Vår venn og kollega Carl-Ivar Dahl døde fredfullt 27. oktober 2013 i sitt omgitt av sine naermest... more Vår venn og kollega Carl-Ivar Dahl døde fredfullt 27. oktober 2013 i sitt omgitt av sine naermeste. Han ble henimot 82 år. Etter medisinstudiet spesialiserte han seg i psykiatri og fikk bred erfaring fra Tromsø, Modum Bad, Dikemark og praksis i Oslo. Etter psykoanalytisk utdanning ble han i1972 deltaker i en forskningsgruppe ved Universitetets psykiatriske institutt i Oslo, initiert av Leo Eitinger. Med deltakelse av ledende psykoterapiforskere, Peter Sifneos fra Harvard og David Malan fra Tavistock, dokumenterte gruppen betydelig effekt av en kortvarig innsiktspreget samtaleterapi. Det ble vist at spesifikke utvalgskriterier bedre enn diagnose identifiserte pasienter som nyttiggjorde seg denne terapien. Behandlingen hjalp, men hva var det i samtalene som var mest avgjørende? Carl-Ivar Dahl viet seg dette mest utfordrende spørsmål i psykoterapiforskningen. Han bidro dermed til at det psykiatriske forskningsmiljøet ved Universitetet i Oslo nå befinner seg i den internasjonale Minneord | Tidsskrift for Den norske legeforening
Tidsskrift for Den Norske Laegeforening, Apr 20, 2002
formann i Legeforeningens utvalg for menneskere igheter sekretaer Menneskere ighetsutvalget har i... more formann i Legeforeningens utvalg for menneskere igheter sekretaer Menneskere ighetsutvalget har i si siste brev til den israelske legeforeningen fordømt at ambulanser er bli brukt til å transportere våpen. Vi mener likevel det er en forskjell mellom hva enkeltindivider foretar seg og de bruddene på internasjonal humanitaer lov vi nå ser fra Israels side. Ifølge generalsekretaeren i Norges Røde Kors er det funnet eksplosiver i én Røde Kors-ambulanse, mens det til nå er drept eller såret 150 leger og annet helsepersonell. Dessuten er den israelske legeforeningen medlem av World Medical Association og er forpliktet av de deklarasjonene som er vedta der. Den israelske legeforeningen har derfor et spesielt ansvar for å si ifra til sine myndigheter når de så åpenbart bryter menneskere ighetene.
The experience of time has a decisive influence on refugees' well-being and suffering in all phas... more The experience of time has a decisive influence on refugees' well-being and suffering in all phases of their flight experiences. Basic safety is connected both developmentally and in present life with a feeling of continuity and predictability. Refugees often experience disruption of this basic sense of time in their home country due to war, persecution, and often severe traumatization, during flight, due to unpredictable and dangerous circumstances in the hands of smugglers, and after flight, due to unpredictable circumstances in asylum centers, e.g., extended waiting time and idleness. These context-dependent disruptions of normal experiences of time may lead to disturbances in mental life and extreme difficulties in organizing one's daily life. This article is based on narrative interviews with 78 asylum seekers and refugees in asylum centers in Norway, exploring their experiences before, during, and after flight. The distinction between abstract, chronological time, and concrete time connecting situational experiences (daily activities, such as daily rhythm of sleep and wakefulness) proved important for understanding how the experiences became mentally disturbing and how people tried to cope with this experience more or often less successfully. Prominent findings were loss of future directedness, a feeling of being imprisoned or trapped, disempowerment, passivity and development of a negative view of self, memory disturbances with difficulty of placing oneself in time and space, disruptions of relations, and a feeling of loss of developmental possibilities. Some had developed resilient strategies, such as imagining the flight as a holiday trip, to cope with the challenges, but most participants felt deeply disempowered and often disorientated. The analysis pointed clearly to a profound context dependent time-disrupting aspect of the refugee experience. An insecure and undefined present made participants unable to visualize their future and integrate the future in their experience of the present. This was connected with the inherent passivity and undefined waiting in the centers and camps, and with previous near encounters with annihilation and death. A response was often withdrawal into passivity.
Die gegenwärtige Vergangenheit. Extreme Traumatisierung und Psychotherapie
Psyche, Sep 1, 2000
Bruch und Verlust charakterisieren das Leben eines schwer traumatisierten Menschen besonders dann... more Bruch und Verlust charakterisieren das Leben eines schwer traumatisierten Menschen besonders dann, wenn er im Exil lebt. Er wird auch die therapeutische Begegnung aus Angst vor dem Wiedererleben und einer erneuten Traumatisierung oft als bedrohlich erfahren und in seiner Fahigkeit, eine vertrauensvolle Beziehung aufzubauen, eingeschrankt sein. In seiner Arbeit stellt Sverre Varvin die aus dem Trauma resultierende Storung der Mentalisierung in den Mittelpunkt und versucht unter Einbeziehung von Fallvignetten, Ansatze zur Behandlung dieser Patienten zu entwickeln. Besondere Bedeutung kommt dabei dem Setting zu, in dem unzureichend symbolisierte Erfahrungen in einem Prozes der Historisierung kontextualisiert werden konnen.
Asylsuchende und Geflüchtete: ihre Situation und ihre Behandlungsbedürfnisse
Psyche, Sep 1, 2016
Vor dem Hintergrund der gegenwartigen Situation fur Gefluchtete in Europa umreist der Autor sein ... more Vor dem Hintergrund der gegenwartigen Situation fur Gefluchtete in Europa umreist der Autor sein Verstandnis der »Fluchtlingserfahrung«, die die oft traumatisierende Vorgeschichte von Gefluchteten, die vielen Verluste und Gefahren, die eine Flucht mit sich bringt, die Ankunft in einem aufnehmenden Land und die Erfahrung des Exils umfasst. Das Exil ist fur ihn ein Prozess, der die Identitat zutiefst erschuttert und transformiert. Extreme Traumatisierungen losen im Funktionsgefuge der Personlichkeit und in Beziehungen zu anderen Veranderungen aus, die bei der Behandlung und Rehabilitation von Gefluchteten berucksichtigt werden mussen. Eine psychoanalytische Behandlung von Gefluchteten erfolgt im Kontext ihrer komplexen Situation, die durch Probleme infolge psychischer und korperlicher Qualen, durch niedrigen sozialen Status und Armut und andere exilspezifische Herausforderungen gekennzeichnet ist. Ein Fallbeispiel verdeutlicht Prinzipien einer solchen Behandlung.
Violence or Dialogue?: Psychoanalytic Insights on Terror and Terrorism
When the present reviewers confront the topic of terrorism and the threat of terrorism, several q... more When the present reviewers confront the topic of terrorism and the threat of terrorism, several questions immediately leap to mind: fi rst, will our children and grandchildren be safe? Second, is the world in which they will live the kind of world we have wished for ourselves and wish for them? Third, what kind of world will we live in for our remaining years? Fourth, what can we do, what can we get others to do, to affect the answers to these questions? Our answers cover a spectrum of activities, from storing up emergency supplies to working politically to infl uence the outcome of elections and of American foreign policy. Compared to the magnitude and immediacy of these questions, the question of what psychoanalysis can contribute appears relatively minor. Yet, being psychoanalysts, reading and writing about terrorism and its threats (threats both from the terrorists and from the war against terrorists) becomes a something that we can do. Our modest hope for psychoanalysis is that our fi eld might provide a model of a space for thinking and for self-scrutiny that could enhance the quality and appropriateness of what we, as psychoanalysts, can and cannot do. These two volumes, major contributions by psychoanalysts, are important acknowledgments of ourselves, our roles as analysts in the world and also of our own subjectivity as citizens living in this world in which we work. Very different in emphasis and scope, each book is a response to the events of 9/11, and to the precursors and consequences of those events. We are at a particular juncture in the history of our psychoanalysis, struggling more openly with the problem of defi ning our place and role as analysts vis à vis violent and traumatic situations in the world. The fi rst book, Coates et al., is primarily clinical. It is based on a conference on trauma and attachment theory: the clinical import of the theory and the systematic research contributing to it. The conference, ‘When the bough breaks’, planned before 9/11, changed its scope and emphasis after that date. The editors and most of the authors are members of a working group of analysts in New York, individuals Int J Psychoanal 2005;86:191–202 BOOK REVIEW ESSAY
MINNEORD O o W. Steenfeldt-Foss døde 17. august. I 1991 ble han valgt som første leder av Legefor... more MINNEORD O o W. Steenfeldt-Foss døde 17. august. I 1991 ble han valgt som første leder av Legeforeningens utvalg for menneskere igheter, et utvalg han som leder av Norsk psykiatrisk forening hadde ta initiativ til. Legers etiske forpliktelse til å behandle alle pasienter likt uavhengig av etnisk og nasjonal bakgrunn var grunnlaget for O os legegjerning. Han var overbevist om at helse kan vaere et utgangspunkt for å skape kontakt mellom parter i en konflikt, og leger og legeforeninger kan spille en rolle i fredsskapende virksomhet.
Tidsskrift for Den Norske Laegeforening, Dec 10, 2000
AKTUELT Legeforeningens utvalg for menneskere igheter Legeforeningens menneskere ighetsutvalg var... more AKTUELT Legeforeningens utvalg for menneskere igheter Legeforeningens menneskere ighetsutvalg var i oktober medarrangør ved konferansen Treatment of Psychotraumatic Disorders i Izmir i oktober. Konferansen var den andre i en serie på fem arrangementer ved behandlingssentre for torturofre i Tyrkia. Leger som arbeider frivillig ved de fem sentrene for torturofre, deltok på konferansen i Izmir i oktober. Foto B.O. Hoftvedt Den første konferansen ble holdt i Diyarbakir i Øst-Tyrkia i 1998. I april samme år arrangerte Legeforeningens menneskere ighetsutvalg en konferanse om medisinsk etikk i samarbeid med Human Rights Foundation of Turkey (se ramme) og den tyrkiske legeforeningen i hovedstaden Ankara.
This study investigated the association between short-term risk assessment measured by the Brøset... more This study investigated the association between short-term risk assessment measured by the Brøset Violence Checklist (BVC) and imminent violence using repeated measurements and differentiating violence characteristics and gender. All patients admitted to an acute psychiatric ward during one year (N = 528) were included. Logistic regression and generalized linear mixed model (GLMM) analyses were conducted. Results confirmed BVC's suitability for both male and female inpatients throughout their hospitalization also when differentiating threats and physical violence, and adjusting for diagnostic subpopulations and circadian variability. Results point to modified interpretations of the BVC sum scores. Future research should adjust for repeated measurements.
Vår venn og kollega Carl-Ivar Dahl døde fredfullt 27. oktober 2013 i sitt omgitt av sine naermest... more Vår venn og kollega Carl-Ivar Dahl døde fredfullt 27. oktober 2013 i sitt omgitt av sine naermeste. Han ble henimot 82 år. Etter medisinstudiet spesialiserte han seg i psykiatri og fikk bred erfaring fra Tromsø, Modum Bad, Dikemark og praksis i Oslo. Etter psykoanalytisk utdanning ble han i1972 deltaker i en forskningsgruppe ved Universitetets psykiatriske institutt i Oslo, initiert av Leo Eitinger. Med deltakelse av ledende psykoterapiforskere, Peter Sifneos fra Harvard og David Malan fra Tavistock, dokumenterte gruppen betydelig effekt av en kortvarig innsiktspreget samtaleterapi. Det ble vist at spesifikke utvalgskriterier bedre enn diagnose identifiserte pasienter som nyttiggjorde seg denne terapien. Behandlingen hjalp, men hva var det i samtalene som var mest avgjørende? Carl-Ivar Dahl viet seg dette mest utfordrende spørsmål i psykoterapiforskningen. Han bidro dermed til at det psykiatriske forskningsmiljøet ved Universitetet i Oslo nå befinner seg i den internasjonale Minneord | Tidsskrift for Den norske legeforening
Tidsskrift for Den Norske Laegeforening, Apr 20, 2002
formann i Legeforeningens utvalg for menneskere igheter sekretaer Menneskere ighetsutvalget har i... more formann i Legeforeningens utvalg for menneskere igheter sekretaer Menneskere ighetsutvalget har i si siste brev til den israelske legeforeningen fordømt at ambulanser er bli brukt til å transportere våpen. Vi mener likevel det er en forskjell mellom hva enkeltindivider foretar seg og de bruddene på internasjonal humanitaer lov vi nå ser fra Israels side. Ifølge generalsekretaeren i Norges Røde Kors er det funnet eksplosiver i én Røde Kors-ambulanse, mens det til nå er drept eller såret 150 leger og annet helsepersonell. Dessuten er den israelske legeforeningen medlem av World Medical Association og er forpliktet av de deklarasjonene som er vedta der. Den israelske legeforeningen har derfor et spesielt ansvar for å si ifra til sine myndigheter når de så åpenbart bryter menneskere ighetene.
The experience of time has a decisive influence on refugees' well-being and suffering in all phas... more The experience of time has a decisive influence on refugees' well-being and suffering in all phases of their flight experiences. Basic safety is connected both developmentally and in present life with a feeling of continuity and predictability. Refugees often experience disruption of this basic sense of time in their home country due to war, persecution, and often severe traumatization, during flight, due to unpredictable and dangerous circumstances in the hands of smugglers, and after flight, due to unpredictable circumstances in asylum centers, e.g., extended waiting time and idleness. These context-dependent disruptions of normal experiences of time may lead to disturbances in mental life and extreme difficulties in organizing one's daily life. This article is based on narrative interviews with 78 asylum seekers and refugees in asylum centers in Norway, exploring their experiences before, during, and after flight. The distinction between abstract, chronological time, and concrete time connecting situational experiences (daily activities, such as daily rhythm of sleep and wakefulness) proved important for understanding how the experiences became mentally disturbing and how people tried to cope with this experience more or often less successfully. Prominent findings were loss of future directedness, a feeling of being imprisoned or trapped, disempowerment, passivity and development of a negative view of self, memory disturbances with difficulty of placing oneself in time and space, disruptions of relations, and a feeling of loss of developmental possibilities. Some had developed resilient strategies, such as imagining the flight as a holiday trip, to cope with the challenges, but most participants felt deeply disempowered and often disorientated. The analysis pointed clearly to a profound context dependent time-disrupting aspect of the refugee experience. An insecure and undefined present made participants unable to visualize their future and integrate the future in their experience of the present. This was connected with the inherent passivity and undefined waiting in the centers and camps, and with previous near encounters with annihilation and death. A response was often withdrawal into passivity.
Die gegenwärtige Vergangenheit. Extreme Traumatisierung und Psychotherapie
Psyche, Sep 1, 2000
Bruch und Verlust charakterisieren das Leben eines schwer traumatisierten Menschen besonders dann... more Bruch und Verlust charakterisieren das Leben eines schwer traumatisierten Menschen besonders dann, wenn er im Exil lebt. Er wird auch die therapeutische Begegnung aus Angst vor dem Wiedererleben und einer erneuten Traumatisierung oft als bedrohlich erfahren und in seiner Fahigkeit, eine vertrauensvolle Beziehung aufzubauen, eingeschrankt sein. In seiner Arbeit stellt Sverre Varvin die aus dem Trauma resultierende Storung der Mentalisierung in den Mittelpunkt und versucht unter Einbeziehung von Fallvignetten, Ansatze zur Behandlung dieser Patienten zu entwickeln. Besondere Bedeutung kommt dabei dem Setting zu, in dem unzureichend symbolisierte Erfahrungen in einem Prozes der Historisierung kontextualisiert werden konnen.
Asylsuchende und Geflüchtete: ihre Situation und ihre Behandlungsbedürfnisse
Psyche, Sep 1, 2016
Vor dem Hintergrund der gegenwartigen Situation fur Gefluchtete in Europa umreist der Autor sein ... more Vor dem Hintergrund der gegenwartigen Situation fur Gefluchtete in Europa umreist der Autor sein Verstandnis der »Fluchtlingserfahrung«, die die oft traumatisierende Vorgeschichte von Gefluchteten, die vielen Verluste und Gefahren, die eine Flucht mit sich bringt, die Ankunft in einem aufnehmenden Land und die Erfahrung des Exils umfasst. Das Exil ist fur ihn ein Prozess, der die Identitat zutiefst erschuttert und transformiert. Extreme Traumatisierungen losen im Funktionsgefuge der Personlichkeit und in Beziehungen zu anderen Veranderungen aus, die bei der Behandlung und Rehabilitation von Gefluchteten berucksichtigt werden mussen. Eine psychoanalytische Behandlung von Gefluchteten erfolgt im Kontext ihrer komplexen Situation, die durch Probleme infolge psychischer und korperlicher Qualen, durch niedrigen sozialen Status und Armut und andere exilspezifische Herausforderungen gekennzeichnet ist. Ein Fallbeispiel verdeutlicht Prinzipien einer solchen Behandlung.
Violence or Dialogue?: Psychoanalytic Insights on Terror and Terrorism
When the present reviewers confront the topic of terrorism and the threat of terrorism, several q... more When the present reviewers confront the topic of terrorism and the threat of terrorism, several questions immediately leap to mind: fi rst, will our children and grandchildren be safe? Second, is the world in which they will live the kind of world we have wished for ourselves and wish for them? Third, what kind of world will we live in for our remaining years? Fourth, what can we do, what can we get others to do, to affect the answers to these questions? Our answers cover a spectrum of activities, from storing up emergency supplies to working politically to infl uence the outcome of elections and of American foreign policy. Compared to the magnitude and immediacy of these questions, the question of what psychoanalysis can contribute appears relatively minor. Yet, being psychoanalysts, reading and writing about terrorism and its threats (threats both from the terrorists and from the war against terrorists) becomes a something that we can do. Our modest hope for psychoanalysis is that our fi eld might provide a model of a space for thinking and for self-scrutiny that could enhance the quality and appropriateness of what we, as psychoanalysts, can and cannot do. These two volumes, major contributions by psychoanalysts, are important acknowledgments of ourselves, our roles as analysts in the world and also of our own subjectivity as citizens living in this world in which we work. Very different in emphasis and scope, each book is a response to the events of 9/11, and to the precursors and consequences of those events. We are at a particular juncture in the history of our psychoanalysis, struggling more openly with the problem of defi ning our place and role as analysts vis à vis violent and traumatic situations in the world. The fi rst book, Coates et al., is primarily clinical. It is based on a conference on trauma and attachment theory: the clinical import of the theory and the systematic research contributing to it. The conference, ‘When the bough breaks’, planned before 9/11, changed its scope and emphasis after that date. The editors and most of the authors are members of a working group of analysts in New York, individuals Int J Psychoanal 2005;86:191–202 BOOK REVIEW ESSAY
MINNEORD O o W. Steenfeldt-Foss døde 17. august. I 1991 ble han valgt som første leder av Legefor... more MINNEORD O o W. Steenfeldt-Foss døde 17. august. I 1991 ble han valgt som første leder av Legeforeningens utvalg for menneskere igheter, et utvalg han som leder av Norsk psykiatrisk forening hadde ta initiativ til. Legers etiske forpliktelse til å behandle alle pasienter likt uavhengig av etnisk og nasjonal bakgrunn var grunnlaget for O os legegjerning. Han var overbevist om at helse kan vaere et utgangspunkt for å skape kontakt mellom parter i en konflikt, og leger og legeforeninger kan spille en rolle i fredsskapende virksomhet.
Tidsskrift for Den Norske Laegeforening, Dec 10, 2000
AKTUELT Legeforeningens utvalg for menneskere igheter Legeforeningens menneskere ighetsutvalg var... more AKTUELT Legeforeningens utvalg for menneskere igheter Legeforeningens menneskere ighetsutvalg var i oktober medarrangør ved konferansen Treatment of Psychotraumatic Disorders i Izmir i oktober. Konferansen var den andre i en serie på fem arrangementer ved behandlingssentre for torturofre i Tyrkia. Leger som arbeider frivillig ved de fem sentrene for torturofre, deltok på konferansen i Izmir i oktober. Foto B.O. Hoftvedt Den første konferansen ble holdt i Diyarbakir i Øst-Tyrkia i 1998. I april samme år arrangerte Legeforeningens menneskere ighetsutvalg en konferanse om medisinsk etikk i samarbeid med Human Rights Foundation of Turkey (se ramme) og den tyrkiske legeforeningen i hovedstaden Ankara.
This study investigated the association between short-term risk assessment measured by the Brøset... more This study investigated the association between short-term risk assessment measured by the Brøset Violence Checklist (BVC) and imminent violence using repeated measurements and differentiating violence characteristics and gender. All patients admitted to an acute psychiatric ward during one year (N = 528) were included. Logistic regression and generalized linear mixed model (GLMM) analyses were conducted. Results confirmed BVC's suitability for both male and female inpatients throughout their hospitalization also when differentiating threats and physical violence, and adjusting for diagnostic subpopulations and circadian variability. Results point to modified interpretations of the BVC sum scores. Future research should adjust for repeated measurements.
Uploads
Papers by Sverre Varvin