g. interpersonal conflicts in the workplace, work overload, balancing work and other areas of life, initiating contact with institutions in the area of work and training, conflicts at life transitions such as starting training, starting work and retirement). Basically, we see work as a positive resource that, in addition to financing life, enables people to develop personally and in a social context, find meaning and structure themselves, for example. The existence of a workplace conflict is not a prerequisite for admission to our setting.
Disorders: Depression, burn-out, eating disorders, somatisation disorders, somatoform disorders, chronic pain disorders, anxiety disorders,
personality disorders, obsessive-compulsive disorders.
In the VT setting, we support people with stressful experiences, strokes of fate, workplace conflicts, patients with eating disorders or with
physical illnesses who want to learn how to achieve a better quality of life with changed living conditions.
The therapy modules in this setting consist of cognitive-behavioural therapy-oriented individual and group psychotherapy, stress management training, social skills training, art therapy, music therapy, relaxation techniques and counselling from the social services.
Our profile
This treatment unit treats psychological complaints such as anxiety, depression, problems with eating and stress caused by physical symptoms that cannot be sufficiently influenced by physical medicine. Problems in the perception of feelings that are experienced as unpleasant, such as anger, rage, envy and hatred, often play a role. Relationships with people in the immediate environment are often severely disrupted by psychological complaints. On the other hand, difficult relationships with other people or the lack thereof also lead to psychological and psychosomatic complaints, as we as humans are socially and biologically designed for attachment.
This is why the focus is on the resource of "relationships and dealing with oneself and other people". In order to enable them to name their therapy goals more clearly and to work on them, we create an individualised case concept with the patients. This summarises the problems and symptoms, interpersonal difficulties, problematic emotions and the associated biographical information in a psychosomatic, schematherapeutic explanatory model. The overarching aim is to work out which basic needs have not been met in the patient's life history, how unfavourable (dysfunctional) coping strategies have developed and become entrenched, how these are currently restricting them and how their own needs can currently be met more appropriately.
Cognitive, emotion-oriented and behaviour-oriented interventions are used to achieve this. Theoretically, we are guided by Young's schema therapy (2003) as a current development in behavioural therapy in conjunction with resource-oriented techniques and common disorder-oriented interventions.
Groups are particularly good at enabling people to gain a deeper insight into their relationships, which is why our concept is characterised by group therapy.
Resource-orientated work means that we work with them to draw on previously successful coping strategies and bring them back into contact with their own abilities and strengths.
We pursue the realisation of the processes described in a multi-professional team with the help of verbal (individual and group therapy) and non-verbal (non-verbal) methods (relaxation, movement and art therapy).
A 4-week, fully inpatient intensive programme
Today we know that chronic pain is a complex process. Multimodal pain therapy involves several medical disciplines and explicitly takes into account psychological, social and cultural components as well as biological and physical ones. Our team therefore also consists of doctors, psychologists, nurses and specialised therapists.
The focus of our disorder-specific treatment programme lies in the psycho-social area. This means that our joint treatment measures primarily include psychotherapeutic therapies in talking and non-talking methods, e.g. art psychotherapy, concentrative movement therapy, mindfulness training. By focussing on group therapy processes in small groups (max. 8 patients) and as part of a large group of around 50 patients in the clinic, an environment is created in which social aspects of the bio-psycho-social model can be easily experienced.
We assume that this approach and the modern psychotherapeutic approaches it contains may be unfamiliar to you at first and may even cause scepticism.
Therefore, please take advantage of our information events, which we offer regularly. The current dates can be found on our website (see below). Interested parties and those affected can find out about our services there, without prior registration or referral, ask questions in person and then make a conscious decision as to whether they want to accept our treatment offer.
Team
People with depression suffer from a depressed mood, exhaustion, fatigue, lack of motivation, loss of joy and sometimes also feelings of inner emptiness, meaninglessness or their own worthlessness. Sleep disorders, loss of appetite, weight loss or pain are also common.
Psychosomatic treatment can help you to learn a different way of dealing with stress and strain, strengthen your confidence in yourself and become active again.
The term "burnout" is not yet clearly defined and does not represent an independent diagnosis. It refers to being "burnt out" in the sense of being chronically overwhelmed, which can occur in the workplace, for example, but can also have an impact on the private sphere. This condition can be a risk factor for a later mental or physical illness. Those affected usually suffer from emotional exhaustion as well as reduced work and performance capacity and despair over several weeks to months.
It is not uncommon for people to suffer from physical complaints for which no adequate explanation can be found in medical examinations. Such complaints can be variable, affect a wide variety of organs and last for a long time. They manifest themselves, for example, in the form of cardiovascular complaints, respiratory and digestive disorders or pain of various kinds and are referred to as "somatoform" or "functional" disorders.
Even if no conclusive physical cause is found for the complaints, there is no doubt that the symptoms are real and can lead to considerable restrictions and suffering for those affected. Mental processes often play an important role here - as a result of the restrictions experienced in everyday life, but also in the development of the symptoms.
Chronic pain is persistent or recurring pain that persists beyond the usual healing process of physical illnesses or occurs without a recognisable physical explanation. Physical as well as psychological and social factors can play an important role in the severity, nature and duration of the pain. In treatment, the aim is to achieve a balance between activity and relaxation in order to improve quality of life.
Anorexia is an eating disorder characterised by self-induced or maintained weight loss. This is usually caused by malnutrition and malnutrition leading to a pronounced underweight. Those affected - often adolescent girls and young women - only eat very small amounts or try to avoid food altogether. Some also vomit, take laxatives and appetite suppressants or do a lot of sport to lose weight. Although they are underweight, those affected feel too fat. Malnutrition often also leads to physical dysfunctions, such as the absence of menstruation in women, circulatory problems and organ damage.
Those affected by bulimia suffer from repeated binge eating, in which very large amounts of food are eaten within a short period of time. Out of exaggerated concern about body shape and weight, attempts are then made to prevent weight gain - by vomiting, exercising or taking laxatives and appetite suppressants. If bulimia is not treated, it can lead to life-threatening functional disorders such as cardiac arrhythmia or chronic inflammation of the oesophagus and stomach lining.
Binge eating disorder is characterised by repeated episodes of binge eating. In short, it can be understood as "bulimia without counteracting behaviour". During binge eating episodes, sufferers often feel a loss of control over their eating, i.e. they can no longer control what or how much they eat. This behaviour usually leads to a sharp increase in body weight.
Overweight and obesity are defined as an increase in body weight due to an increase in body fat above the normal level. Obesity is often associated with physical illnesses such as high blood pressure, lipometabolic disorders or diabetes. In some people, severe obesity also leads to self-esteem problems or problems with social interaction and even underlying mental illnesses such as depression and anxiety disorders. Psychotherapeutically guided interventions to overcome obesity can prove effective in these cases. In this context, we also carry out psychosomatic preliminary examinations for bariatric operations.
Anxiety disorder is a collective term for mental disorders in which there is either an unspecific fear or a specific fear (phobia) caused by an object or situation. Panic disorder, in which strong, panic-like fears suddenly occur, is also categorised as an anxiety disorder.
Sufferers experience excessive anxiety in situations that people without an anxiety disorder have no or significantly less fear of. As a result, anxiety-inducing situations are often avoided, which can mean considerable restrictions in coping with everyday life.
Personality disorders are persistent patterns in a person's experience and behaviour that usually affect several functional areas, such as mood, drive, perception, thinking and relationships. This refers to complex disorders of a person's interaction with their environment, which is why they are also referred to as relationship disorders. These can lead to impairments in personal and social situations that cause suffering for those affected.
The psychosomatic nursing team consists of registered nurses, many of whom are further qualified. The nursing staff are present around the clock and are the first point of contact for all patients. They are part of the relevant treatment team. On the one hand, they take care of the typical nursing tasks, and on the other, they lead various therapy programmes such as relaxation therapy, mindfulness training and the eating disorder group. Depending on requirements and the therapy plan, special care consultations are also offered, such as eating disorder consultations.
Individual psychotherapy is carried out by doctors and psychologists, with the number and duration of weekly sessions varying depending on the treatment setting. In the individual therapies, an attempt is made to understand the causes of the disorders together with the patients and to develop possibilities for change. This can also bring up issues that are difficult to address in group therapy. The individual therapist is the main point of contact for the patient.
Many of the therapies we offer take place in a fixed group of patients. The discussion group offers the opportunity to work together on personally important issues. This often leads to the experience that many patients have similar issues and that they can support each other very well. There is the opportunity to learn from each other and to bring about change together. One or two psychotherapists lead the group and try to make the processes in the group as favourable and helpful as possible for everyone.
Many patients are under constant inner tension, which promotes the development of psychosomatic complaints. Learning relaxation techniques is therefore particularly important. Special relaxation techniques (e.g. progressive muscle relaxation, mindfulness training, Tai Chi) are offered for this purpose. It is important that these techniques are practised as independently as possible so that they can also be used as a technique outside the clinic.
Body-orientated psychotherapy focuses on the connection between the body and mental processes. It promotes the ability to perceive, move and feel and to connect physical sensations and complaints with the psychological experience. In this way, coping and solution strategies in relation to oneself and others can be recognised and new ways of experiencing and acting can be developed for oneself and in the group.
Under the professional guidance of nutritionists, regular, healthy and balanced eating behaviour is learned and practised. We advise you on various illnesses (e.g. diabetes, eating disorders, chronic inflammatory bowel disease). We also have a training kitchen where you can learn how to prepare healthy and balanced meals under supervision.
Some patients find it easier to put something on paper instead of describing what is bothering them in words. In art therapy, you are encouraged to express your feelings and moods, but also conflicts and tensions, in a picture or sculpture. In a subsequent discussion with the group and the art therapist, the resulting experiences are reflected on together. Working in art therapy promotes self-awareness and strengthens self-esteem and self-confidence.
Special artistic skills are not necessary for art therapy.
In music therapy, it is possible to express psychological and social issues using musical means. Many easy-to-play instruments are available. There is the opportunity to express oneself in special exercises, but also in free improvisation and to gain experience. These are then worked through together in a group discussion. The therapy is led by a music therapist. No experience with a musical instrument or knowledge of sheet music is required.
Mindfulness training trains their perception and sharpens their concentration on themselves and their surroundings. To this end, exercises are carried out in the group under the guidance of a therapist that focus on body awareness while sitting and walking.
Many patients have questions regarding social issues such as sickness benefit, housing, employment, retraining measures, professional reintegration, etc. We have an experienced member of staff who is available for discussions and counselling after registration by the individual therapists. For such discussions, it is important to compile the necessary documents in advance and bring them with you to the clinic.
Contact & Appointments
You can reach us by telephone during our office hours:
Monday to Thursday: 8:00 - 11:30 and 14:00 - 15:30
Friday: 08:00 - 11:30 a.m.