European Journal of Mental Health 8 2013/ 2

Volume 8  Number 2  Dec European Journal of Mental Health Volume 8  Number 2  Dec 2013

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mental health promotion  multidisciplinary approaches  individual, family, community, society

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This interdisciplinary periodical represents the view that mental health promotion must not be limited to the protection and improvement of the individual’s mental health but must be extended to include the community, and through the cooperation of all human services it must contribute to the emergence of a mentally healthy society. The journal publishes theoretical and research-oriented articles as well as work-in-progress papers, short communications and the descriptions of efficient practices with original approaches.

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We interpret mental health promotion to include every effort and all manner of individual and communal endeavour to realise principles and ideals of mental health at a social level. This means approach and attitude, praxis and theory, fields of activity and institutional systems alike. This approach to mental health promotion always requires cooperation and communal efforts, these days not only between individuals, specialists and groups but also between states, nations and research groups.

East Central Europeans must therefore strive to find each other and come closer together, but certainly not at the price of the hard-won contacts between the two halves of an all too long divided continent. On the one hand, our common history, the many similarities in our past pave the way for cooperation both rationally and emotionally; on the other, we all share a vision of a truly common European future, hopes and goals that unite us. Between past and future, our situation, our problems and experiences are similar but not identical. They can mutually complement and enrich each other and contribute to the achievement of our common goals, the reduction of harmful factors and the promotion of mental health. For mutual and deep understanding, however, we must develop a common language, common forums and organs in which we can share our experiences and reflect on them together. This journal seeks to contribute to that effort with its abstracts in 9 languages in order to serve, through the emergent dialogue, a colourful and many-faceted reality which consists not so much of education, social work, health care, religion, mass media, political activity and legislation as of individuals, families, communities and societies.

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European Journal of Mental Health Individual, Family, Community and Society VOLUME 8, NUMBER 2, DECEMBER 2013 Editors-in-Chief / Leitende Herausgeber Prof. Norbert Mette, Universität Dortmund (Germany) Prof. Teodóra Tomcsányi, Semmelweis Egyetem, Budapest (Hungary)

Editorial Board / Beratende Herausgeber Prof. Jerzy Aleksandrowicz, Uniwersytetu Jagiellońskiego w Krakowie (Poland) Prof. Jacob A. Belzen, Universiteit van Amsterdam (Netherlands) Prof. Jozef Corveleyn, Katholieke Universiteit Leuven (Belgium) Dr. habil. Beáta Dávid, Semmelweis Egyetem, Budapest (Hungary) Prof. Valerie DeMarinis, Uppsala universitet (Sweden) Dr. Rita Fóris-Ferenczi, Universitatea Babeş-Bolyai, Cluj-Napoca (Rumania) Prof. Skaidrīte Gūtmane, Latvijas Kristīgā akadēmija, Jūrmala (Latvia) Prof. Katalin Horváth-Szabó, Semmelweis Egyetem, Budapest (Hungary) Dr. Gábor Ittzés, Semmelweis Egyetem, Budapest (Hungary) Dr. habil. Pavlína Janošová, Akademie věd ČR, Praha (Czech Republic) Prof. Martin Jäggle, Universität Wien (Austria) Prof. Paavo Kettunen, Joensuun yliopisto (Finland) Dir. Em. Michael Manderscheid, Fortbildungs-Akademie des DCV, Freiburg i.Br. (Germany) Dr. habil. Ilona Pataky, Pázmány Péter Katolikus Egyetem, Piliscsaba (Hungary) Dr. Regina Polak, Universität Wien (Austria) Dr. habil. Igor Škodáček, Univerzita Komenského v Bratislave (Slovakia) Prof. László Tamás Szabó, Debreceni Egyetem (Hungary) Dr. habil. Péter Török, Semmelweis Egyetem, Budapest (Hungary) Prof. András Vargha, Károli Gáspár Református Egyetem, Budapest (Hungary) Prof. Andreas Wittrahm, Caritasverband für das Bistum Aachen (Germany) Prof. Siniša Zrinščak, Sveučilište u Zagrebu (Croatia)

INSTITUTE OF MENTAL HEALTH Faculty of Health and Public Services Semmelweis University, Budapest

Advisory Board / Wissenschaftlicher Beirat Dr. Imre Makszin, Budapest (Hungary) Prof. István Bitter, Semmelweis Egyetem, Budapest (Hungary) Dr. Jessie Dezutter, Katholieke Universiteit Leuven (Belgium) Dr. Artur Filipiak, Uniwersytet im. Adama Mickiewicza w Poznaniu (Poland) Dr. Ede Frecska, Debreceni Egyetem (Hungary) Márton Gerő, Magyar Tudományos Akadémia, Budapest (Hungary) Dr. Tibor Imrényi, Magyar Ortodox Egyházközség, Szeged (Hungary) Dr. Béla Káposztássy, Szob (Hungary) Prof. Endre Nagy, Semmelweis Egyetem, Budapest (Hungary) Prof. Bernadette Péley, Pécsi Tudományegyetem (Hungary) Karolina Krysinska, Katholieke Universiteit Leuven (Belgium) Dr. Katalin Szikora, Semmelweis Egyetem, Budapest (Hungary)

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Frontcover: The view of Delphoi (sanctuary, theater, and stadium) Titelblatt: Sicht auf Delphoi (Tempel, Theater und Stadion)

CONTENTS / INHALT STUDIES / STUDIEN Research Papers / Wissenschaftliche Arbeiten Máté Joób & Paavo Kettunen: Confession from the Point of View of the Experience of the People Seeking Help: An Empirical Study about Confessional Practices in Finland and Hungary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis: Learning Projects and Their Background Motivations: Relationships with Mental Health in Midlife and Later Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Common Past / Gemeinsame Vergangenheit Robert J. Biel: Die Atheisierung der Kultur im kommunistischen Polen . . . . . . . . . . . . . . . 212 Case Study / Fallstudie Jozef Hašto & Hana Vojtová: Posttraumatic Stress Disorder, Bio-Psycho-Social Aspects, Eye Movement Desensitisation and Reprocessing and Autogenic Training in Persistent Stress: Case Study, Part 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 BOOK REVIEWS / REZENSIONEN Ákos Tóth: Salutogenesis in Transcultural Management: Theory and Hypothesis Building (C.-H. Mayer (2011) The Meaning of Sense of Coherence in Transcultural Management) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 ABSTRACTS / ZUSAMMENFASSUNGEN (Croatian, Czech, English, German, Hungarian, Polish, Rumanian, Russian, and Slovakian Abstracts / Kroatische, Tschechische, Englische, Deutsche, Ungarische, Polnische, Rumänische, Russische und Slowakische Zusammenfassungen) Apstrakti (275), Abstrakty (277), Abstracts (279), Zusammenfassungen (281), Összefoglalók (284), Abstrakty (287), Abstracte (290), Резюме (292), Abstrakty (295) Contributors to This Issue / Autoren dieses Heftes

STUDIES / STUDIEN

European Journal of Mental Health 8 (2013) 163–186 DOI: 10.5708/EJMH.8.2013.2.1

Máté Joób* & Paavo Kettunen

CONFESSION From THE POINT OF VIEW OF THE EXPERIeNCE OF THE PEOPLE SEEKING HELP An Empirical Study about Confessional Practices in Finland and Hungary (Received: 13 December 2011; accepted: 5 December 2012)

The article presents confession practice from the point of view of the confessants. The practice and experiences of the confessants are presented based on two earlier research studies. The source material of both researches was based on letters written by the confessants themselves with the need of stress relief. As the collection and analysis of the material was conducted with a similar method, it is also possible to compare the findings of the two research studies. Based on letters from Finnish and Hungarian respondents, the authors look at several topics: expectations of the confessants, criteria of experiencing absolution, the relationship between confessant and confessor and the effect of confession on the spiritual life of the confessant.

Keywords: confession, confessional practice, confessor, confessant, absolution, anxiety, sin, guilt, distress Beichte aus der Perspektive der Erfahrungen Hilfesuchender: Empirische Studie über die Praxis der Beichte bei Finnen und Ungarn: Der Artikel stellt die Praxis der Beichte aus der Sicht der beichtenden Person, des Büßers, vor. Die Beichte und die Erfahrungen der Büßer werden von zwei früheren Studien ausgehend untersucht. Das Quellenmaterial dieser Studien bilden Briefe von Büßern mit dem Bedürfnis nach Stressreduzierung. Da die Materialsammlung und -analyse in beiden Studien auf ähnliche Weise erfolgte, konnten die Ergebnisse miteinander verglichen werden. Auf der Grundlage der Briefe von finnischen und ungarischen Untersuchungsteilnehmern haben die Autoren verschiedene Themen untersucht: Erwartungen der Büßer, Kriterien für das Erleben der Lossprechung, das Verhältnis zwischen Beichtvater und Büßer sowie die Wirkung der Beichte auf das spirituelle Leben des Büßers.

Schlüsselbegriffe: Beichte, Praxis der Beichte, Beichtvater, Büßer, Lossprechung, Angstzustände, Sünde, Schuld, Reue *

orresponding author: Máté Joób, Institute of Mental Health, Semmelweis University, Nagyvárad tér 4., 19.

C em., H-1089 Budapest, Hungary; mate.joob@public.semmelweis-univ.hu.

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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1. Introduction The topic of confession has been studied widely in the fields of systematic theology and canonical justice. In the two thousand years of the Church’s history, confession has always been present (although with different priorities and interpretations) as a framework provided by the Church and the given community as a response to the basic human needs of stress relief and liberation from burdens. According to the understanding of the Church, this human need achieves its goal if the process is realised in a transcendental dimension. Despite its special character, confession practice has been marginalised among believers. In Protestant churches, it has practically disappeared and even the Lutheran Church looks at it as a part of our own pastoral tradition or as a method of spreading the gospel which is, alas, forgotten. In the Roman Catholic Church where confession was elevated to the role of a sacrament, confession as a way of relieving stress and laying down one’s burdens is practised in a much more lively manner. At the same time, following World War II the Roman Catholic Church has also been speaking of a crisis of the sacrament of confession. The first reactions to this statement were mainly negative.

Many scholars insisted that an institution which is based on Holy Scripture and which the Church has preserved for centuries must not suffer a crisis. In 1984, pope John Paul II declared at the end of a Bishops’ Synod that the sacrament of penance is in a crisis.1 Now, after thirty years the statement and its consequences are still relevant.

Although there is extensive literature on the research of confession, those are mainly theoretical papers. One can very rarely see studies which approach the question of confession from the practical point of view, primarily from the confessant’s perspective.

The present article would like to introduce and compare two empirical research studies which approached the question of confession not from an academic but from a practical point of view. In 1998, Paavo Kettunen published an extensive study on confession in Finland (Kettunen 1998). It was based on letters sent in reply to requests published in newspapers calling for personal experiences of confession. Máté Joób (2006) defended his PhD thesis at the Evangelical-Lutheran Theological University in Hungary (A békesség élménye: Az egyéni bűnbánat kvalitatív tartalomelemzése pasztorálpszichológiai szempontból / An Experience of Peace: A Qualitative Content Analysis of Private Confession from the Perspective of Pastoral Psychology).2 This was also based on letters in which Hungarians wrote about their experiences of confession. Although the two research studies were conducted with a few years’ time difference and both of them date back to more than 10 years, the questions they stated are still valid.

Confession practice cannot be studied without looking at its circumstances: the church and society in which those churches serve. At the same time confession meets a basic human need in which sense we must not forget its significance for mental health.

In the present sample, many participants also said that confession (sharing the burdens) has a stress-relieving effect independent of any theological dimension. If the confes1 2

On the crisis of penance, see also Csizmadia 1999, 188–190. n experience of peace. A qualitative content analysis of private confession from the perspective of pastoral A psychology (Joób 2006).

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sant experiences an inclusive and supportive attitude, it further strengthens the cathartic (cleansing) experience. In addition to the stress-relieving effect of sharing, it also underlines taking responsibility which is an important factor relating confession practice to mental health (in addition to maintaining our spiritual life). The empathetic (merciful) attitude of the confessor can further strengthen the self-appreciation of the confessant.

2. Confessional practices in different denominations Before presenting the findings of the two research studies, we briefly present the confession practice in different communities as codified in church prescriptions.

2.1. In the Roman Catholic Church Confession practice in the Roman Catholic Church is part of the liturgical renewal following the Second Vatican Council. Ordo Paenitentiae (The Rite of Penance) was published on 2 December 1973 and it is still the basis of the confession practice in the Roman Catholic Church. Based on it, the compulsory act of private confession for believers is construed as follows: the confessor receives the confessant and calls upon him/her to trust in God. He freely quotes the Word of God or reads passages according to the situation. The confessant confesses his/her sins, shows contrition and receives absolution from the confessor after the necessary advice, personal address and answers. The confessant gives thanks to God for his grace and takes leave (Sólymos 1975, 20). Ordo Paenitentiae does not only publish the order of private confession but also describes its elements in detail. A short summary of this could help a better understanding of the confession practice itself.

The first part of the sacrament of penance is contrition. Contrition also includes the intention of sinning no more (Horváth & Tomka 2002, 219). Since the Middle Ages, the teaching of the Roman Catholic Church has used the distinct concept of contritio in which the believer arrives at penance from a heartfelt love towards God. Contrition is actually already a way to salvation – even in the case of grave sins. The tension between the teaching of the Church and the outcome of contrition is solved as follows: eartfelt contrition must include the intention that we will do whatever our God requests.

H This way we are also ready for sacramental confession. We definitely need contrition if having committed a grave sin and having gotten into deadly danger but with no possibility to confess. Contrition together with a wish to confess purifies our soul.

(Horváth & Tomka 2002, 222, our trans.)3 3

riginal text: ‘A tökéletes bánatnak magában kell foglalnia azt a szándékot is, hogy O mindent megteszünk, amit Isten kíván tőlünk. Így készek vagyunk a szentségi kiengesztelődésre, a gyónásra is. Tökéletes bánatra feltétlenül szükségünk van akkor, ha súlyos bűnt követtünk el, és halálveszélybe kerültünk, gyónásra pedig nincs módunk.

A tökéletes bánat a gyónás szándékával egybekötve megtisztítja lelkünket.’

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In addition to contrition, there is the concept of the less perfect notion of attritio in which the believer repents his/her sins for fear of a righteous punishment.

This is not enough to achieve an absolution of grave sins but it prepares the believer to ask for absolution through the sacrament of penance (Catechism of the Catolic Church 2000, 364–65 = No. 1453). In the case of less grave sins, it is enough to seek God’s absolution through repentant deeds. Repentant deeds are, for example, fasting, prayer and the deeds of Christian love. In the case of grave sins, sacramental confession is necessary. In the case of attrition, one should make confession at once, whereas in the case of contrition the sacrament can be taken later on. However, such a delay should not prevent the believer from fulfilling the order according to which the sacrament of penance should be taken at least once a year (989).

The second part of the sacrament of penance is confession. Confession is necessary because the believer admits his/her sinfulness before God and the Church and through that receives sacramental forgiveness. Confession must be uttered to a priest who is given a legal mandate to receive confession. In case of a deadly danger, every priest has this capacity.

The third part of the sacrament of penance is the act of penance (satisfaction).

Ordo Paenitentiae teaches that true conversion can only be fulfilled through acts of penance, amendment of conduct and reparation of injury. Satisfaction is a good deed, specified by the priest, which must be completed so that the injury caused by the sin can be remedied and the penitent could be strengthened on the way of Christ (Horváth & Tomka 2002, 237).

The last part of the sacrament of penance is absolution. Although all priests have received a mandate to grant pardon to sinners within the sacrament of holy orders, for a valid absolution, however, they also need a mandate to give the sacrament of penance. This is usually granted after an examination by the ordinates. In deadly danger, absolution may nonetheless be spoken without such a mandate (245).

2.2. In the Lutheran Church In the Lutheran Church, there is no unified and compulsory teaching on the practice of private confession. Although Luther does present a confessional order in his Small Catechism, ‘How plain people are to be taught to confess’, but he also states that ‘this is intended simply as an ordinary form of confession for plain people’ (1959, 351).

Several national churches publish some guidelines and, in some cases, also forms of confession in their hymn books used today. Within the hymn book of the Evangelical-Lutheran Church in Hungary, there is a special part on confession among other prayers (Evangélikus énekeskönyv 1998, 693–702). Although this section does not include a liturgy of confession, it still gives a few guidelines for the believers. For

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the question ‘How many types of confession are there?’ (our trans.),4 the fourth answer says: ‘Private confession to a pastor’ (694, our trans.).5 The text goes on: ‘Jesus Christ mandated his Church, the official servants of the Word to give absolution for sins in His name’ (701, our trans.).6 In addition to the above – i.e. that the Lord of the Church has given the task of absolution to the official servants of the Word – there are no more practical guidelines for practising private confession. Therefore it is very important how a pastor teaches and offers this form of conciliation to the members of his/her congregation.7 In the Lutheran practice, confession events are often connected to lengthy pastoral discussions. It is not typical for a congregation member to ask for a few minutes’ confession event from the pastor. Usually there is first a pastoral discussion in a free form after which – on request from the confessant or suggested by the pastor – the event can be transformed into a confession and an absolution. The believer seeking help has a decisive role in making this change – both form- and contentwise.

2.3. In the Orthodox tradition Orthodox Christians are suggested to practise regular confession in order to arrange the sins conducted since the last Communion. Prerequisites of absolution include: intensive examination of one’s conscience; reconciliation with those one has hurt; penitence and intention for amendment; and confession in the face of Jesus Christ, witnessed by the priest. Up until the 14th century, lay monks were mandated to receive confessions. From then on, only priests, monastic priests, and bishops have had this mandate. In the Orthodox practice, confession is often connected to a lengthy pastoral discussion. Penitences have an important function but they have a healing function rather than a satisfactory one, i.e. they are supposed to lead the penitent back to Christ (Ohme 2001, 77–80).

2.4. In the Reformed Church Hungarian Reformed literature on pastoral care is not very elaborate when speaking about the forms and practice of private confession.8 On the other hand, it analyses in 4 5 6

7

8

riginal text: ‘Hányféle gyónás van?’

O Original text: ‘A magángyónás, a lelkipásztor előtt négyszemközt.’

Original text: ‘Jézus Krisztus az ő egyházának, az ige hivatalos szolgáinak adta azt a hatalmat, hogy feloldozást adjanak: az Ő nevében bűnöket bocsássanak.’

The official Confirmation Catechism of the church may give a suitable starting point. Although it does not include guidelines for the practical fulfilling of private confession, it does mention the theoretical background (Konfirmációi káté 2004, 38–41).

Géza Boross does not even mention the possibility of private confession in his ʻPastoral Theology’ (1997, 98–102). Csaba Fekete comments on today’s situation as follows: ‘In the life and practice of the Protestant churches after the Reformation, the abolition of confession to the ear and the loss of importance of the

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detail a type of pastoral dialogue which – taken its direction and goal – can well be understood as a form of private confession.

In his work Lelkigondozástan (Pastoral Care), Tivadar Rózsai (1981) defines the elements of private confession in the classical way: The role of the Word in confession is 1. satisfactio, i.e. satisfaction through the redeeming sacrifice of Christ which has no conditions; 2. absolutio, which means the announcing of free grace, and 3. confessio, which means confession and creed at the same time (35). Reversing the order of absolutio and confessio this way is highly untypical. However, Rózsai did not want to define a given form for pastoral workers. He was speaking of the role of the Word in private confession.

A book published by the Hungarian Reformed Church in 1949 (Van-e evangéliumi gyónás?) had certainly had an effect on the fact that the formal requirements of private confession have remained in the background. In this short work, Eduard Thurneysen defines confession and absolution as an activity of the congregation and mentions two possible forms: 1. Based on James 5:16, confession of sins and absolution among the members of the congregation. Thurneysen underlines that in confession, we need Christian brethren who can help us explore our sins.9 2. The other form of confession and absolution is the common confession and absolution at the service (11–13).

Of course Thurneysen does not exclude the possibility that the Christian ‘brethren’ of the confessant could be the pastor of the congregation. But at the same time he takes listening to confession and preaching the gospel as a general task.

2.5. In the Baptist Church In the Baptist Church, there are no teachings or regulations concerning the practice of private confession so we can only speak about general guidelines (Hyde 1984, 48–49).10 In the liturgy of a Baptist service, confession and absolution are included before receiving Communion. Confession happens through silent prayer which is followed by general absolution. Before the Communion service, congregation members are asked to acknowledge their sins. This often happens in the form of a prayer confessing sins in the face of God. Confession and absolution among the congrega-

9

10

common confession has created an unfilled vacuum both in the divine service and in the spiritual life of the congregation’ (2001, 61, our trans.). Original text: ‘A protestáns egyházak életében és gyakorlatában a reformáció után, a fülbegyónás megszűnésével és a közgyónat elhomályosodásával, majd elhanyagolásával betöltetlen űr keletkezett az istentiszteleti rendtartásban és a gyülekezet lelki életében.’

In contrast with Thurneysen, János Pásztor has a different position: ‘The servants of the Lord are mandated to preach the word of absolution’ (1985, 103, our trans.). Original text: ‘A bűnbocsánat hirdetésére az Úr szolgáit hatalmazza fel.’

The majority of the information presented here originates from a discussion with Zoltán Nemeshegyi, teacher of the Department of Practical Theology at the Baptist Theological Academy.

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tion members is also a well-known and practised form in Baptist communities. In family-like communities with a limited number of members, this practice seems to be preferred to the case when the confessants ask a third person (the pastor) to be of assistance in the acknowledgement of their sins. In Baptist confession practice, content elements are much more important than the form itself.

3. Empirical research on confession A great part of research on private confession deals with the history and practice of private confession in the different Christian communities. Now we would like to briefly refer to a few empirical studies on the practice of private confession completed in the last century in Western Europe. The first one is the research done by Georg Wunderle (1921). Wunderle looked at the Roman Catholic sacramental practice from a psychological point of view. He used a questionnaire through which he gained direct information from the believers practising the sacramental and indirect information from professors and pastors giving absolution on the confession practice of the given community. This study focused on exploring the internal needs of the believers.

In his doctoral thesis published in 1946, Erik Berggren discussed the psych­ ology of private confession. He chose texts in which authors from different Christian communities wrote about the practice of private confession. Berggren came to the conclusion that independently of the variation in the teaching of different churches, general psychological processes can be detected in the confessants during the confession event. In his opinion, the confessant is primarily characterised by a breach of psychological harmony – although less so than in the case of neurotic patients.

Namely, when someone confesses a given activity or lifestyle as sin, he/she realises at the same time that his/her will is instable and the personality needs to achieve internal unity. The striving towards a confession event is at the same time a sign of need for internal unity and peace. As the psychotherapeutic methods also aim to help the person achieve psychological harmony, Berggren compared those processes to the Christian confession practice.

The next important empirical research was conducted at the end of the 1970s.

Konrad Baumgartner (1978) collected his material for two and a half years. A thousand questionnaires were distributed to German Catholics in cities and in the countryside to explore their experiences connected to the sacrament of penance.

Baumgartner concluded that the decrease in practising the sacrament of penance is due not only to the persons who do not come to confession anymore. Neither can secularisation be blamed as the main reason behind the scarcity of confessions. The reasons can be better explored if we let the believers themselves tell their experi­ences of the confession practice. Baumgartner also indicates that young people should be introduced to confession practice only when they are already well-developed in faith. Many unpleasant childhood experiences could be avoided if young people EJMH 8:2, December 2013

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would start to practise the sacrament of penance at the right age with better focus on individual abilities. Baumgartner also concludes from the feedback from the informants that in theological education, greater emphasis should be laid on pastoral psychology and pedagogy.

In 1996, a research study on a given age group was published by Ursula Silber.

She looked at the confession experiences of women between the age of 30–45. The study showed that the members of this age group are the most likely to turn away from confession practice. It can have grave consequences as this age group is responsible for the raising of the next generation. According to Silber, it is hard to think of parents who do not practise the sacrament of penance themselves but would be able to lead their children and give them a good example of how to do so. This study also speaks about how this age group tries to eliminate the feeling of guilt without practising the sacrament of penance. Silber also concludes that childhood environment and experiences of confession then have a strong effect on one’s confession practice in adulthood. Communication (or more precisely the lack of communication) in family and congregation is also a decisive factor in how a person is able to handle his/her guilt and frustration. She also has some important findings concerning the relationship between confessant and confessor. In her opinion, it is a problem for the majority of women between the age of 30–45 to confess their sins to a man. Thus confessants have strongly ambivalent feelings towards the persons speaking the absolution. The study also shows that the confessants have very high expectations towards the persons speaking the absolution and that these persons often fall short of those expectations.

We do not know of any research done in Hungary except for the study presented here that would focus on the practice of private confession especially from the point of view of the persons seeking help and practising the sacrament. The Jesuit periodical Távlatok (Perspectives), in its Christmas issue in 1997 published an article ‘Kérdések a gyóntatással kapcsolatban’ (Questions about confession) after which many readers sent their comments to the editors. The reflections were published in the next issue (1998, 65–70). Here the writings of three priests are complemented with opinions from several lay authors. The collection gives a certain overview of how Roman Catholic believers understand the sacrament of penance. However, the texts are not followed by any comment or analysis from the editors.

4. Research topics Both researchers aimed at exploring confessional practices on the basis of personal experiences. The motive for research on confession was to look at it from a qualitative perspective. Both research studies had a similar goal, although there were a few formal discrepancies. The Finnish research focused on six subtopics: 1. What kind of confessional practices are there in Finland?

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towards them? How did the confessors perform and how have the confessants perceived their actions?

3. What is the distress expressed in confession and what is the confessed sin and guilt?

4. How did the confession help the confessants?

5. What kind of view of God and spiritual life is conveyed through confession?

6. What are the confessants’ experiences of themselves during confession?

(Kettunen 1998, 72) The Hungarian study focused on the following questions: For what and in what way did the penitent obtain help during confession? How did they perceive the help they got? How did it influence their spiritual life (Joób 2006, 8, 19–20)?

The Hungarian study investigated the internal and external motives of the person seeking help (the penitent), problems during preparation for confession, expect­ ations towards the person giving the absolution, factors influencing the liberating experience of confession, reasons for the lack of a liberating experience, connections between confession and spiritual life and connections between confession and spiritual direction (Joób 2006, 21).

5. Collection of the material and method Both sets of research material were collected by requests published in newspapers.

Kettunen published his invitation in at least 32 newspapers. Some of the papers were Church-related, and the others were daily newspapers and magazines (Kettunen 1998, 72, 78–79). Joób published his request in seven Church-related newspapers.

In Finland, 201 letters were received, in Hungary, 117. Due to differences in the ecclesiastic and social context, the collecting of the material was conducted in the two countries in different ways. In Hungary, the requests were only published in Church media and those represented a wider variety of communities than in Finland. In Finland, the requests also appeared in a number of non-denominational newspapers but the pool of respondents came from a narrower sample of creeds. Based on the material, it was apparent that the letters would mirror experiences from a variety of confessional groups.

Both researchers used the method of qualitative content analysis which was already a well-established research method in practical theology in Finland while it was still quite new in theological studies in Hungary. Therefore, Máté Joób published a separate article introducing the method (2003, 310–12). Both researchers chose a pastoral psychological approach which meant that the letters of confession were analysed both from a theological and a psychological point of view. This was very much needed as both confession studies focused on the personal experiences of the confessants.

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Fin

5%

No data

6. Participans Other

Hun

M. Joób & P. Kettunen

3%

In both countries, 2% the majority of the respondents were women. In Finland, the proBaptist portion of women (79%) was even higher than in Hungary (68%). Consequently, Calvinist the proportion of5%Finnish men (17%) was smaller compared to the proportion of (see Figure 1). In Hungarian men (30%) (Kettunen 1998, 100–01; Joób 2006, 28) 73% Catholic 4% bothRoman sets of research material, there were a few letters from which the gender of the author could not be deduced. The gender ratio of the authors was less balanced in 9% Orthodox Finland than in Hungary. However, the ratio of women and men among the respondents isLutheran not an indicator of 15% the proportion of both genders taking part in confession.

79% A German research from the 1970s concerning the experiences of confession shows 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% is a similar majority of women (Baumgartner 1978, 15–18). In spite of this, there no differentiation between the genders in statistics on confessants.11 There is a difference between going to confession and writing about it. It is general knowledge that women are usually more communicative about discussing their inner experiences, regardless of the positive or negative nature of the experience (Atkinson 1995, 348; Gordon & Burch 2001, 17).

Fin

Hun

2%

No data

4%

30%

Men 17%

68%

Women

79%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Figure 1 Gender of the respondents

11

I n Hungary mass and prayer are taken as the most important factors of personal and community religious life.

Personal confession is rarely mentioned in Church statistics (Tomka 2001, 86–87).

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Fin

Hun

5%

No data

3%

Other

2%

Baptist

Calvinist

5%

Roman Catholic

73%

4% 9%

Orthodox

15%

Lutheran 0%

10%

20%

79% 30%

40%

50%

60%

70%

80%

90%

Figure 2 Religious background

All in all, it is surprising how many Finnish and Hungarian respondents were Fin Hun of confession. Even more so since many ready to write about their experiences people consider confession such a personal, delicate and holy matter that they would not want to share it with anybody else. Confession has been discussed very little in 2% No data any Church tradition because of the sensitivity of the issue. A Swedish study from 4% the 1940s concerning the psychology of confession claims that it is more difficult to collect material concerning the confession from Catholic than from Protestant confessants. It is due to the fact that secrecy binds not only priests but also confessants 30% 1946, 1–4).

(Berggren Men 17% of respondents in each country, the ratio of Lutherans As for the background and Roman Catholics is reciprocal in Finland and Hungary. In addition to this, there were no Calvinist respondents in Finland and respectively no Orthodox respondents inWomen Hungary (see Figure 2). The importance of confession 68% in the Orthodox and Roman Catholic Churches is confirmed by the fact that members of these 79% Churches responded in a much higher number than the proportion of the members of these churches in 0% Finland10%would20%have 30% indicated.

The50%proportion of70%Lutheran respond40% 60% 80% 90% ents was smaller than it would have been expected from the size of their church in Finland.12 In Hungary, a slightly similar phenomenon was observed. The proportion 12

t the time of publishing the research, about 1% of Finnish people belonged to the Orthodox Church, while A they represented 10% of the respondents. The Roman Catholic Church has only a 0.1% ratio in Finland, however, 4% of the respondents were Catholic (Kettunen 1998, 104).

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of Catholic respondents (73%) was clearly higher than their representation in the whole population (56%). In Hungary, there was a much higher amount of Lutherans (15%) among the respondents than it was expected in view of their presence in the Hungarian society (3%). This phenomenon was not observed in Finland. On the contrary, there were much fewer Calvinist respondents (5%) than their proportion in Hungary on the whole (16%) would have suggested.13 The high proportion of Catholic respondents in the Hungarian study refers to the majority role of that church in Hungary and especially to the importance of confession in it. Respectively, the over-representation of Lutherans is probably due to the fact that the request was published twice in their national newspaper (Evangélikus Élet).14 Comparing additional background information of the respondents is more problematical as the principles concerning the collection of the material were slightly different. However, a few conclusions can still be drawn. A majority of the respondents in both countries came from cities and especially metropolitan areas. The average Hungarian respondents were slightly older than those in Finland. In Hungary, more than 47% of the respondents were over 61 years old, whereas in Finland only 24% of them were over 64 years old. There were hardly any respondents under the age of 20 in both countries. 39% of Hungarian respondents were aged 21–60, while in Finland the so-called ‘active age group’ (25–64) formed the majority of respondents (55% in all).15 7. Results 7.1. Different confessional practices Both researchers studied the practice of confession more than the theoretical views people hold about it. The principled conception of confession may be in conflict with the practice of confession. The practice of confession that most influences the confessant’s life is more important. In the analysis of confessional practice, researchers examined the methods of confession and its function, meaning and aftermath for the letter writers. It was not always easy to draw a line between different confessional practices as certain forms could be categorised in several ways. For example, regular confessional practice could refer to pastoral confession that was realised at the altar, by mail or by phone. Categorisation was based on the persons’ own views of their confessions (Kettunen 1998, 109–10). As the source material and the ecclesiastic background are different in the two countries, a standard categorisation could not 13

14 15

he representation of different creeds in Hungary is based on the 2001 census which was the most recent at T the time Joób published his research (2006, 31). Proportions given for church membership refer to the whole population of the country while proportions of the respondents refer to the number of respondents.

3 March 2002 and 14 July 2002.

For the details, see Kettunen 1998, 100–03; Joób 2006, 30.

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be applied. The Finnish study focused on different practices of confession and their characteristics and efficiency (110–87). The Hungarian source material was grouped in line with the internal and external motivations of the confessants, i.e. the grouping was done according to the reasons why they wanted to confess (Joób 2006, 70–110).

The Finnish study explored nine forms of confession, namely (in the order of their frequency) partaking in a regular confessional practice (31%), one-off confession (24%), pastoral confession (17%), transitional confession (11%), confession by phone (4%), confession by mail (4%), general confession and communion as a form of confession (4%), sacramental and liturgical confession plus confession at the altar (3%) and direct confession to God (2%) (Kettunen 1998, 111).16 The internal motives for Hungarian respondents were liberation from burdens, partaking in a regular confessional practice and confession based on conscience. The main external motive was a duty to confess imposed by a certain church. Many respondents mentioned several coexisting reasons (Joób 2006, 71–73).

In both studies, the largest group was that which took part in a regular confessional practice. 77 Hungarian and 71 Finnish respondents mentioned this form of confession, i.e. a much larger proportion of Hungarians (66%) belonged to this category compared to the Finnish proportion (36%). 40 Hungarian respondents (34% of all) did not give any information on their confessional practice or they had only occasional experiences of confession. 53 Finnish respondents (27% of all) mentioned one-off confession. More than half of these respondents had no revival movement background or it was not mentioned. This indicates that one-off confession is more characteristic of Lutherans not belonging to a revival movement. A positive feature of one-off confession may be that it is the first opportunity to verbalise a certain problem. The problematic side is that the confessant has magical expectations concerning the confession event and the confessant hopes to arrive at a quick solution to his/her problems (Kettunen 1998, 111, 121, 135, 137, 139–40; Joób 2006, 80–81).17 Lutheran confessional practice in Finland and Hungary differs in many ways from the Catholic way as there are no general, compulsory rules in the Lutheran Church. The absence of formal requirements might also indicate that confession is still searching for its place in the pastoral care of the Church. On the other hand, it is possible that confessional practices are defined by their freedom. Still, it is noticeable that a few Lutheran Churches in Western Europe do offer a set framework for confession, in addition to confession in free form.18 The varied practice within 16

17

18

he proportions given above do not refer to the number of letters but to the different practices as one author T may have mentioned several practices. The values are, therefore, only approximative.

Please note that the quantitative comparison between different confessional practices is only approximative.

This is most obvious when comparing one-off confession and living in a regular confessional practice. It is quite easy to sort out from the source material those persons who have only used confession once in their life.

On the other hand, it is difficult to represent statistically those who confess regularly, as they are not oriented towards the quantity but rather towards a lifestyle. Thus Kettunen’s (1998, 111, Figure 6) estimations about the proportions of different confessional practices are also only approximative.

Cf. Kirkollisten toimitusten kirja (1984, 42–44); Den svenska psalmboken (1986, 22–23); Evangelisches Gesangbuch (1995, 1511–17).

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the Finnish and Hungarian Lutheran Churches clearly shows how formal freedom gives an opportunity for both to fulfill the function of confession and to respond to the individual needs of the confessant/penitent. If we understand confession through its function (i.e. helping people to be relieved from their burdens), it can be stated that since people practise formal confession less frequently, the function of confession is actually more often realised in other forms. The liberty of form also backs up this process along with the new methods of pastoral care, which help people to be relieved of their guilt. Nowadays, confession happens more often in the framework of a pastoral conversation. This, of course, applies to Lutheran practice only, as in the Catholic Church confession is a sacrament of which absolution is an integral part (Kettunen 2002, 25).

7.2. The confessor and the confessional relationship Kettunen studied the process of finding a confessor, the method of choosing him/ her and the reasons for changing this person after a time. Research was done on the expectations of the confessants related to the confessor’s person and on experiences about different kinds of confessors. The aim was to have an overview of the expect­ ations and disappointments related to the person receiving confession (Kettunen 1998, 189–259). The expectations concerning the confessor were split into five categories in the Finnish research. These were: 1. pastoral expectations, 2. expectations concerning spiritual life, 3. expectations concerning priesthood, 4. expectations concerning the confessor as an advisor and counsellor, 5. expectations concerning the gender of the confessor.

These expectations were not exclusive; the same confessant could simultan­ eously expect a pastoral attitude, a belief in God and a given gender from the priest receiving his/her confession (203–04). Joób also scrutinised the different expect­ ations and reasons for changing one’s confessor. The reasons were divided into three categories.

1. There were external reasons for change: for example, because the priest was moved to another town. This was a general practice during the Socialist era when the system tried to prevent the formation of close relationships between the priests and the members of the congregation. Many respondents mentioned that this made it difficult for them to establish a proper confessional relationship.

They felt it was problematic that confession was compulsory for the Catholics but at the same time the Church made it difficult to fulfil this duty.

2. Another reason for change was disappointment in the confessional situation or the behaviour of the confessor.

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3. Some of the respondents said they wanted to change their confessor because they strived to develop in their spiritual life. For them, spiritual direction and confession were very close concepts (Joób 2006, 142–63).

Interestingly, there appeared to be no expectations concerning the priesthood or the gender of the confessor in the Hungarian study. Of course, in the Catholic Church there is no such flexibility in choosing a confessor as there is in the Lutheran Church.

For Catholics, the confessor can only be an ordained priest who is naturally a man.

The overwhelming majority of both Finnish (61%) and Hungarian respondents rated the pastoral character of the confessor as the most important expect­ation.

The Finnish respondents mentioned trustworthiness, the ability to listen and to understand, self-understanding, secrecy, therapeutic skills, an unhurried attitude and a warm, empathic and accepting nature (Kettunen 1998, 203; Joób 2006, 152–58).

In Hungary, it was often mentioned that the personality of the confessor played a central role in the formation of a liberating experience (Joób 2006, 142). They linked this with the expectations towards the confessor. Joób showed that these expectations are very much like the techniques and tools which appeared in Carl R. Rogers’s theory concerning the relationship between a psychotherapist and his/her client (Faber & Schoot 2002, 38–51; Purhonen 1988, 53–70).19 When looking at the role of the confessor and the confessional relationship, two factors emerged strongly from the Finnish material. In most cases, the primary factor in the experience of being helped was the confessional relationship that developed between the confessant and the confessor. The experience of being relieved was realised within the framework of this relationship. If a relationship cannot be formed, it is unlikely that the person will have a relieving experience (Kettunen 1998, 255).

According to Joób, it became apparent that expectations concerning religious life and the behaviour of the listener had a major role when defining the confessional relationship (2006, 145–48). According to the material (and partly against the findings of Kettunen), personal characteristics also have an important role in the sacramental confession. The way the confessor realises his/her vocation has a central role in the confessional relationship and the experience of being helped. Expectations concerning the religious life of the priest (the priest has to be a strict believer, love God with all his might, give himself to God, be an authentic believer) show that the person giving absolution has to be a so-called middleman before all. He has to be in contact with the person to whom he mediates absolution and, at the same time, with the source of absolution (145). The expectations concerning behaviour show that the helper has to act as an example for the whole community. For the penitent, there is a surprisingly strong relationship between the helping role, pastoral task and spiritual life of the priest, although expectations concerning religious life and behaviour also mirror the personal goals of the believer (‘that is how I would like to live after absolution’).

In the Finnish study, expectations concerning the religious life of the confessor 19

To read more about the importance of the healing relationship, see Rogers 2003, 73–96.

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either appeared alongside with the pastoral expectations or they did not have any connection with them. For the confessant, they also meant forming a bond of trust and a relationship with the person receiving confession. They also expressed the confessant’s ideals about Christian life. The confessor should ‘be a good Christian’, ‘know the Bible’ or ‘show unconditional love’. As a whole, the expectations summar­ ised the conception that the person should be ‘a person believing in God’. However, there was great variation regarding what this meant for each letter’s author. For some of them, faith meant a similar creed to what they held themselves. For others, it was connected to priesthood and the professional secrecy of the priest. There were also those for whom the position in a Church did not have primary importance. All in all, expectations concerning spiritual life showed that confession is not only a human interaction system but it is defined by our relationship with God. Without that, there is no sense in confession at all. It is meaningless to confess a sin which separates the person from God if the relationship with God is not important to the confessor.

The concept that spiritual expectations are often combined with human relationship skills is also worth noting. When describing the person of the confessor, spiritual reasons were not enough. A professional attitude (professional secrecy of the priest, for example) was taken to be especially important because of the ‘wretched human nature’ (Kettunen 1998, 211–12).

7.3. Anxiety in confession and the expectation of absolution The request published in Finnish newspapers asked people to write about the reasons why and topics on which they wanted to confess. Most respondents did not only write about the actual sins and guilt but about general anxiety they wanted to be relieved of by confession. Often sin or guilt was not even mentioned but rather ‘sinfulness, which was the driving force to confess’. This might also be due to the fact that the confessant did not want to repeat the things uttered at the confession event. Some of the respondents said they did not want to tell about something that had already been forgiven because that would have decreased the value of forgiveness. On the other hand, the topic of the confession could not be clearly categorised as a sin or reason for guilt. On the basis of the Finnish study, sinfulness and distress can be expressed in at least three ways.

1. There is the confession of actual sins and the reception of absolution.

2. One can enter confession without having any clear sins or guilt to confess. The reason may be a ‘generally bad and uneasy feeling for all that has been said and done’.

3. The confession can be linked to the care of religious life.

The anxiety and distress that unfolds in confession (similarly with the multiplicity of confessional practices) shows that confession is nowadays used in a much wider sense in Finland than the traditional definition would indicate. Confession does not only mean a formal confession of sins and guilt and the reception of absoluEJMH 8:2, December 2013

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tion for that. The different forms of distress and response to these distresses are also strongly present (Kettunen 1998, 261–62).

Although Hungarian confessants did not mention actual sins or topics which they confessed, they used very colourful expressions when they described their expectations related to the confessional situation (Joób 2006, 72). It emerged that believers do not always seek confession events because of their sins and needs for absolution. It seems that the primary goal of confessional situations is to give an opportunity to the penitent to be relieved of the burden of sins and return to a harmonic relationship with their Creator, the liberating God. From the penitents’ point of view, the basis of confession was a need to be free of a chaotic situation, a sin or something that disturbed their conscience. According to the material, the search for a confessional relationship also meant a search for pastoral care or spiritual direction (232–35).20 According to the findings of the Finnish and partly of the Hungarian results, confession is a framework within which one can face many kinds of distress. The confessor’s and the confessant’s conceptions concerning the nature of confession often differ from each other, even in the same confessional situation. This, of course, makes it more difficult to receive help. Some people seek relief from uneasiness, some from anxiety, and others from problems in human relationships or simply from loneliness. Some people confess because of a sin or guilt experienced in front of God, while others confess because of alcoholism. For some people there is an actual deed behind the confession, others seek general advice and guidance for their life.

This multiplicity is not always clear for the confessors. Often they have a traditional conception of confession and absolution, which may differ very much from the confessants’ conceptions. In this case, the latter are less likely to receive the experience of being helped (Kettunen 1998, 371–72; Joób 2006, 73–79). In the Finnish study, confession proved also to be a channel through which people seek quick help, relief and change in their life. There is a danger that it becomes a magical and mechan­ ical tool for transferring problems instead of solving them. This kind of approach to confession expresses a postmodern attitude which stands for a short-term, quick and project-like life. This attitude may prove to be problematic when the difficulties have accumulated during many decades. Such problems cannot be relieved easily by a few words instead of a long working process. Confession used as fast food pastoral care makes it a mechanical tool and is very close to an ex opere operato way of thinking. God might become Deus ex machina, taking all bad feelings away in a magical way. According to the Finnish study, the most difficult point in facing the distress (expressed in confession) is that a very similar helping model (absolution) is practised in very different contexts of guilt and anxiety. Thus, the real function of confession (forgiveness and liberation) cannot be realised. It does not reach those 20

I n the theology and church practice of different times, there have been many attitudes to confession: whether it should be spiritual counselling or should lead to that, or whether the spiritual counsellor and the confessor should be the same person or not. For a detailed description, see Thornton 1990, 1210; Jones 1990, 1213– 15; Kettunen 1998, 401–03.

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layers of human personality where pain and distress are hidden. It is only ‘preaching’ mental knowledge which does not touch the emotional spheres (Kettunen 1998, 372, 375–76, 379).21 7.4. The relationship between confession, the view of God and spiritual life It was typical for both source materials that the confessants’ view of God could not be clearly figured out. Indirect ideas could still be deduced on the basis of the confessants’ stories. The view of God was often communicated through ideas, experiences or expectations concerning the confessor’s person. The views of God and the confessor were merged. The confessant met God in the person of the confessor and God was perceived as the confessor. This means that the responsibility of the confessor is huge. He/she does not only stand for him/herself but also for God, whom the confessant identifes him/her with (Kettunen 1998, 392; Joób 2006, 149).22 According to the Finnish study, it is impossible to draft a common picture of God for each confessant. It seems they have different images of God, the emphasis of which changes during their lifetime and because of different situations. For some people, a change in their view of God is a threat, while it means hope and freedom for others.

The Finnish study showed that different confessional practices and situations reveal different elements in the view of God. Transitional confession and the Laestadian way of purification hint at an alluring and fascinating view of God (using the termin­ ology of psychoanalytical object relation theory):23 a God that forgives everything and satisfies everyone’s needs. One-off confessants often see an omnipotent God who takes all bad feelings and guilt away quickly and at once. This God cannot be frail but strong, active and able to take away all pain and anxiety. This God does not come near but stays on his distant throne. In pastoral confession, God’s gracefulness and love rather than his omnipotence are in the centre: these are expressed by God’s presence, his walking along with us. He does not take away guilt and distress but takes the burden upon himself and carries it along after it has been confessed 21

22

23

his happens, for example, when guilt connected to sexual life is only interpreted from a moralistic point of T view and absolution is pronounced. The emotions belonging to every created person are ignored.

Theologically it is an important differentiation whether the confessor acts as a deputy for God or Christ in the confessional situation or whether he/she is in a mediator’s role. In the latter case, the situation is threefold: there are three parties present. The confessant and the confessor are face to face but there is also a Third Party. The confessor is not the Third Party, he/she is not God or Christ but a mere mediator of his word, love and grace. But if the confessor stands for God or Christ, there are only two parties in the situation. The confessant sees God or Christ in the confessor. The key point is what kind of God or Christ the confessant sees in the confessor. The confessor can sometimes be loving and graceful, at other times judgemental and distant. Based on Finnish confession research sources, this experience is not static either: the same person can appear different at each time (Kettunen 1998, 394).

Psychoanalytic object relation theory is used here along the lines of the basic ideas of relations theory

by Matti Hyrck. People’s inner ideas of God are the central elements of this theory. See 1997, 64–76; Kettunen 1998, 74–78.

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(Container function). This is more of a deputy-type and a healer-type view of God (Kettunen 1998, 470–72). Finnish respondents write a lot about conscience. This hints that they have a demanding view of God. Bad conscience refers to a God who claims justice, truth and justification. Such a God sets high ethical standards for mankind. The demanding God wants an ethically high standard of life, but on the other hand, he offers forgiveness to the sinful and penitent (472–73). From the confessional point of view, it is important to see that except for the healer, all other object relations include, to some extent, the view of an omnipotent God. The alluring and fascinating type offers total satisfaction while the governor has an authority not to be questioned. The view of a withdrawing God refers to the absolute being, very far away. The demanding God wants a morally spotless life. For the respondents, a Christian life seems to involve believing in a governor or a demanding type of God (Kettunen 1998, 474).

Joób claims that the view of God in Hungarian responses is dominantly that of the deputy and the healer. Only a few respondents write about expectations mirroring a view of a governor God (2006, 153). The characteristics of the deputy and healer were especially strong in those letters, which described confession making as the condition that made taking communion possible again. This was so positive for many penitent people that it had an influence on their view of God (165–170). For many Hungarian respondents, writing about their spiritual life was a central elem­ ent. On the contrary, Finnish confessants hardly mentioned their view of God or their spiritual life. For Hungarians, the reason could be that for many respondents, living in a regular confessional practice and taking care of their spiritual life were close – for many confessants even identical – concepts. This approach was very general among Hungarian Catholic and Finnish Orthodox respondents (Kettunen 1998, 396–97, 468; Joób 2006, 210).24 Confession is not only a place for receiving absolution but an opportunity to grow and prosper in spiritual life (Joób 2006, 219). From this point of view it is clear why many people became more active in confession when problems appeared in their spiritual life. Although the majority of the Finnish confessants did not write about their spiritual life a lot, they still took it as a considerable source of power in their life. When using confession as a tool for spiritual care, the focus was on healing and maintaining the relationship with God or clarifying one’s view of God, and often also on supporting religious confidence (Kettunen 1998, 467–68).

Confession as taking care of one’s spiritual life is related to an individualised spirituality. It is based on personal experience about one’s life, reality, conflicts of life, insecurity and anxiety. The experience has its roots in the immanent reality of the person, not in the transcendent one. Our spiritual life and relationship with God mirror the realities and meanings of this world to God and transcendence. Interestingly, spiritual life also often sticks to this reality. It is not fully changed through confession 24

I n more than one fourth of the Finnish letters, confession was accompanied with prayer or blessing. While Orthodox confessants define confession more as taking care of one’s spiritual life than others, they criticise sacramental confession and desire more possibilities for pastoral conversation.

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and absolution. Sinfulness and guilt on account of community matters does not belong to the reality of spiritual life, neither before confession nor after that. The source material shows that people do not strive for confession because righteousness has not been fulfilled but out of a worry for their own spiritual welfare. This also shows that the persons using confession as a tool for taking care of their spiritual life have pietistic views (Thayer 1985, 56–57, 69; Kettunen 1998, 403–04, 468).

On the basis of the Hungarian material it seems that for Catholic confessants it is easy to ‘find’ an opportunity for confession. The role of a religious education that stresses the importance of private confession can be clearly seen here, along with the teaching of the Church, which holds that everybody should confess at least once a year. Many letter writers hinted that they did not go to confession in order to confess an actual sin but to seek help in questions regarding their spiritual and everyday life and to share their problems (Joób 2006, 72).25 Dealing with such questions in a confessional situation can help the believers to see their own responsibility. In confession, everybody deals with his/her own problems and questions and confesses his/her own sins. The focus is not on what somebody else has done but on how he/ she him-/herself has acted. It is problematic both from the practical and the theo­ logical point of view if all issues in spiritual and everyday life are interpreted from the sin perspective. It is good to pay attention to this because, as we earlier stated, for many confessants, practising regular confession and maintaining their spiritual life are very close to each other. Confessants often stated that in addition to confession and spiritual counselling they had a need for pastoral and group discussions,26 which would help the believers solve their problems.

8. Discussion When examining these Finnish and Hungarian studies on confession, it is important to note that this was the first time in both countries when scholars looked at personal experiences of confession. The attitude was not a statistical one (how many people practise confession). It was not dogmatic either (what the Church says about confession). Still, both of these questions have been looked at in the scope of the study.

For the Finnish respondents, the most important question was not if they practiced confession in its historical meaning. They now look for confessional practices different from the inheritance of past centuries. In view of this, the borderline between confession and pastoral care is shifting. If one wishes to look at confession from an 25 26

This practice appeared most frequently in the Protestant writers’ letters. lthough the next theory originates from a very different environment, it can well be adapted to the operation A of a helpers’ group solving religious and everyday problems. The members of the groups can offer the following to each other: conversational community (telling), the interest of a helping community (listening), the stability of an integrative community (satisfaction), realities of an evaluative community (evaluation), questions coming from a motivating community (interest) and the renewing power of a spiritual group (Szabó 2002, 62).

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angle of statistics, it is worth comparing the sum of confessions and pastoral conversations in different eras (Kettunen 1998, 504–05). If we define confession based on its function (liberating and helping people), it seems a well-grounded suggestion that confession has been increasingly used in Finland. Often pastoral conversations and other forms of assistance have taken over the function formerly taken by confession (Kettunen 2002, 25).27 However, the Hungarian sources do not support these findings. This comes from the fact that in Hungary, confession is mostly understood in its historical context: as actual confession and absolution. On the other hand, at the time of conducting this research in Hungary, the development of methods of pastoral care was inferior compared to the Finnish situation. The shift of the confession’s function towards pastoral care is not as noticeably observable in Hungary as in Finland. In the Lutheran context, this may originate from the fact that the development of pastoral care methods only started after the end of the Socialist era. When looking at the Roman Catholic and Orthodox respondents, one has to keep in mind that confession is a sacrament in these churches, both in Finland and in Hungary. It is a tool through which God (with the help of the priest) pours his grace and forgiveness upon the confessant. From the point of view of these churches, the promotion of confession is theologically based, in that for them the function of confession is not realised in a pastoral conversation. In Hungary, research has shown that one reason for the decreasing confessional practice is that the concept of sin is not clear anymore (Orosz & Vértesaljai 1985, 153; Bourgeois 1999, 430–31). This is also true when it comes to discussing sin, guilt and moral questions in general. Before the age of enlightenment, Churches had a strong role in defining moral rules and Christians were more confident in what was against the will of God and what belonged to the scope of confession. It is very clear from the letters that today the situation has changed. Even those practising confession regularly are sometimes not sure what they have to confess (Joób 2006, 206).

Thus, it is understandable that many confessants would like to change the present confessional practice.

The changes in the confessional situation have to be looked at in light of the emergence of confession. One reason for the uneasiness about confession in many churches worldwide is the difference between the world views of medieval and modern times, and between the concepts of man and of sin in the two eras. The concept of man used in confession is based on the reality at the time of its emergence, i.e. the Middle Ages. Then, the Church defined clearly what was right and wrong. Living according to the rules of the Church meant being redeemed. Non-adherence to the rules was a way to damnation. For the sinner, confession was a way to integrate again into the salvation offered by the Church. People in the 21st century do not define right and 27

I f we take forgiveness, grace and liberation as the main functions of confession, confessing ‘correctly’ is of marginal importance. The main thing is whether the person gets help or not. Therefore, no confessional practice can be canonised. From this perspective, speaking about the revival of confession is meaningless. It would be more precise to speak about the revival of helping people and finding ways in which forgiveness and grace can be realised best (Kettunen 1998, 505).

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wrong in this context anymore. Their problems seem to be more complex and the ways to find help are also more varied (Kettunen 1998, 41, 514).

The role of private confession is still unique in the Roman Catholic Church. It seems that it is hard to replace it with other confessional practices even if there had been an opportunity to do that historically. Due to its position as a sacrament, private confession is theologically prioritised over other forms of confession (Joób 2006, 56–57).28 It can be an opportunity to take care of one’s spiritual life but it can also operate independently of it. The sacramental characteristic can also lead to a use of confession unconnected to spiritual life, in a mechanical manner. It is apparent from the source material that an ex opere operato usage of the sacrament has a negative effect on the depth of confession, leaving the confessant in a passive role (144).

If the aim of confessional practice is to express a possibly very strong sense of absolution, it is worth looking at the present form and content matters. Formwise, there are considerable differences between the Roman Catholic and the Lutheran practices. The Roman Catholic confessional practice is based on a tradition dating back a few hundred years and it was last confirmed at the second Vatican Council.

The decision of the synod (better known as Ordo Paenitentiae) gives the opportunity to the ordained priest (who is given permit to receive confessions and who represents the salvation function of the Church) to adapt private confessional practice to the needs of the believers. The letters show a desire for confession outside of the confessional too (201–04). On the formal side, there are also expectations concerning the customary length of the confession (205–09). For those who only want to fulfil a duty, the general practice of spending a few minutes in the confessional is enough.

Many people, however, feel a desire for confession where problems and questions could be discussed in detail and solutions found together (208).

The Finnish and Hungarian results show that the use of confession often shows a very unbalanced view of human distress. Distress is looked at from the point of view of sin and sinfulness. In this way grief, shame, solitude, and pain that come from an inferiority complex or lack of being loved – all experiences for which people may seek help through confession – are not healed during the confessional situation.

These problems cannot be erased by absolution. In addition, shame is often mixed up with guilt. This is theologically problematic, just as is blurring anxiety with guilt.

Based on all letters received, it can be generally stated that people in both countries seek help from confession for a much larger issue than simply sin or sinfulness.

Which means the tools the confessor applies also have to be more varied and not restricted to absolution. Besides, one must note that for many people confession (confessing a sin and sinfulness and receiving forgiveness) is a very important and 28

rdo Paenitantiae defines three forms of confessional practice: 1. private confession and private absolution, O 2. general confession and private absolution, 3. general confession and general absolution. The last one can only be used in special cases, for example crises. For those taking part in this, private confession is compulsory within a year. Only synods can define such special cases but in Hungary this has not occurred up until now. Therefore, for the Hungarian Catholics the only formally allowed practice is sacramental private confession (Bűnbocsánat és oltáriszentség szertartáskönyv 1976, 8).

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healing sacrament and a form of pastoral care. In order for it to work in a suitable way for the person in question, confrontation should be used in confession too. This would help to find the best possible way to handle each person who is seeking help (Kettunen 1998, 378, 511–15).

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Csizmadia, I. (1999) A papság szerepének hangsúlyváltozásai a bűnbánat szentségének történetében (PhD diss., Pázmány Péter Catholic University, Budapest).

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Faber, H. & E. Schoot, van der (2002) A lelkigondozói beszélgetés lélektana, trans. L. Fodor (Budapest: Semmelweis Egyetem TF – Párbeszéd (Dialógus) Alapítvány).

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Hyde, C. (1984) To Declare God’s Forgiveness: Toward a Pastoral Theology of Reconciliation (Wilton: Morehouse Barlow).

Hyrck, M. (1997) ‘Ihmismieli ja Jumalan kohtaaminen’ in P.R. Sundell & H. Tikkanen, eds., Keskusteleva psykologia (Helsinki: Tulevaisuuden ystävät ry) 64–76.

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Joób, M. (2003) ‘Új kutatási metodológia lehetőségei a gyakorlati teológiában’, Lelkipásztor 78, 310–12.

Joób, M. (2006) A békesség élménye: Az egyéni bűnbánat kvalitatív tartalomelemzése pasztorálpszichológiai szempontból (PhD diss., Evangelical-Lutheran Theological University, Budapest).

‘Kérdések a gyóntatással kapcsolatban’ (1998) Távlatok 39, 65–70.

Kettunen, P. (1998) Suomalainen rippi (Helsinki: Kirjapaja).

Kettunen, P. (2002) ‘The Function of Confession: A Study Based on Experiences’, Pastoral Psychology 51, 13–25.

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Kirkollisten toimitusten kirja: Suomen evankelis-luterilaisen kirkon kirkkokäsikirja III (1984) (Helsinki: Suomen kirkon sisälähetysseura).

Konfirmációi káté (2004) (Budapest: Luther Kiadó).

Luther, M. (1959) Small Cathecism, trans. Th.G. Tappert in Th.G. Tappert, ed., The Book of Concord: The Confessions of the Evangelical Lutheran Church (Philadelphia: Mühlenberg) 337–56.

Ohme, H. (2001) ‘A szentségek’ in R. Thöle, ed., Bevezetés az ortodoxia világába, trans. A. Gromos (Budapest: Kálvin) 66–88.

Orosz, L. & L. Vértesaljai (1985) ‘Elvárás és valóság a gyónási gyakorlatban’, Teológia 19, 151–55.

Pásztor, J. (1985) Liturgika: A református keresztyén egyház istentisztelete (Debrecen: DRTA).

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Rogers, C.R. (2003) Valakivé válni: A személyiség születése, trans. L. Simonfalvi (Budapest: Edge).

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Silber, U. (1996) Zwiespalt und Zugzwang: Frauen in Auseinandersetzung mit der Beichte: Studien zur Theologie und Praxis der Seelsorge (PhD diss., Universität Würzburg, Würzburg).

Sólymos, Sz. (1975) ‘A bűnbánat-tartás új rendje az egyház életében’, Teológia 9, 19–24.

Szabó, L. (2002) ‘A lelkipásztor lelkigondozása’, Lelkipásztor 77, 60–65.

Thayer, N. (1985) Spirituality and Pastoral Care (Philadelphia: Fortress).

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Thurneysen, E. (1949) Van-e evangéliumi gyónás? trans. I. Jánossy (Budapest: Ref. Egyetemes Konvent).

Tomka, M. (2001) Vallás és társadalom Magyarországon: Gyakorlati teológiai és vallásszociológiai megközelítések (Habil. diss., Evangelical-Lutheran Theological University, Budapest).

Wunderle, G. (1921) Zur Psychologie der Reue (Tübingen: Becher).

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 187–211 DOI: 10.5708/EJMH.8.2013.2.2

Krisztina S. Petik*, Anikó Kézdy & Fruzsina Kocsis

LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS Relationships with Mental Health in Midlife and Later Life (Received: 16 April 2012; accepted: 13 June 2012)

Human development is a life-long, complex process accompanied by gains and losses. Among the difficulties of adult development, midlife calls for special attention, for, during the long transition from youth to old age, one has to face several losses, and, as a result of that, the special psychological tasks of accommodating to new circumstances. The purpose of the study was to explore the relationship between projects – especially projects concerning learning – and indicators of psychological and physical health in midlife and later life. We hypothesised that individuals who are experiencing crises in the second half of their lives would be more open towards educational programmes on physical and mental health. We also expected that individuals with intrinsic goal motivation would be more motivated for self-developing learning, and that intrapersonal goals would be connected with a greater openness to training programmes on mental health. The sample consisted of 585 people (M = 50.6, SD = 8.5). For further analysis the sample was divided into six age groups on the basis of Levinson’s classification. The results confirmed that the middle-age and the old-age generations are open to educational programs that develop self-directing functions.

Contrarily to our hypothesis, it is not a crisis linked with decreased physical and mental health that makes one open to such programmes, but good physical health and new life situations presented by stressful life events. Besides, the need to participate in educational programmes aimed at selfdevelopment is stronger in the case of individuals whose motivational system is dominated by intrinsic goals (goals related to basic psychological needs).

Keywords: aging, midlife, personal projects, learning projects, psychological well-being, andragogy Der motivationale Hintergrund von Lernzielen und sein Zusammenhang mit der mentalen Gesundheit bei Personen im mittleren und hohen Alter: Die Entwicklung des Menschen ist *

orresponding author: Krisztina S. Petik, Sapientia College of Theology, Piarista köz 1., H-1052 Budapest, C Hungary; somogyine.krisztina@sapientia.hu.

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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ein mit Gewinnen und Verlusten verbundener, komplexer, lebenslanger Prozess. Von den unterschiedlichen Schwierigkeiten der Entwicklung im Erwachsenenalter verdienen die Probleme der mittleren Lebensphase besondere Aufmerksamkeit, weil Menschen während des langen Übergangs von der Jugend in ein höheres Alter mit zahlreichen Verlusten kämpfen haben und dabei mit besonderen psychischen Aufgaben der Anpassung an neue Situationen konfrontiert sind. Die Zielsetzung unserer Forschungsarbeit ist, den Zusammenhang zwischen Zielen – insbesondere Lernzielen – und den Parametern der psychischen und physiologischen Gesundheit in den mittleren und höheren Lebensjahren zu erschließen. Unserer Hypothese nach stehen Personen, die in der zweiten Lebenshälfte eine Krise durchgemacht haben, Schulungen im Bereich der körperlichen und mentalen Gesundheit offener gegenüber. Ebenso gingen wir davon aus, dass Personen mit einer intrinsischen Zielmotivation eher zu ihrer Persönlichkeitsentwicklung dienendem Lernen motiviert sind. Des Weiteren nahmen wir an, dass ein Zusammenhang zwischen dem Vorhandensein intrapersonaler Ziele und einer Offenheit gegenüber Trainings zur mentalen Gesundheit besteht. Die von uns untersuchte Stichprobe bestand aus 585 Personen (Durchschnittsalter 50,6 Jahre, Streuung 8,5). Auf der Grundlage der Klassifizierung nach Levinson haben wir die Probanden in sechs Altersgruppen eingeteilt. Unsere Ergebnisse bestätigen, dass Personen im mittleren und höheren Alter gegenüber Ausbildungsprogrammen im Bereich der Entwicklung der Selbststeuerungsfunktionen offen sind. Im Widerspruch zu unserer Hypothese entsteht diese Offenheit nicht als Konsequenz einer Krise durch nachlassende körperliche und mentale Gesundheit, sondern infolge durch belastende Lebensereignisse bei guter körperlicher Gesundheit ausgelöste neue Lebenssituationen. Darüber hinaus war das Bedürfnis nach Schulungen im Bereich der Persönlichkeitsentwicklung ausgeprägter bei Personen, in deren Motivationssystem intrinsische (im Zusammenhang mit grundlegenden psychologischen Bedürfnissen stehende) Ziele überwiegen.

Schlüsselbegriffe: Altern, mittlere Lebensphase, persönliche Ziele, Lernziele, psychologisches Wohlbefinden, Andragogie

1. Introduction Human development is a life-long, complex process accompanied by gains and losses.

In various phases of life the human being has to answer the challenge of specific developmental tasks, and the requirements of adjustment linked to these tasks. One of the components of development is learning how to adjust oneself to these new situations. Certain life events provoke crises because the forms of problem solving used up to that point cannot provide enough help for successful coping. In the course of adult developmental crises, the individual is faced with the fact that he/she has to acquire new adjustment styles. Moreover, the growing speed of scientific, technical, and economic changes makes it obvious that continuous adult learning is a necessary part of life. It is often emphasised in andragogical literature that the world’s constant change demands constant adjustment on the part of the individual, thus the requirements of life-long learning include not only the continuous increase of professional knowledge but a widening of knowledge in all aspects of life (Szabóné Molnár 2009). For holding on in different stages of life and for solving possible crises creatively subject knowledge alone is not enough, no matter how wide it is. For coping with problems of life several competences of the personality are needed: emotional EJMH 8:2, December 2013

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coping, problem-solving thinking, creativity. In coping with a crisis most people draw on what they have learnt in their family of origin and in the culture of the broader society. A general survey in Hungary suggests that problem solving does not have adaptive means alone. Destructive forms of crisis solving are present on a large scale: alcoholism, drug abuse, suicide, psychosomatic illnesses (Kopp et al. 2006b). Adult education should therefore engage in the caring for and the development of the personality as a whole (Durkó 1999; Maróti 2005; Miller 2000). This attention to the personality would be very much needed because learning successful adjustment that requires intense self-reflection represents an unknown, foreign, and anxiety-filled road for many people.

Among the difficulties of adult development, midlife calls for special attention, for during the long transition from youth to old age, one has to face several losses, and as a result of that, special psychological challenges. This confrontation is made more difficult by the anxiety that is rooted in the helplessness of society concerning its own ageing. According to estimations, 30% of the total population in the European Union will be above 65 by 2015.1 The insolvability of the problem of ageing provokes prejudice (Szabóné Molnár 2009) and anxiety on the level of both the individual and the society. Society does not have the financial resources for caring for the growing number of old people, and, regarding the problems of the second part of life, does not have models of coping that would be valid for everyone and could be used in all circumstances of the changing world. Thus, in many cases, middle-aged people are already left alone with their problems, and react to the fact of approaching old age with developmental stagnation, or even with crisis.

It seems evident that adult education should present answers for the question of how to learn to adapt, since many people seek psychological help only in times of deep crises. However, it is a fact that, although in andragogy the idea of life-long learning refers to the development of the whole person, in practice it often serves only the grounding of professional achievements, and the concern for personality development and education in a broader sense remains in the background (Maróti 2002). There are hardly any helping programs specialising in the developmental problems of different adult age groups, and this is especially true in the case of the middle generation.

To fill this gap, we have aimed at exploring the factors that influence the life, the psychological well-being, and the difficulties of middle-aged people, and at uniting and using research results and means of andragogy and psychology within the framework of an interdisciplinary study, for the specific purpose of handling the particular problems of middle-aged people. For mapping the developmental and thus possibly the learning needs of the second phase of life, the study of the motivational level of the personality seems to be adequate. McAdams (2009) describes motives as the second level of the personality. Previous research has also proved that the indi1

Benedek, A. (2009) ‘Kihívások, kérdések és feladatok a magyar felnőttképzésben’ (UNESCO CONFINTEA VI. Conference, Pécs).

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vidual’s personality can be well grasped through defining his/her goals and projects.

Goals express one’s needs, and also reflect his/her system of values. Moreover, they reveal the individual’s level of integration and can thus serve as a base for predicting successful adaptation (Martos 2009). Personal projects can also be linked with Levinson’s (1978) personality development theory as expressions of Dream.

2. Aims of the study The purpose of the study was to explore the relationship between personal projects, especially projects concerning learning, and psychological well-being in midlife and later life. The study was part of a larger research that aimed to map the specific psychological needs of the second phase of life, in order to develop an adult education program that can help solving the age-related developmental tasks effectively, and strengthen the adaptive and stress managing capacities to cope with the challenges of midlife.

2.1. Hypotheses 1. a) Points of crises in the second half of life are indicated by the decrease in psychological well-being and in the self-rating of physical health.

1. b) In such periods individuals are more open towards educational programmes on physical and mental health.

2. a) Individuals with intrinsic goal motivation (concerning basic psychological needs) are more motivated for self-development learning.

2. b) Within that group, the appearance of intrapersonal goals (inner, concerning the self) is connected with a greater openness to training programmes on mental health.

3. Method 3.1. Participants Participation was voluntary and anonymous. Participants had to be older than 37.

The sample was a convenience sample, recruited by snowball method. The sample consisted of 585 people, 431 women (74%) and 154 men (26%). The mean age of the participants was 50.6 (SD = 8.5), the youngest participant was 37, the oldest 78, and data was missing in ten cases. For further analysis the sample was divided into six age groups on the basis of Levinson’s (1978) classification (Table 1).

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LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS Table 1 Distribution of the sample according to age groups and gender Age groups

Men

Women

Total

1) 37–44 years (midlife transition)

33 (22.6%)

113 (77.4%)

146

2) 45–49 years (early midlife period)

28 (22.6%)

96 (77.4%)

124

3) 50–54 years (age fifty transition)

36 (28.3%)

91 (71.7%)

127

4) 55–59 years (late midlife period)

23 (29.9%)

54 (70.1%)

77

5) 60–64 years (late adult transition)

20 (34.5%)

38 (65.5%)

58

6) 65 years and above (late adulthood)

12 (27.9%)

31 (72.1%)

43

152 (26.43%)

423 (73.57%)

575

Total

(Data missing in 10 cases)

Regarding the educational level in the sample, three people had eight or less classes of basic education, 19 had vocational training, 137 graduated from high school, and 427 had BA or MA degrees.

3.2. Measures Data was gathered with the help of a self-administered questionnaire. The questionnaire consisted of scales assessing well-being, personal projects, and learning goals.

3.2.1. Assessment of well-being Psychological well-being was measured by the short version of the WHO Well-Being Scale. This 4-point Likert scale consists of five items and has been validated through Hungarian samples (Susánszky et al. 2006).

Physical health was assessed by the self-rating health scale used in the national

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representative study of HungaroStudy (Kopp et al. 2008). Participants had to answer the question ‘How would you rate your overall physical health?’ Possible answers ranged from 1 (very bad) to 5 (excellent).

Life events that might adversely influence well-being were assessed with the help of the short version of the Life Events Scale (Szabó 2008), consisting of 20 items, each naming a stressful life event. Data analysis was based on the number of ‘yes’ answers by respondents to occurrences of events.

3.2.2. Assessment of projects Personal project assessment was conducted in three steps using the procedure

by Little (1983), adopted into Hungarian and used in Hungarian samples by Martos and colleagues (e.g. Martos 2007; Martos et al. 2011). First, participants were asked to write a list of their current personal projects which were defined as follows: ‘Your personal projects are the goals which you are already taking steps to achieve’. As a second step, participants were asked to select the five projects that are ‘the most characteristic/most present in your everyday life’. Finally, participants were asked to evaluate each of these five projects against a series of predefined aspects that were intended to map different motivations for the project. These were introduced by the question: ‘Why are you working on this project?’ Eight possible motivational reasons were provided: 1. meaning in life, 2. well-being, 3. improving relationships, 4. financial safety, 5. respect from others, 6. personal development, 7. transcendental orientation, 8. improving family relationships. Participants rated their projects on a 5-point Likert scale with the anchor points of ‘strongly disagree’ and ‘strongly agree’.

Personal projects were analysed also on the basis of their content. Based on the Wheel of Wellness Model by Myers, Sweeney and Witmer (2001), nine categories were created representing life tasks that are necessary for the healthy functioning of the personality: 1. spirituality (e.g. spiritual growth, relationship with God, meaning of life); 2. goals focusing on the self/self-related goals (e.g. personal development, interests, hobbies); 3. health (e.g. healthy lifestyle, avoiding illness, recovering from an illness); 4. material wealth (e.g. money, apartment, car, possessions); 5. work (e.g. keeping one’s job, professional tasks); 6. friendship, human relationships (e.g. relationship with friends, relationship with groups and communities); 7. love, marriage, family; 8. children (e.g. the education of one’s children, programs with grandchildren); 9. learning.

Each project listed by the participants was assigned to one of these cat­ egories. This data provided information on the life tasks the different age groups EJMH 8:2, December 2013

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were working on. Within the category of goals focusing on the self, or self-related goals, the subgroup of intrapersonal goals was separated for projects aiming on the inner development of the self (e.g. personal growth, to become wiser). According to the literature, such goals indicate that the person focuses on himself/herself and is working on his/her inner development (Little 1993). It can be a sign of crisis, inner conflicts, but also of the process of creatively discovering oneself (Martos 2007). Each of these can signify an intense developmental process in adulthood. Thus intrapersonal goals can indicate openness to possibilities of selfdevelopment and learning.

Learning projects and their motivational background were assessed with the same method as personal projects. In this case participants could rate their learning objectives using a 5-point scale for the following 10 motivational aspects: 1. financial growth, 2. keeping one’s job, 3. interesting work, 4. keeping intellectually fit, 5. interesting knowledge, 6. finding one’s way in the world, 7. spending one’s free time well, 8. getting to know people, 9. harmony of private life, 10. renewal. These motivational aspects have been established on the basis of the most frequent learning motives described in the andragogy research literature (e.g. Radnai 1967; Boshier 1991). The ten motivational aspects described above were divided into the following two categories: 1. extrinsic motives (focusing on external incentives: financial growth, keeping one’s job); 2. intrinsic motives (focusing on internal incentives: free time, harmony of private life, relationships, intellectual fitness, interesting knowledge, renewal).

For analysing learning projects on the basis of their content, five categories were created: 1. professional (e.g. degree, computer skills); 2. hobby (e.g. pottery, horse riding); 3. health (e.g. healthy diets); 4. other self-development (e.g. relationships, meditation); 5. foreign language.

3.3. Data analysis Gender, age, psychological well-being, the number of critical life events, and selfrated health were included in the data analysis as independent variables. It was not possible to include educational level as an independent variable because most of the participants had a BA degree or more.

For the statistical analysis of the variables, to detect differences between groups – in case the condition of normal distribution was met – the independent samples T-test for comparing data of two groups, and variance analysis (ANOVA) as well as its various Post Hoc tests for comparing several groups were used. (In case of statistical matching of the variances of the variables, the Tukey B test, in case of statistical difference of the EJMH 8:2, December 2013

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variables, Dunnett’s T3 test was used.) In case the examined data did not follow normal distribution, the analysis was performed with the non-parametric versions of the above tests, the Mann-Whitney and Kruskal-Wallis tests. To identify the relationship between the variables, in case the condition of normal distribution was met, Pearson correlation was calculated, in case it was not met, Spearman’s rho was calculated.

4. Results 4.1. Participants’ psychological well-being and self-rated physical health In our sample there was no gender difference regarding the results of the WHO WellBeing Scale (M = 1.67 in the case of men and M = 1.68 in the case of women, t = –0.341, p = 0.733).

Regarding age groups, the lowest level of psychological well-being was found in the group aged 55–59, whereas the highest level was shown by those aged 60–64.

However, statistically significant difference was not found between the age groups (F = 1.661, p = 0.142) (Figure 1).

33

2.5 2,5

22

1.7

1.68

1.65

1.82

1.68

1.57

1.5 1,5

11 0.5 0,5

00

37-44 years 50-54 years 60-64 years 37–44 years 45-49 45–49 years years 50–54 years 55-59 55–59 years years 60–64 years

over over 65 65

Figure 1 Relationship between psychological well-being and age

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There was no gender difference either regarding self-rated health status (M = 3.57 in the case of men and M = 3.62 in the case of women, Z = –0.841, p = 0.400).

The highest level of self-rated health was found in the youngest age group. The group of 55 to 59-year-olds scored significantly lower in the self-rated health scale than the group of 37–44, and lower also than the two older age groups (F = 3.052, p = 0.01) (Figure 2).

5 4.5 4,5

4

3.8

3.6

3.7

3.4

3.5

3.5

3.5 3,5

3 2.5 2,5

2 1.5 1,5

1 0.5 0,5

0

3744 37–44 years years

45 - 49 45–49 years years

50 - 54 50–54 years years

55 - 59 55–59 years years

60 - 64 60–64 years years

over over65 65

Figure 2 Relationship between self-rated physical health and age

According to the results of the variance analysis, there was a significant positive relationship between psychological well-being and self-rated health (F = 27.967, p = 0.00) (Figure 3).

There was a significant negative relationship between the number of stressful life events and the degree of psychological well-being (rho = –0.091, p = 0.028), that is, an increased number of stressful life events was linked with a decrease in psychological well-being. The relationship between self-rated physical health and the number of stressful life events was also significantly negative (rho = –0.151, p = 0.00).

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3 2.5 2,5

2.04 1.78

2

1.54 1.19

1.5 1,5

0.93 1 0.5 0,5 0

1

2

3

4

5

Figure 3 Relationship between psychological well-being and self-rated physical health

6%

12%

Learning

10%

Spirituality Self-focused Health

17%

12%

Material Work Relations

11%

9%

Love, family Children

3% 20%

Figure 4 Distribution of personal projects in the full sample

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.3 9

Men

0

2.

5

Wom en

Women

23

3.

40

6.

45 5.

80

9.

57

.4 3 6.

93

10

8.

37

8.

89

10

11 .9 4

15

12 .4 2 12 .2 8

12 .4 2 12 .3 7

15

.3 3

20

197

Men

20

25

20 .6 20 5 .0 5

LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS

Self

Material

Children

Work

Learning

Family

Health

Relations

Spirituality

Figure 5 Distribution of personal projects according to categories

4.2. The content of personal projects Personal projects listed by the participants were assigned to one of the nine categories representing important life tasks. In our sample the category that had the largest number of projects assigned to it was goals focusing on the self/self-related goals, followed by material wealth, children, learning, love-marriage-family, health, relationships, and spirituality (Figure 4). Almost all the categories included goals that could, in some aspect, be described as learning goals. However, the main interest of this study are the projects that can be classified as learning and focusing on the self/self-related goals, for these are the projects that can – according to our hypothesis – motivate self-development and learning, and thus, participation in adult education. In our sample the projects that included learning explicitly constituted 11.2% of all the projects, and 20% of all the projects described goals focusing on the self. Thus almost one third of the projects were related to learning.

Regarding gender differences in the content of the projects, men and women differed significantly in four of the categories: the women listed more learning projects (Z = –3.022, p = 0.003), family-related projects (Z = –2.081, p = 0.037), and healthrelated projects (Z = –2.759, p = 0.006) than the men. The difference is the most significant in the case of the projects concerning health. The men listed more projects focusing on material wealth (Z = –2.118, p = 0.034) than the women (Figure 5).

Analysis of the distribution of projects in the nine categories in the different age groups showed significant differences in three categories: the number of self-related goals increased significantly with age (χ2 = 5.542, p = 0.008), similarly to the number of goals focusing on friends and relationships, which was outstandingly high in the two oldest age groups (χ2 = 14.178, p = 0.015). The number of learning projects decreased significantly until 64 years of age (χ2= 36.901, p = 0.00). 17% of the projects refer to learning in the group of 37–44, whereas it is only 6.8% in the group of 60 to 64-year-olds (Figure 6).

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over 65 37–44 years

Spirituality

Relations Relations

60 64 45–49 years years

Health Health

55 50–54 years 59 years

Family Family

Learning Learning

50 54 55–59 years years

Work Work

45 49 60–64 years years

Children Children

Material Material

37 – 44 over 65 years years

SelfSelf

00

0,05 0.05

0,1 0.1

0,15 0.15

0,2 0.2

0,25 0.25

Figure 6 Distribution of personal projects according to age groups EJMH 8:2, December 2013

0,3 0.3

LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS

%

0,5 0.5

0.45

0,45 0.45

0.41 0.38

0.4 0,4 0.35 0,35

199

0.33

0.32

0.28

0.3 0,3

0,25 0.25 0.2 0,2

0,15 0.15 0.1 0,1

0,05 0.05 00

37-44 years 45-49 years 50-54 years 55-59 years 60-64 years 45–49 37–44 50–54 55–59 60–64 years years years years years

over 65 over 65 years

Figure 7 Relative occurrence of intrapersonal projects in the age groups

5 4.5 4,5

4.50 4.03

3.74

44 3.5 3,5

33

3.22 2.80

3.10 2.57

2.56

2.5 2,5

22 1,5 1.5 11 0.5 0,5

00

Meaning in life Relationships Relation- Financial Meaning Well-being ships safety in life

Respect Respect

Personal Transcendental Transcen- Family reladevelop- orientation dental tionships ment orientation

Figure 8 Average values of motives for personal projects in the full sample EJMH 8:2, December 2013

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7.08% of the overall projects were classified as intrapersonal goals – the subgroup separated within the category of goals focusing on the self, or self-related goals, for projects aiming on the inner development of the self. The lowest number of intra­ personal goals was found in the group of 37 to 44-year-olds, and highest number in the group of 45 to 54-year-olds (Figure 7). Intrapersonal projects were significantly positively related to self-developmental learning goals (see 4.5, rho = 0.212, p = 0.00).

Family relationships

Wo men

Women Transcendental orientation

Personal development

Men

Men Respect from others

Financial safety

Improving relationships

Well-being

Meaning in life

0

1

2

3

4

5

Figure 9 Comparison of the motivational background of personal projects according to gender EJMH 8:2, December 2013

in life

Meaning Meaning in life Well-being

Improving Respect from Respect fromothersPersonal Transcendental Improving Financial safety Family Transcendental relationships relationships others relationships orientation development orientation

60–64 years

00

0,5 0.5

55–59 years

11

1.5 1,5

50–54 years

22

2.5 2,5

45–49 years

33

3.5 3,5

37–44 years

44

4.5 4,5

55

over 65 years

60-64 years

55-59 years

50-54 years

45-49 years

37-44 years LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS

201

over 65 years

Figure 10 Comparison of the motivational background of personal projects according to age groups

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4.3. The motivational background of personal projects Regarding the motivational background of personal projects, the highest scoring motiv­ a­tional aspects were well-being, meaning in life, and personal development (Figure 8).

Men and women differed in two of the motivational aspects of the personal projects: it was a significantly more important motivational aspect for men to be respected by others (Z = –2.566, p = 0.01), and their projects were also more strongly motivated by the desire to improve family relationships than it was for women, although the difference was only coming close to statistical significance (Z = –1.954, p = 0.051) (Figure 9).

Regarding the analysis of the motivational background of personal projects in the various age groups, statistically significant difference was found in the motiv­ ation for personal development: the older a person is, the less he or she is motivated with reasons of personal development (χ2 =14.982, p = 0.01) (Figure 10).

4.4. Openness to participation in trainings in one’s personal projects Participants were also asked whether they would take part in a training or course in the area of their listed personal projects. Men would take part in trainings in about 42% of their projects (data missing in 39 cases), whereas women would join courses in 51.15% of their projects (data missing in 121 cases). This means that women were significantly more open to taking part in courses and other forms of formal education concerning their projects than men (Z = –2.047, p = 0.041).

0.84

over years over 65 years

1.52

60–64 60 - 64years years

1.80

55–59 55 - 59years years

1.96

50–54 50 - 54years years

1.84

45–49 45 - 49years years

2.03

37–44 37- 44years years 00

0,5 0.5

11

1,5 1.5

2

2

2,5 2.5

Figure 11 Average number of listed learning projects according to age groups EJMH 8:2, December 2013

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4.5. The content of the learning projects The average number of listed learning projects was 1.79 in the case of men, and 1.81 in the case of women. The difference is not statistically significant. The highest number of learning projects was given by the youngest age group, that is, by those aged 37 to 44 (M = 2.03). In the group of those older than 65 the average number of listed learning projects is less than one (Figure 11).

Foreign language 25%

Professional 31%

Other selfdevelopment 10% Health 8%

Hobby 26%

Figure 12 Distribution of learning projects according to categories in the full sample

According to our data, the number of learning projects listed by each participant was positively related to the self-rated physical health (rho = 0.088, p = 0.037), and to the number of stressful life events (rho = 0.113, p = 0.006). There was no significant relationship between the number of learning projects and psychological well-being (rho = 0.066, p = 0.112). This means that individuals who have better physical health and are faced with a higher number of stressful life events are more willing to learn.

Regarding the content of the learning projects, the most frequent content categories were professional (31.2%), hobby-related (26.1%), and foreign languagerelated (25.3%) learning goals. The proportion of health and self-developmental learning projects was found to be much smaller, 17.4% altogether (Figure 12).

In our data, men listed more learning projects related to profession, hobby, and self-development than women, whereas women seemed to be more open to learning foreign languages and about health. However, the difference was not significant in either case, not even in the case of learning projects on health (Z = –1.1882, p = 0.06) (Figure 13).

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.0 3

M en

31

.5 4

Men

27

30

24

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25

25

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.6 7

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31

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K. S. Petik, A. Kézdy & F. Kocsis

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W o m en

Women

20

94 8.

8.

81

10

.8

7

15

5.

80

10

5

0

Professional

Hobby

Foreign language

Other selfdevelopment

Health

Figure 13 Distribution of learning projects according to gender

According to the statistical analysis, the number of professional and foreign language learning projects decreased significantly with age (χ2 = 26.336, p = 0.00, and χ2 = 23.818, p = 0.00, respectively). The largest number of professional learning projects was listed by those in the two youngest age groups. The number of hobby-related learning goals, on the other hand, increased with age, except for the group of 45 to 49 years who listed more professional and fewer hobby-related learning projects. Those in the group of 55–59-year-olds listed the highest number of health-related, and the lowest number of self-development-related learning projects.

Learning projects concerning self-development were mentioned the most often by participants in the oldest age group (Figure 14).

4.6. The motivational background of the learning projects In the total sample the mean level of extrinsic motivation for learning projects was 2.47, and 3.54 for intrinsic motivation. There was a significant positive correlation between extrinsic and intrinsic motivation for learning projects (rho = 0.284, p = 0.00). Gender difference was not found in this aspect: the mean level of extrinsic motivation was 2.50 for men and 2.46 for women; the difference is statistically not EJMH 8:2, December 2013

0

5

10

15

20

25

30

35

40

Professional

Hobby

Health

Self development Foreign language

over 65 years over 65 years

60–64 60 - years 64 years

55–59 55 - years 59 years

50–54 50 - years 54 years

45–49 45 - years 49 years

37–44 37 - years 44 years

LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS

205

Figure 14 Distribution of learning projects according to age groups

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significant (Z = –0.295, p = 0.768). The mean level of intrinsic motivation was 3.64 for men and 3.51 for women; the difference is statistically not significant (t = 1.521, p = 0.129). In our sample the importance of extrinsic motives for learning projects decreased significantly with age (χ2 = 43.84, p = 0.00). The difference in the im­ portance of intrinsic motives was also significant among the age groups (F = 2.883, p = 0.014), but not with a straight decreasing tendency (Figure 15).

44 3.5 3,5

33 2.5 2,5 Extrinsic motives Extrinsic motifs Intrinsic motives Intrinsic motifs

22 1.5 1,5

11 0.5

0,5

00

45–49 37–44 50–54 55–59 60–64 over65 37-44 years45-49 years50-54 years55-59 years60-64 years over years years years years years 65years years

Figure 15 Occurence of extrinsic and intrinsic motives for learning projects according to age groups

Regarding the ten given motivational categories, no difference was found between men and women in the motivational pattern of the learning projects. Significant differences were found among the age groups regarding the motivational background of the learning projects (Figure 16).

The level of financial motives for learning decreased with age, and it was significantly higher among the 37 to 44-year-olds than in the other age groups, except for the 45 to 49-year-olds (χ2 = 36.129, p = 0.00). Finding an interesting job also had the tendency to be a weaker motivation for learning in the older age groups; the difference between age groups was significant (χ2 = 42.215, p = 0.00). The importance of keeping one’s job also decreased with age, with significant differences between the age groups (χ2 = 36.393, p = 0.00).

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over 65 years 00

0.5 0,5

11

1,5 1.5

22

2.5 2,5

33

3.5 3,5

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4.5 4,5

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edge

Finan­cial InterestingFreetime FindingGetting Inter- Renewal Free Harmony Keepingone's Getting toKeeping Financial Keeping Interesting work time of private one’s job one’s way to know intellectu- esting job know people knowledge life people ally fit knowl-

over 65 years

60-64 60–64 years years

55-59 55–59 years years

50-54 years 50–54 years

45-49 45–49 years years

37-44 37–44 years years

LEARNING PROJECTS AND THEIR BACKGROUND MOTIVATIONS

Figure 16 Occurrence of motives for learning projects according to age groups

The highest level in the motive named ‘finding one’s way in the world’ was found in the age groups 37 to 44 and 55 to 59, whereas the lowest level was shown by the oldest age group. The difference between these groups is significant (χ2 = 19.47, p = 0.002). Getting to know people as a motive for learning also weakened EJMH 8:2, December 2013

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with age – there was a significant difference between the oldest age group and the rest of the groups in this aspect (χ2 = 22.470, p = 0.00). Similarly, renewal as a motive for learning was found to be important in all the age groups, except for the oldest one (χ2 = 18.295, p = 0.003). Keeping intellectually fit and acquiring interesting know­ ledge remained a strong motivation for learning in all the age groups. The wish to spend free time well and the need for harmony of private life have a tendency of becoming more important with age, but the differences were not significant. Regarding intrinsic motivations for learning, free time and harmony of private life showed the highest level in the oldest age group, whereas the same age group was less motivated by getting to know other people, finding one’s way in the world, and renewal as reasons for learning. However, the importance of keeping intellectually fit and acquiring interesting knowledge seemed to remain a strong motivational force for them.

5. Discussion The purpose of the study was to explore the relationship between projects, especially projects concerning learning, and indicators of psychological and physical health in midlife and later life. First, we hypothesised that in periods of crises, indicated by the decrease of psychological well-being and self-rating of physical health, individ­ uals would be more open towards educational programmes in these fields. Second, we expected that intrinsic goal motivation would be associated with motivation for learning aimed at self-development, and intrapersonal goals would be linked with a greater openness to training programmes on mental health.

In our sample, the indicators of psychological well-being did not show any tendency that could be linked to the hypothesis of development theories, namely that in the early 40s the stability of the person would be temporarily upset. Our data also seem to contradict the results of the HungaroStudy research, where a strong decrease in the feeling of well-being with age was recorded (Kopp et al. 2006a). Though we did not analyse data for younger generations, and therefore our results can only identify limited tendencies, in our sample, the measure of well-being did not decrease with age, in fact, it increased in the early 60s.

The relationship between health status and age seemed to be complex. Our results only partially coincided with findings of the other research on self-rated phys­ ical health and levels of depression for the whole Hungarian middle-aged population (Kovács & Jeszenszky 2006). The decreasing tendency of self-rated physical health was not continuous in our sample. Again, those aged 55 to 59 showed the lowest level of self-rated physical health, as was also the case with the indicator for psychological well-being. A possible explanation for the lower values of those aged 55 to 59 is that they reflect the problems related to retiring, and the higher psychological well-being in the age of 60 to 64 indicate the liberating experience of the first pension years.

According to our results, if there is at all a crisis linked with an age group, then, EJMH 8:2, December 2013

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in our sample in 2009, those were the indicators of the age group 55–59 that implied a ‘worst phase’, characterised by decreased psychological well-being and physical health. However, contrary to our hypothesis, this age group was also characterised by an increased proportion of extrinsic goals, and a lower number of self-development-related learning goals. This age group is probably experiencing an identity crisis rooted in carreer loss, and, according to our results, they are looking for answers not in developing the coping capacities of the personality but in efforts aiming at changing the environment. Thus the above result does not support our hypothesis that crisis would make people open to educational programmes.

Our results showed that the individuals who reported better physical health, or were faced with more challenging/stressful life situations were the ones who were more prepared to learn. This result indicates that in stressful life situations people seek help through learning; learning is a kind of problem-focused coping. In this interpretation, learning is a creative solution to crisis. According to our data, the number of self-related goals increased with age. This tendency is in line with the key findings of developmental theories on middle and old age, namely, that towards old age the individual invests less and less energy into accommodation to external requirements, and turns inwards instead, spending his/her energy to develop the neglected parts of his/her personality. In line with the above, the number of the goals aiming at improving relationships also increased with age, and showed the highest level in the two oldest age groups. This result supports the theory that with age the individual puts more and more emphasis on intimate relationships (Carstensen 1999).

At the same time, the analysis of motives underlying the projects showed a significant difference in the motives of personal development among the various age groups: surprisingly, the older the person, the less motivated he/she was to list projects supporting personal development. This result seems like a contradiction if we compare it with the increasing number of self-related goals with age. This tendency may be explained in two ways. Ageing people might be aiming at carefree self-real­ isation, where they want to just ‘be’ rather than make efforts. At the same time, it may be that in the later years individuals do not regard the tendency of turning inwards, contemplation, or working on integration as self-development.

It is important to note that the motives underlying the projects showed a significant difference between men and women regarding family relationships. Men were more strongly motivated to improve their family relationships than women.

This data, on the one hand, reflects the tendency of middle-aged men to turn to their families, described by literature (Tamir 1982). On the other hand, it confirms our hypothesis that middle-aged men try to compensate their uncertain self-esteem by strengthening their family relationships. This result seems to contradict the data found earlier that women mentioned family-related topics significantly more frequently among their projects. It seems as if men’s tendency to turn to their families is more likely to appear on the motivational level, and is not reflected explicitly in the specific projects.

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tiv­ation for learning aimed at self-development, and intrapersonal goals (that is, projects aiming on the inner development of the self) would be linked with a greater openness to training programmes on mental health. Both hypotheses were confirmed: learning motives aimed at self-development, as well as intrapersonal projects representing 7.08% of the overall projects, were significantly positively related to selfdevelopmental learning goals. The training programmes on personal de­velopment will probably be attended by this small group of people.

6. Summary and conclusions The empirical study proved that the middle-age and the old-age generations are open to educational programs that develop self-directing functions. Contrarily to our hypothesis, it is not a crisis linked with decreased physical and mental health that makes one open to such programmes, but good physical health and new life situations presented by stressful life events. Besides, the need to participate in educational programmes aimed at self-development is stronger in the case of individuals whose motivational system is dominated by intrinsic goals (goals related to basic psychological needs).

The results also suggest that it is not only the explicitly declared educational needs that have to be taken into account when adult learning programmes are de­ veloped, but also the hidden motivations of the individuals. However, it is important to emphasise that the sample in our study is not representative, thus it is not possible to generalise the results. A second limitation rooted in the sample is the uneven distribution of the participants in the different age groups, which also puts restrictions on statistical analysis.

There are two possible and important directions to continue the research. On the one hand, it would be possible to obtain results that are more suitable for generalisation through a representative sample including all layers of the society. However, there is an apprehension that there would be fewer people in the enlarged sample who would show interest in the topic of learning, thus the answers would not serve the assessment of educational needs well. Another possible direction for further research would be a comparative study extended to the whole of the adult life course, regarding learning goals and preferences of learning methods.

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Carstensen, L.L., D.M. Saacowitz & S.T. Charles (1999) ‘Taking Time Seriously: A Theory of Socioemotional Selectivity’, American Psychologist 54, 165–81.

Durkó, M. (1999) Andragógia (Budapest: Magyar Művelődési Intézet).

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Kopp, M. & M.E. Kovács, eds. (2006) A magyar népesség életminősége az ezredfordulón (Budapest: Semmelweis).

Kopp, M., Á. Skrabski & A. Székely (2006a) ‘Az életminőség nemi, életkor szerinti és területi jellemzői a magyar népesség körében a HungaroStudy 2002 vizsgálat alapján’ in Kopp & Kovács (2006) 84–105.

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Little, B.R. (1993) ‘Personality and the Distributed Self: Aspects of a Conative Psychology’ in J. Suls, ed., Psychological Perspectives on the Self, 4 vols. (Hillsdale: Erlbaum) 4:157–81.

Maróti, A. (2002) ‘Lehet tanulni egy életen át?’ Új Pedagógiai Szemle 7–8, 3–17.

Maróti, A. (2005) Tanulmányok és előadások a felnőttek képzéséről (Budapest: Nyitott könyvműhely).

Martos, T. (2007) ‘Vallásosság és az értelmes élet pszichológiája’ in K. Horváth-Szabó, ed., Vallásosság és személyiség (Piliscsaba: PPKE BTK) 9–37.

Martos, T. (2009) ‘Célok, tervek, törekvések II: A személyes célok és életcélok kapcsolata – módszertani kérdések és demonstráció’, Magyar Pszichológiai Szemle 64, 573–92.

Martos, T., A. Kézdy & K. Horváth-Szabó (2011) ‘Religious Motivations for Everyday Goals: Their Religious Context and Potential Consequences’, Motivation and Emotion 35,75–88.

McAdams, D.P. (2009) The Person (New York: Wiley).

Miller, M.E. (2000) ‘Introduction: New Visions for Adulthood in the Postmodern Era’ in M.E. Miller & A.N. West, eds., Spirituality, Ethics, and Relationship in Adulthood: Clinical and Theoretical Explorations (Madison: Psychosocial Press) 1–13.

Myers, J.E., T.J. Sweeney & J.M. Witmer (2001) ‘Optimisation of Behavior, Promotion of Wellness’ in D.C. Locke, J.E. Myers & E.L. Herr, eds., The Handbook of Counseling (Thousand Oaks: Sage) 641–52.

Radnai, B. (1967) A népművelés pszichológiai és pedagógiai kérdései (Budapest: Tankönyvkiadó) 15–29.

Susánszky, É., B. Konkolÿ Thege, A. Stauder & M. Kopp (2006) ‘A WHO Jól-Lét Kérdőív rövidített (WBI-5) magyar változatának validálása a HungaroStudy 2002 országos lakos­ sági egészségfelmérés alapján’, Mentálhigiéné és Pszichoszomatika 7, 247–55.

Szabó, G. (2008) ‘Az esélyteremtés szintjei: Életesemények, stressz és egészségi állapot’ in M. Kopp, ed., Magyar Lelkiállapot: Esélyerősítés és életminőség a mai magyar társadalomban (Budapest: Semmelweis) 477–85.

Szabóné Molnár, A. (2009) ‘Tanulás időskorban’ in L. Zrinszky, ed., A megújuló felnőttképzés (Budapest: Gondolat) 174–83.

Tamir, L.M. (1982) ‘Men at Middle Age: Developmental Transitions’, Annals of the American Academy of Political and Social Science 464, 47–56.

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 212–231 DOI: 10.5708/EJMH.8.2013.2.3

Robert Biel*

DIE ATHEISIERUNG DER KULTUR IM KOMMUNISTISCHEN POLEN UND IHRE KONSEQUENZEN FÜR DIE GEGENWART (Erhalten: 27. August 2012; angenommen: 5. Dezember 2012)

Mit der Aufklärung hat in Europa die Religionskritik im modernen Sinn eingesetzt. Viele der damals entwickelten atheistischen Gedanken haben ihre Wirkung bis in die Gegenwart behalten und beeinflussen bis heute das Leben und die Kultur vieler Generationen. Dieser Prozess führte in den kommunistischen Ländern zur Atheisierung der Kultur, was sich in der VR Polen deutlich zeigte. Die Kirche in Polen übernahm bereits vor Jahrhunderten die Rolle eines Mäzens der Kultur, was besonders in den Perioden der politischen Abhängigkeit, also bei Teilungen oder Besetzungen, von Bedeutung war.

Die Machtübernahme durch die Kommunisten führte zur Bevormundung der Kultur und ihre Unterordnung unter die strukturellen und politischen Prinzipien der kommunistischen Partei. Forthin galt es als höchste Berufung der Kultur, im Dienste des Kommunismus zu stehen. Die von den kommunistischen Behörden geplante Marginalisierung der christlichen Kultur führte nach und nach zur Entstehung eines Gettos der christlichen Kultur und Kunst. Besonders seit der Verhängung des Kriegsrechts in Polen (1981) führten diese für die christliche Kultur geschaffenen Getto-Verhältnisse zur sog. inneren Emigration der Künstler und zum Boykott des polnischen Rundfunks und Fernsehens.

Als Konsequenz hieraus entstand ein inoffizielles Kultursystem, das die diesbezüglichen Bedürfnisse des größten Teils der Bevölkerung stillte. Das inoffizielle Kultursystem bildeten jene Kulturschaffenden, die im Bereich des Kulturlebens nicht der Staatsmacht unterstanden, oder ihr zwar unterstanden, aber so viel Autorität und Freiheit genossen, dass sie Werte, Normen und Verhaltensweisen überliefern konnten, die nicht mit dem geltenden sozialistischen Kultursystem übereinstimmten. In Kirchen und Gemeinderäumen wurden Theatervorstellungen und Vorlesungen durchgeführt. Das inoffizielle Kultursystem trug wesentlich zur gesellschaftlichen Integration bei und half die nationale Identität zu bewahren. Die neue gesellschaftliche Lage nach der Wende zwang die Kirche in Polen zu neuen Positionsbestimmungen auf dem freien Markt der ethischen, kulturellen und religiösen Werte und zur Überwindung der Spaltung, die zwischen dem Evangelium und der modernen Kultur erfolgt war.

Aufgrund der tiefen Verbundenheit zwischen Kirche und Kultur und des Bewusstseins des geistigen und kulturellen Erbes der vergangenen Jahrhunderte können und wollen die Christen in Polen nicht auf das verzichten, was einen unveräußerlichen Teil der nationalen und religiösen Identität darstellt.

Die Christen, die das Antlitz der geistigen Kultur über Jahrhunderte geprägt haben, wollen auch heute an der neuen europäischen Wirklichkeit gleichberechtigt mit anderen Europäern mitwirken.

Schlüsselbegriffe: Staat und Kirche, Polen, Kommunismus, Staatssozialismus, Diktatur, Geschichte, Rückblick, atheistische Ideologie, Kirche, Wendezeit, Kultur

*

Robert Biel, 33-100 Tarnów, ul. Urszulańska 9/8., Polen; rbiel@diecezja.tarnow.pl.

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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The atheisation of culture in Communist Poland and its present-day repercussions: The Age of Enlightenment marked the beginning of modern religious criticism in Europe. Several atheistic ideas born at that time have maintained their influence and affected the life and culture of many generations. This process, which clearly manifested itself in the People’s Republic of Poland as well, led to the atheisation of culture. The church in Poland has been acting as the patron of culture for centuries and this role was especially important at times of political dependence such as the division or the occupation of the country. Under the Communist rule culture was given a subordinate status based on the structural and political principles of the Communist Party. Consequently, culture was primarily expected to serve Communism. The intention of authorities to marginalise Christian culture and art resulted in its increasing ghettoisation. Following the declaration of a state of emergency (1981) the ghetto conditions created for Christian culture contributed to the so-called internal emigration of artists and the boycott of the Polish radio and television. This process generated an unofficial system of culture, which could cater to the needs of the majority of citizens. This unofficial system comprised actors and trustees of culture who were not subservient to state power or had enough authority and freedom to represent different values, norms or forms of behaviour than those of the dominant cultural system. For example, churches or parish community rooms hosted theatre shows and other performances as well. The unofficial system of culture contributed to social integration in a significant way and helped to preserve national identity. The social status quo following the political turn compelled the Polish church to re-define its position on the free market of ethical, cultural and religious values and played a role in eliminating the gulf between the Christian message and modern society. Since church and culture have been deeply intertwined and Christians are conscious of their centuries-long spiritual and cultural heritage, they cannot and do not want to give up this unalterable element of national and religious identity. Christians have been forming the image of intangible culture for centuries and they will continue to strive for a position as equal and full partners in constructing the new European reality.

Keywords: state and church, Poland, Communism, State Socialism, history, dictatorship, retrospection, atheist ideology, church, political turn, culture

1. Einleitung Die Kultur (lat. cultura) und die Religion standen immer schon miteinander in Verbindung. Ursprünglich war der Begriff „Kultur“ doppeldeutig und meinte sowohl „Ackerbau“ und als auch „Verehrung“ (cultus). Kultur hat daher zwei Grundbezüge: einen zur Erde und einen zur ewigen Heiligkeit. Religion und Kultur bestimmen einander gegenseitig und sind vielfältig miteinander verbunden. Aufgrund dieser engen Verflechtung ist Kultur zum Gegenstand von Angriffen atheistisch geprägter Denkströmungen geworden. Es ist es deshalb wichtig, die Ursachen des Atheismus und der Atheisierung der christlich geprägten europäischen Kultur aufzuzeigen. in wichtiger Faktor ist die westeuropäische Modernisierung. . . . Es ist eine Art „AtheisieE rung von innen“, geboren aus der westeuropäischen Aufklärung. In Osteuropa wiederum verursachte der religionskämpferische Marxismus-Leninismus eine Art „Atheisierung von oben“, durch ein totalitäres System mit mehr oder weniger Erfolg in den jeweiligen Gesellschaften durchgesetzt.

(Zulehner 2011, 77)

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Religionskritik im modernen Sinn begann in Europa im Rahmen der Aufklärung. War es zunächst eine Kritik an den Kirchen, den etablierten Religionen, so wurde im 19. Jahrhundert daraus eine Kritik an der Offenbarung und schließlich an Religion überhaupt. Viele der damals entwickelten atheistischen Gedanken haben ihre Wirkung bis in die Gegenwart behalten und beeinflussen bis heute das Leben und die Kultur vieler Generationen. Die erste Kritik an der Religion stammte von Auguste Comte und lautete: Religion ist eine Erscheinung aus der Frühphase der Menschheit, in der die Menschheit zunächst eine mystische oder religiöse Phase durchlaufen musste. Die verschiedenen Naturerscheinungen wurden bestimmten Gottheiten zugeschrieben, die man als Verursacher ansah, weil man die wissenschaftlichen Gründe dieser Naturphänomene noch nicht kannte. Religion hafte folglich immer der Verdacht des Kindlichen, Unfertigen und Überholten an (Deninger 1985, 7).

In diesem Sinne ist auch die Aussage von Francis Bacon (um 1600) zu verstehen, der das Wissen – es handelte sich bei ihm um das Wissen über die Natur – in den Dienst des Menschen gestellt hatte. Zugunsten eines „endlosen Fortschritts“ solle der Mensch ebenso wie in Gottes Wort ohne falsche Bescheidenheit erst recht auch in Gottes Werk forschen. Das Ziel dieser Forschung sollte the kingdom of men sein (Kern 1982, 19). Was Bacon damals erdachte, ist inzwischen Realität geworden: Das Beschleunigen des Blühens von Pflanzen, die Steigerung der Größe von Früchten und Tieren, die Züchtung neuer Arten, die Verwandlung verschiedener Arten ineinander, dazu künstliche Abtötung und Wiederbelebung, die Verriesung und Verzwergung, das Fruchtbar- und Unfruchtbarmachen (Löwith 1968, 20). Auf diesem Wege entwickelte sich stetig das Ethos des modernen, atheistischen Fortschrittsglaubens.

Der zweite Kritikpunkt an der Religion stammt von Karl Marx, dessen Gesellschafts- und Kulturkritik zunächst von der Kritik an der als „Opium des Volkes“ bezeichneten Religion ausging. Bevor aber der dialektische Materialismus die unterdrückte Arbeiterklasse befreien konnte, hatte die Religion Marx zufolge eine gewisse gesellschaftliche Funktion. Sie habe Trost im irdischen Jammertal geboten und einen gerechten Ausgleich im Jenseits versprochen. Allerdings habe sie damit aber auch den Blick der Menschen auf die irdischen Realitäten verstellt, die Revolution verhindert und das bestehende System gestützt. Religion werde daher überflüssig geworden sein, sobald der Klassenkampf sein Ziel erreicht hat. In dieser Kritik von Marx steckt also der Gedanke, dass Religion nicht freimache, sondern repressiv wirke, nicht Kräfte für die menschenwürdige Gestaltung der Welt und der Gesellschaft mobilisiere und freisetze, sondern die Menschen eher fessele und lähme (Deninger 1985, 8). Ähnlich wie Marx verstand auch Lenin die Rolle der Religion.

I n weitaus giftigerem Tonfall deutete Lenin jede Abweichung von dem, was er sich als Marxismus zurechtgelegt hatte, entweder als Dummheit oder als bösartigen Verrat. Seine Argumentationsweise ist nicht zufällig mit den Worten „zitiere und schlage mit dem Prügel zu“ zusammengefasst worden.

(Lobkowicz 1993, 69)

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In allen kommunistischen Ländern sah sich die Ideologie des Marxismus-Leninismus, zu der wesentlich der Atheismus gehört, mit der Kirche konfrontiert. Obwohl hier nicht der Ort ist, die Atheismus-Implikation des Marxismus ausführlich zu behandeln, sollen zumindest stichwortartig einige Grundgedanken der Ideologie festgehalten werden, in denen die wesensmäßige Feindschaft zum Glauben und zur christlichen Kultur zum Ausdruck kommt. Im Sinne dieser Ideologie wird der Begriff „Gott“ verschwinden, wenn die Welt vernünftig wird. Religion vernebelt, wie die Kommunisten behaup(te)ten, die Erkenntnis der Wirklichkeit. Deshalb kam es schon bei Marx nicht darauf an, die Welt zu interpretieren, sondern sie zu „verändern“. Lenin übernahm dieses Gedankensystem und überführte es – in Verbindung mit einem militanten Materialismus – in radikale politische Maßnahmen (Zulehner & Tomka 2000, 27–28).

Was die Eurokommunisten, also auch die Kommunisten in Polen, von den sow­ jetischen Kommunisten unterschied, war nur ein Etikett, geprägt von einer gewissen Distanz gegenüber dem Kommunismus, wie er von Moskau verwirklicht wurde.

Doch dies war im Grunde genommen keine Distanz zum Kommunismus, wie vielfach leichtgläubig angenommen wurde. Es war vielmehr bloß eine auf Teilbereiche beschränkte Kritik an tadelswerten Erscheinungsformen des sowjetischen, zutiefst unmenschlichen Bürokratismus und Imperialismus. Eurokommunismus war demnach keine demokratische Spielart des Kommunismus, sondern lediglich alter Wein in neuen Schläuchen. Nur diese Sicht – und daraus politisch abzuleitende Konsequenzen eines freiheitlichen Anti-Kommunismus – konnte Europa davor bewahren, den verderblichen Schritt zu tun, der in der Politik die Schwelle bezeichnet, an der Wachträume zu Alpträumen werden (Westphalen 1982, 44). In diesem Zusammenhang verwundert es nicht, dass sich das Plädoyer für den homo faber des humanistischen oder postulatorischen Atheismus in den vergangenen zwei Jahrhunderten gegen den Schöpfergott wendete (Kern 1982, 20). Diese Verdrängung Gottes durch den homo faber musste der kommunistischen Ideologie zufolge auf unabwendbare Weise zur Atheisierung der Kultur führen, was sich in der kommunistischen Volksrepublik Polen deutlich gezeigt hat.

2. Die christlichen Wurzeln der polnischen Kultur Die tiefe Verbundenheit der polnischen Nation mit der katholischen Kirche bestimmte auch die polnische Kultur und Kunst. Zahlreiche vom Christentum geprägte Werke der Kultur und Kunst gehören heute zu den Schätzen der polnischen Tradition.

Der Gesang „Bogurodzica“ (Gottesgebärerin) gilt als Perle der polnischen Sprache (Johannes Paul II. 1995, 2) und hat viele Generationen von Polen nicht nur bei der Verteidigung der gerechten Sache auf dem Schlachtfeld, sondern auch bei der Gestaltung des Lebens der Nation inspiriert. Diese enge Verbundenheit, ja sogar Verflochtenheit der Kirche mit der polnischen Kultur führte dazu, dass die Kirche bereits vor Jahrhunderten die Rolle eines Mäzens der polnischen Kultur übernomEJMH 8:2, December 2013

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men hat, was besonders in den Perioden der politischen Abhängigkeit wichtig war, also bei Teilungen, Kriegen oder Besetzungen (Episkopat Polski 1974, 633).

Diese Funktion der katholischen Kirche kam in allen Handlungen zum Tragen, die zum schwierigen Prozess der Integration von Nation und Volk sowie zur Integration der polnischen Kultur beitrugen. Unter den geschichtlich-politischen und gesellschaftlich-kulturellen Gegebenheiten in Polen scheint diese integrierende Funktion der Kirche eine herausragende Rolle gespielt zu haben. Es muss hier erwähnt werden, dass Polen – besonders in der Zeit der Dreiteilung – unter dem Einfluss von drei verschiedenen Besatzungsmächten stand. Dies führte dazu, dass das polnische Volk lange Jahre stark von drei verschiedenen Kulturen, Sprachen und Wertesystemen und zwei „fremden“ Konfessionen geprägt wurde. Besonders damals fand die überwiegend katholische polnische Gesellschaft einen Rückhalt in der hierarchischen Verfassung der Kirche. Dies half ihr dabei, die Zeiten der Teilungen und der Besatzung zu überstehen, ohne ihre Identität zu verlieren. Die Verbundenheit der Kirche mit dem Volk und seine unerschütterliche Standhaftigkeit wurden im Laufe der Zeit zum geistigen und kulturellen Erbe und zu einem wichtigen Faktor, der die Nation zusammenhielt und ihre Identität und ihre Einheit in besonders schwierigen Zeiten sicherte.

Besondere Beachtung verdient in diesem Zusammenhang die für die polnische Kirche typische marianische Wallfahrtsfrömmigkeit, mit deren Hilfe die Kirche die nach den polnischen Teilungen noch vorhandenen Mentalitätsschranken durchbrach, die Religiosität reinigte und die ländlichen Traditionen in die gesamtnationale Kultur einbezog. Der Marienwallfahrtsort Jasna Góra wurde zur geistigen Hauptstadt Polens, er inspirierte die polnische Nation gerade in politischen oder religiösen Notzeiten, bei ihrer „Königin“ Zuflucht und Hilfe zu suchen. Die Geschichte Polens zeugt immer wieder von der Hilfe, die das Land durch die Fürbitte Mariens erfahren hat. Als Polen im Jahre 1795 nach der dritten Teilung für mehr als 120 Jahre von der Landkarte Europas verschwunden war, bildete Jasna Góra einen Bezugspunkt für die geteilte Nation, er war die Schatzkammer der polnischen Kultur. Er stärkte in dieser schmerzvollen Zeit der polnischen Geschichte das Nationalbewusstsein und die polnische Sprache und Kultur, indem er die Polen daran erinnerte, dass sie Kinder eines einzigen Vaterlandes waren, und indem es ihren Herzen die Hoffnung auf Freiheit eingrub. Das Bild der Muttergottes wurde auf diese Weise Zeichen und Pfad für ein freies Polen. Man kann mit Recht behaupten, dass „in keinem anderen Land die Gottesmutter als Schutzpatronin alle machtpolitischen Veränderungen so wie in Polen überdauert hat“ (Institutum Marianum 1975, 108). Sie war jahrhundertelang eine großartige Quelle der geistigen Inspiration des polnischen Volkes.

Aus den bisherigen Ausführungen lässt sich folgern, dass die Kirche sowohl als Institution als auch als Glaubensgemeinschaft wesentlich zur Integration, zur nationalen Kultur und zur Einheit der polnischen Gesellschaft beigetragen hat. Die Kirche war daher Verbündete des polnischen Volkes und seiner kulturellen Identität, oftmals war sie sogar die einzige Anwältin gegen die vielen inneren und äußeren Feinde.

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tig mit der atheistisch-sozialistischen Staatsführung auseinandersetzen. Wenn man heute von den Kennzeichen des polnischen Katholizismus spricht, muss stets darauf hingewiesen werden, dass die Kirche in Polen sehr mit dem gesellschaftlich-kulturellen Hintergrund verbunden ist. Der Katholizismus ist nicht nur als Gemeinschaft der Laien und Priester zu verstehen, sondern auch als wesentlicher Bestandteil des gesellschaftlich-kulturellen Systems. Deshalb gilt auch für den polnischen Katholizismus in gewisser Weise der Satz: „Jeder ist ein Gefangener seiner eigenen Geschichte“ (Messori 1994, 7).

Die Stellung der katholischen Kirche in Polen lässt sich also nicht einfach mit einer natürlichen Religiosität des polnischen Volkes erklären. Sie ist nur vor dem Hintergrund der geschichtlichen Entwicklung des Landes und des Volkes zu verstehen. Oft genug musste die Kirche die Rolle des Staates mit übernehmen, und das nicht nur in den Phasen, als ein polnischer Staat gar nicht existierte. Der polnische Katholizismus ist von den einmaligen geschichtlich-kulturellen Bedingungen geprägt, die im Folgenden geschildert werden. Der Einsatz der Kirche scheint seine Wurzeln in dem Bewusstsein zu haben, dass „die Kirche schwach wird, sobald sie sich dem Völkerleben entfremdet. Sie wird stark und verjüngt sich, sobald sie wieder in unmittelbare Berührung mit dem Volk und seinen praktischen Bedürfnissen tritt“ (Riehl 1856, 320).

Die Machtübernahme durch die Kommunisten führte zur Bevormundung der Kultur und ihre Unterordnung unter die strukturellen und politischen Prinzipien der kommunistischen Partei. Als höchstes Ziel der Kultur galt es, im Dienste des Kommunismus zu stehen. Die Normen des Realsozialismus wurden zum künstlerischen Dogma erklärt. Die dialektisch-materialistische Auffassung von Kunst und die Verbreitung der Ideen des Kommunismus führten dazu, dass die Kultur eine Frage der Politik und der Ideologie wurde. Deshalb waren die Ausbildung vom Kindergarten bis zur Universität, die Literatur, die Kunst, die Architektur, das Theater und die Massenmedien in der Hand des Staates. Die Künstler waren daher außerstande, einen konstruktiven Beitrag zum gesellschaftlichen Leben zu leisten. Sie mussten den sogenannten „sozialistischen Menschen“ und die „sozialistischen Beziehungen“ prägen (Dyczewski 1988a, 147). Kunst sollte den Arbeitsalltag des homo sovieticus und seine Heldentaten besingen. Daher waren Helden und Pathos in der realsozialistischen Kultur sehr wichtig. Die Kunst sollte die sozialistische Wirklichkeit bestätigen. In ihr sollte der homo sovieticus seine ästhetische Entwicklung finden. In der verlogenen Plakatsprache konnten der kämpferische Parteigeist und andere Züge der sozialistischen Kunst zum Ausdruck kommen. Weil die sozialistische Kunst vom Heldenpathos und vom Aufbau des Sozialismus nicht zu trennen war, wurden alle Versuche des kulturellen Pluralismus als Abweichung von den ideologischen Prinzipien der kommunistischen Partei bezeichnet und als individualistische zügellose Anarchie bekämpft. Die den kommunistischen Prinzipien treuen Künstler hatten dagegen die gleichen Privilegien wie die Parteiführer, weil sie erhabene Abbilder der kommunistischen Götter schufen. Nur die Diktatoren konnten den Künstlern den Weg zu den „Höhen der Kunst“ eröffnen, indem sie ihnen Ausstellungsräume zur EJMH 8:2, December 2013

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Verfügung stellten. Den anderen, kritisch eingestellten Künstlern galten Repressionen und politische Bevormundung.

Die polnische Bischofskonferenz betonte immer wieder, dass die polnische Kultur seit tausend Jahren von der christlichen Tradition geprägt ist. Die Kommunisten versuchten, diese beiden Wirklichkeiten zu trennen, indem sie atheistische Erziehungsmuster verbreiteten und die Kultur zu laizisieren begannen (Episkopat Polski 1974, 633). Sie hofften, durch die Verbreitung einer atheistischen Kultur die Bedeutung des Christentums in Polen reduzieren zu können (Morawski 1963, 237) und versuchten, dieses Ziel der kommunistischen totalitären Ideologie durch Erzeugung von permanentem massivem Druck, durch Propaganda, Lüge und Verlogenheit zu erreichen. Im Laufe der Zeit entpuppten sich die sogenannten Ämter für die Glaubensangelegenheiten als wichtigstes Instrument der Partei im Kampf gegen die Kirche und die christliche Kultur. Dies zeigt sich auch darin, dass die Leitung dieser Ämter zum einen überzeugte Atheisten innehatten (Choromański 1968, 485), zum anderen Priester, die ihr Amt niedergelegt hatten oder aus disziplinären Gründen entlassene Priesteramtskandidaten (Wyszyński 1962, 209).

3. Das inoffizielle Kultursystem Die polnische Kunst und Kultur waren seit Jahrhunderten stark vom Christentum geprägt; dies versuchten die Kommunisten zu ändern. Ihre Bestrebungen hatten zum Ziel, für die christliche Kultur ein Getto zu schaffen, sie aus dem öffentlichen Leben zu verbannen und so der sozialistischen Kultur eine Monopolstellung zu ermöglichen (Episkopat Polski 1974, 638). Die kommunistische Partei wachte darüber, dass die verbreiteten Werte, Normen und Verhaltensweisen und die einzelnen Kunstformen mit den kommunistischen Direktiven übereinstimmten; andernfalls erhielten sie keinen Zugang zur Öffentlichkeit. Zu diesem Zweck wurde ein spezielles Amt, das „Kontrollamt für Presse und Veranstaltungen“, gegründet, das das Kultursystem zentralistisch und einheitlich gestalten und alle ideologisch fremden Aspekte beseitigen sollte (Dyczewski 1988, 147). Auf diese Weise kam „das eigentlich Totalitäre des Sowjetsystems“ zum Vorschein, elches es von bloßen Diktaturen unterscheidet und die Verwandtschaft mit dem Dritten w Reich ausmacht: Jeder Winkel des Lebens, ja des Denkens wurde politisiert, in den Sog einer Ideologie gezogen, die teils mit Verlockungen, teils mit brutalster Verfolgung den ganzen Menschen, sein gesamtes Denken und Fühlen beanspruchte.

(Lobkowicz 1993, 73).

Die Omnipotenz und Omnipräsenz des sozialistischen Staates war enorm.

Durch das jahrelange Wirken des Kommunismus waren die Menschen schließlich davon überzeugt, dass alles nur mit der Konzession der kommunistischen Machthaber funktioniert. Und allmählich glaubte man, dass es nur mit der Genehmigung der Behörden möglich sei, dass Bäume wachsen, Wasser fließt, Fabriken arbeiten, Schriftsteller schreiben, Sänger singen und die frommen Christen Gott preisen

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(Tischner 1993, 115). Durch den ideologischen Druck und die massive atheistische Prägung der Gesellschaft wurden in der Zeit der kommunistischen Herrschaft andere kirchliche wie auch gesellschaftliche Probleme weniger deutlich erkennbar, etwa das verblassende Kulturchristentum, dessen atheistischer Kern meist von religiöser Folklore verdeckt war (Wanke 1994, 13).

Das so erzwungene offizielle sozialistische Kultursystem konnte in der christlichen Gesellschaft keine Wurzeln schlagen, und viele Bürger nahmen Abstand von ihm. Es entwickelte und verstärkte sich eine selektive Haltung gegenüber den kulturellen Institutionen, gegen den Inhalt und die Formen der Kultur, die durch das offizielle System angeboten wurden. In den Jahren 1970 bis 1983 sank die Zahl der Theaterbesucher von 10 auf 7,4 Millionen, die Zahl der Kinobesucher von 137 auf 87 Millionen. In den 1980er Jahren verringerte sich auch die Zahl der Fernsehzuschauer und der Zeitungsleser stark. Auch der Zustrom der Jugend an die Gymnasien und Hochschulen ließ nach (Dyczewski 1988a, 148–49). Das offizielle Kultursystem basierte auf einem zentralistisch-monolithischen Kulturmodell, wohingegen die Gesellschaft stark zu einem pluralistischen Kulturmodell tendierte. Die Gründe für die Abwendung vom offiziellen Kultursystem waren vielfältig. Die entscheidende Rolle in diesem Prozess scheint das für die polnische Gesellschaft nicht akzeptable Verspotten der christlichen Werte und der Kirche im Rahmen der von den Kommunisten angebotenen Kulturveranstaltungen gespielt zu haben (Choromański 1952 b, 366).1 In diesem Zusammenhang ist eine Theateraufführung von Kazimiers Dejmek zu erwähnen, in der dieser die Kirchenväter und den christlichen Glauben verspottete (Episkopat Polski 1962, 192–93), aber auch andere kulturelle Veranstaltungen, die die Gefühle der Gläubigen verletzten (Choromański 1962, 185–86).

Die Unbeliebtheit der kommunistisch geprägten Kultur ist Dyczewski (1986) zufolge auf folgende gesellschaftliche Phänomene zurückzuführen: Die Diskrepanz zwischen den von der Mehrheit der Gesellschaft geschätzten christlichen Werten und Normen und denen, die offiziell von den Kommunisten verbreitet wurden; die Unterordnung der Kultur gegenüber den Interessen der Staatsmacht und der mit der Staatsmacht verbundenen kommunistischen Partei; die Degradierung der Kultur zum bloßen Freizeitvergnügen; die starke Verbundenheit der offiziellen Kultur mit der Kultur der Sowjetunion, während die ganze polnische Kultur mehr mit der Kultur des Abendlandes verbunden war; schließlich waren Sprache und Form der kulturellen Aktivitäten des offiziellen Kultursystems stark ideologisch geprägt und wurden deshalb nicht akzeptiert.

Die polnischen Bischöfe haben stets mit Sorge hervorgehoben, dass die christlichen Künstler in der VR Polen marginalisiert würden (Episkopat Polski 1974, 637).

Die Kultur im kommunistischen Polen glich immer mehr einem „Reich der Zerstörung“; und diejenigen, die sie am deutlichsten so erlebten, waren Intellektuelle, 1

uf einer Kunstausstellung waren folgende Karikaturen zu sehen: zum einen eine Zeichnung mit dem Titel A „Heiliger Stuhl“: Auf dem Thron sitzt ein Amerikaner. Dahinter steht der Papst, in seiner ausgestreckten Hand die päpstliche Tiara, in die der Amerikaner Dollars steckt. Eine weitere Karikatur, „Die Beichte des Papstes“, zeigt, wie Truman im Beichtstuhl sitzt und dem Papst die Beichte abnimmt.

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denen buchstäblich nichts als ihre Fähigkeit zur Reflexion erhalten geblieben war.

Verzweifelt mussten sie untätig zusehen, wie eine Welt, die sie im Stillen liebten, Tag für Tag brutaler zerstört wurde (Lobkowicz 1993, 94).

Im offiziellen Kultursystem fanden die Werke von Dichtern, Wissenschaftlern und Künstlern, die nicht mit der Regierung übereinstimmten, keine Beachtung, obwohl diese Werke für die polnische und europäische Kultur wichtig und wertvoll waren, z.B. die Werke des Nobelpreisträgers Czesław Miłosz, von Leszek Kołakowski oder Zbigniew Herbert (Dyczewski 1988a, 148). Deshalb versuchte die Kirche, die wissenschaftliche und kulturelle Tätigkeit der von der offiziellen Kultur unabhängigen Künstler zu unterstützen und zu würdigen. So verlieh die Katholische Universität Lublin (KUL) dem von den Kommunisten nicht anerkannten Literaturnobelpreisträger Miłosz im Rahmen eines Festaktes die Ehrendoktorwürde. Die KUL hätte Miłosz diesen Titel gerne einige Jahre früher verliehen, war jedoch damit bei der Regierung zunächst auf Widerstand gestoßen.

Die Kirche in Polen zeigte jahrhundertelang die Fähigkeit und die Bereitschaft, ihre christlich, römisch und lateinisch orientierte Kultur friedlich mit anderen Kulturen zu verbinden (Wyszyński 1974, 647). Die Kommunisten versuchten jedoch, diese kulturstiftende Tätigkeit der Kirche zu verhindern. In diesem Prozess, der der Atheisierung der Kultur dienen sollte, spielte – wie bereits erwähnt – das Amt für Glaubensangelegenheiten eine wichtige Rolle, das durch administrative Verordnungen versuchte, jegliche von den Kommunisten unabhängige kulturelle Tätigkeit unmöglich zu machen. In diesem Zusammenhang muss auf Handlungen der kommunistischen Behörden hingewiesen werden, die die unabhängige christliche Kultur zu behindern versuchten: Ständige Kontrollen in allen kirchlichen Bibliotheken und Beschlagnahmung von Büchern, die sich auf die christliche Kultur, die Auseinandersetzung mit dem Kommunismus sowie die christliche Ethik bezogen (Episkopat Polski 1960, 20–22); die Verbreitung von unmoralischen Büchern unter Kindern (Choromański 1952a, 339–40), die Beschlagnahmung von päpstlichen Auszeichnungen durch Zollbeamte (Choromański 1954, 741) oder Versuche der Sprachmanipulation und Umbenennung von Städten wie Katowice zu Stalingrad (Mieszkańcy Stalingrodu 1956, 557–58). Im Zuge dieser gegen die unabhängige Kultur gerichteten Handlungen der kommunistischen Behörden sind auch fast alle theologischen Fakultäten in Polen aufgelöst worden, so an der Jagiellonen-Universität in Krakau und an den Universitäten in Posen (Poznań) und in Breslau (Wrocław) (Episkopat Polski 1974, 636).

Diese von den kommunistischen Behörden geplante Marginalisierung der christlichen Kultur hatte die Begrenzung ihres gesellschaftlichen Einflusses zum Ziel und führte zu einer zunehmenden Gettoisierung der christlichen Kultur und Kunst (Episkopat Polski 1974, 637–38). Besonders seit der Verhängung des Kriegsrechts in Polen (1981) hatte dies die innere Emigration der Künstler und einen Boykott des polnischen Rundfunks und Fernsehens durch eine beträchtliche Zahl von Schauspielern zur Folge. Es entstand ein inoffizielles Kultursystem, das die Bedürfnisse des größten Teils der Bevölkerung stillte. Die freien und unzensierten EJMH 8:2, December 2013

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Kulturschaffenden, die keinen Zugang zum offiziellen Kultursystem hatten, fanden so neue Ausdrucksmöglichkeiten. Besonders die katholische Kirche prägte weithin eine andere Kultur als das offizielle Kultursystem. Sie blieb die einzige Institution mit den notwendigen organisatorischen und räumlichen Möglichkeiten, die einem breiten Spektrum gesellschaftlicher Aktivitäten (vor allem Bildung und Kultur) Zuflucht gewährte (Bingen 2009, 10). Die Kirche wurde so zu einem Zufluchtsort für viele, die im Kommunismus Freiheit eingebüßt hatten. Von ihren zahlreichen Mitgliedern wurde sie als Stätte des freien Wortes, des offenen Dialogs und der Kreativität erlebt (Zulehner & Tomka 2000, 35). Der Kirche gelang es in der Zeit des Kommunismus, einen Raum der Freiheit für viele Menschen zu schaffen, die unabhängig von ihrer religiösen Einstellung in der Kirche die Wahrheit suchten und ihre Werte vor den kommunistischen „Hofexperten für Ohrfeigen“ zu verteidigen wussten (Życiński 1996, 43).

So konnte die unabhängige Kultur mithilfe der Kirche erste Schritte wagen.

Berühmte Schauspieler führten ihre Theaterstücke in kirchlichen Räumen oder privaten Wohnungen auf. Das inoffizielle Kultursystem stützte sich vor allem auf die Kirche und auf Institutionen, die mit der sozialen Bewegung Solidarność in Verbindung standen. Die Vorhallen der Kirchen und die Kreuzgänge der Klöster avancierten damals zu unabhängigen Galerien, im Regelfall aus einer martyrologischen bzw. oppositionellen Verpflichtung heraus (Sabor 2009, 72). Die Polnische Bischofskonferenz beschloss, einen Kulturrat zu berufen und so die unabhängige Kultur zu unterstützen: „Wie das Brot zum biologischen Leben vonnöten ist, so sind die von den Kulturschaffenden aufgezeigten geistigen Werte für eine normale Entwicklung eines jeden Menschen unumgänglich“ (Episkopat Polski 1982, 27). Dank dieser Unterstützung der Kirche entstanden viele Amateurtheater und unzensierte Literaturkreise. Unabhängige Schriftsteller gründeten eine Redaktion für nicht zensierte Schriften, die unter den Namen Zapis und Puls bekannt wurden. Dazu kamen noch weitere Zeitschriftentitel (Dyczewski 1988a, 150). Das inoffizielle Kultursystem bildeten jene Kulturschaffenden, die im Bereich des Kulturlebens nicht der Staatsmacht unterstanden oder aber ihr zwar unterstanden, aber so viel Autorität und Freiheit genossen, dass sie Werte, Normen und Verhaltensweisen vermitteln konnten, die nicht mit dem geltenden sozialistischen Kultursystem übereinstimmten.

4. Der Beitrag der Kirche zur Bewahrung der nationalen Kultur Da die Ideologie des kommunistischen Klassenkampfes alle oppositionellen Kräfte auszurotten versuchte, verblieb die Kirche als einzige oppositionelle Kraft. So wie in ihrer ganzen Geschichte hatte sie auch in der Zeit des kommunistischen Totalitarismus reichlich Gelegenheit, ihre oppositionelle Haltung zu beweisen. Diese schwierige Zeit wurde vom bekannten Non possumus der polnischen Bischöfe geprägt, das die würdevolle Haltung der Kirche gegenüber der atheistischen und antipolnischen Ideologie zum Ausdruck brachte (Episkopat Polski 1953, 413–27).

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Die Kirche wollte jedoch nicht die Rolle der politischen Opposition übernehmen und sich als politische Alternative darstellen. Es steht außer Zweifel und wird doch oft übersehen, dass die Kirche in Polen stets bemüht war, allem aus dem Wege zu gehen, was sie in den Ruf einer politischen Opposition hätte bringen können (Bingen 2009, 9). Sie griff vor allem die pathologischen und totalitären Züge des Sozialismus an, nicht den Sozialismus als solchen. Die Kirche war zwar eine Opposition, jedoch sind die Bezeichnungen „kulturelle Widerstandskraft“ (cultural resistence), und „namenlose Opposition“ (opposition without name) treffender (Kondziela 1978, 105–06).

In den 1980er Jahren entwickelte die Kirche Institutionen, die sich mit kulturellen Tätigkeiten im engeren Sinne des Wortes beschäftigten. So gab es Klubs der katholischen Intelligenz, Redaktionen der mit der Kirche verbundenen Zeitschriften, Priesterseminare und Zentren der Akademikerseelsorge. Es entstanden auch ganz andere Institutionen, die der Entwicklung der christlichen Kultur dienten, so z.B. „Sacrosong“ – ein Festival religiöser Lieder, das jedes Jahr in einer anderen Stadt organisiert wurde,2 ferner Wochen der christlichen Kultur mit Vorträgen, Diskussionen, Vorstellungen, Theaterstücken, Wettbewerben in den Bereich religiöse Kunst, Poesie und Vokalkunst. Derartige Veranstaltungen, die in Polen dank der Initiative von Stefan Wyszyński seit 1974 alljährlich in vielen Städten stattfanden, schufen die Gelegenheit, die in der polnischen Kultur verankerten christlichen Werte einem breiten Publikum zu präsentieren. In vielen Kirchen fanden Begegnungen mit namhaften polnischen Schauspielern, Schriftstellern, bildenden Künstlern und mit den Redaktions-Teams der katholischen Zeitschriften statt. Während der Wochen der christlichen Kultur boten die Kirchen und die anliegenden Kirchen- und Unterrichtsräume Theatervorstellungen und Vorlesungen Platz.

Die katholische Universität in Lublin versuchte ihrerseits, die unabhängige Kultur auf alle mögliche Weise zu unterstützen. Hierfür verlangte die Kirche von den Künstlern Treue zu den nationalen und christlichen Werten. Primas Wyszyński formulierte diesen Wunsch auf folgende Weise: „Ein Mensch, der die Feder zur Hand nimmt, der den Mund öffnet, ist für die Wahrheit verantwortlich. Er kann und soll sie nicht verbergen. Sonst ist er ein Dieb der Gesellschaft“ (1981, 48).

Für die Machthaber war das inoffizielle Kultursystem eine große Konkurrenz, die sie als Bedrohung verstanden. Sie warfen der Kirche vor, die unabhängige christliche Kultur versuche, sich die gesamte nationale Kultur unterzuordnen und aus der nationalen Kultur „fortschrittliche und revolutionäre Bestandteile zu eliminieren.

Diese kirchlichen Tendenzen trachten danach, die polnische Kultur von der sozialistischen Kultur der Völker anderer sozialistischer Staaten, namentlich von der Kultur der Nachbarn Polens, abzusondern“ (Łopatka 1983, 28). Das so entstandene inoffizielle Kultursystem war für die im Kommunismus lebende Gesellschaft, für deren Bewusstsein und Integration von großer Bedeutung, was sich auf unterschied2

Seit

1970 fand in Kraków – Mistrzejowice das Musikfestival „Sacrosong“ statt. Die Jury des Festivals, zusammengesetzt aus hervorragenden Vertretern der polnischen Musikwelt, vergab mehrere Preise und Auszeichnungen in den Kategorien Chor, Kinderchor sowie Musik- und Gesangsensemble.

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liche Weise zeigte (Dyczewski 1988a, 151–52). Es verband die junge Generation mit der unverfälschten Geschichte und der gesamten polnischen Kultur und half die „weißen Flecken“ aus dem Bewusstsein auszulöschen. Das inoffizielle Kultursystem hielt die Verbindung mit der christlichen und westlichen Kultur aufrecht, mit der die polnische Gesellschaft vom Anfang ihrer Staatlichkeit an verbunden war. Sein Vorhandensein bewirkte, dass in Polen ein pluralistisches und nicht kommunistisch geprägtes, nicht monopolistisches Kulturmodell funktionierte. Das inoffizielle Kultursystem trug wesentlich zur gesellschaftlichen Integration bei und half die nationale Identität zu bewahren. Die unabhängige Kultur in Polen wird mit Recht als Trägerin der christlichen und nationalen Werte bezeichnet. Sie war auch die Widerstandskraft, die das Überleben des Volkes und seiner Tradition erst ermöglichte. Die Sorge der Kirche um die christliche Kultur kommt insbesondere in den Hirtenbriefen der polnischen Bischöfe zum Ausdruck. 102 von 184 Hirtenbriefen der Bischofskonferenz aus den Jahren 1945–1975 enthielten eine Kritik an der gelenkten Laizisierung (Epis­kopat Polski 1975, 27).

Die Gettoisierung der christlichen Kultur und verschiedene Versuche der Atheisierung der unabhängigen Kultur führten dazu, dass die polnische Kultur „auf Jahre hinaus zu einem hoffnungslosen Provinzialismus verurteilt“ war. „Nicht nur in wirtschaftlicher Hinsicht, sondern auch in der Wissenschaft, in der Kunst, in der effizienten Verwaltung und Organisation verschiedenster Lebensbereiche“ war man durch eine „beschämende . . . Rückständigkeit“ gebrandmarkt, obwohl Polen mit seiner alten Kultur und einer der ältesten Universitäten nördlich der Alpen – die Jagiellonische Universität in Krakau wurde 1364 errichtet – „zu den ältesten Kulturstätten des Abendlandes“ zählt. Die Verluste im Bereich der Kultur und Kunst sind enorm, und die Tatsache, dass die polnische Kultur nun wie ein „falsch erzogene[s] . . . Kind [. . .] in das moderne Europa zurückfinden [muss], vertieft die Scham“ (Lobkowicz 1993, 90).

5. Die Kulturlandschaft nach der Wende Die Betrachtung der gesellschaftlichen Landschaft nach der Wende führt zu der deprimierenden Erkenntnis, dass das alte System von der Substanz des Landes gelebt hat und in vielen Bereichen – ökonomisch, ökologisch, aber auch in mancher Hinsicht bildungspolitisch und im Blick auf die politische Kultur der Gesellschaft – eine Wüste hinterlassen hat. as nach dem Sturz der marxistischen Systeme im Osten Europas zutage kam, bestätigt W diese Diagnose. Die wachsten und lautersten Geister der befreiten Völker sprechen von einer ungeheuren seelischen Verwahrlosung, die in den Jahren der geistigen Verbildung eingetreten sei; von einer Abstumpfung des moralischen Sinns, die als Verlust und Gefahr schwerer wiege als die wirtschaftlichen Schäden, die eingetreten sind.

(Ratzinger 1993, 38)

Der Kommunismus hat tiefe „kulturelle Schäden“ hinterlassen. „Sie werden ungleich schwieriger zu überwinden sein als dessen wirtschaftliche Folgen“ (LobEJMH 8:2, December 2013

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1993, 85). Es ist das Erbe der Struktur- bzw. Konturlosigkeit, verbunden mit fehlender Erfahrung, das nicht nur die Wirtschaft und die Politik, sondern die gesamte Kultur des Landes belastet (103). Dies kann dazu beitragen, dass gerade im Scheitern des Kommunismus und in der schwierigen Umbruchzeit sozialistische Ideale eine neue Attraktivität erlangen. Daher wird für die Zukunft entscheidend sein, wie und von wem das im jetzigen Übergang unvermeidliche politische Vakuum ausgefüllt wird. Zunächst gab es Anzeichen dafür, dass das auf die tyrannische marxistisch-leninistische Ideologie folgende Vakuum in den Menschen einen Hunger nach christlichen Werten weckt. Doch wurde dieses Vakuum oft durch rein konsumorientierte Lebenseinstellungen gefüllt. Neue Sinnangebote machten die Sekten, die aus dem Westen ins Land kamen (Zulehner & Tomka 2000, 53).

Diese neue Sachlage zwingt die Kirche, neue Wege zu gehen, um die weitere Entwicklung durch ein christliches Ethos für Gesellschaft und Kultur zu beeinflussen, und dabei die säkulare Gesellschaft mit einzubeziehen (Dylus 1993, 375). Es wird aber immer schwieriger, der Entwicklung in Richtung einer oberflächlichen Konsumgesellschaft mit einem christlichen Ethos entgegenzutreten. Die Kirche darf sich nicht mit Warnungen vor einem Wertverlust begnügen, sondern muss kreativ sein und ihre Werte vorleben (Máté-Tóth 2002, 31). Sie muss also mit allen Mitteln danach trachten, die Welt christlicher zu machen, wenngleich in dem Bewusstsein, dass bestimmte kulturelle Veränderungen nicht mehr rückgängig zu machen sind (Nosowski 2009, 28). Die neue Situation der Kultur nach dem Zusammenbruch des Kommunismus in Polen kowicz

r uft das Gefühl hervor, trotz einer Tradition, die oft älter und geschichtlich nicht selten ruhmreicher ist als jene so mancher westlicher Kulturzentren, nahezu unwiderruflich rückständig, jedenfalls auf Jahrzehnte zum Provinzialismus verurteilt und damit ein Entwicklungsland mitten im Herzen Europas zu sein.

(Lobkowicz 1993, 91) ast noch bedrückender als der Eindruck, man sei dazu verurteilt, weit hinter dem RhythF mus der Gegenwart einherzuhinken, so weit, dass nicht zu sehen ist, wie man ihn aufholen, sich ihm einverleiben könnte, ist der Provinzialismus jener, die nicht einmal in der Lage sind, ihn wahrzunehmen.

(93)

Der Prozess der Freisetzung des Menschen aus gesellschaftlichen Bindungen beschleunigt Erfahrungen, wie sie die Kirche im Westen bereits seit einigen Jahrzehnten beobachten kann: eine offene, liberale Gesellschaft, Kritik an vorgegebenen kirchlichen Verhaltensmustern, ein Abschmelzen religiöser Milieus und ein Nachlassen der prägenden Kraft von Traditionen, eine starke Subjektivierung des Glaubensvollzugs, verbunden mit öffentlicher Kritik an der Institution Kirche, ein Auswahlchristentum, das Verbindlichkeiten meidet. Dieser Prozess bedeutet auch, dass die verspätet und umso heftiger über die polnische Gesellschaft hereinbrechende Säkularisierungswelle auf ein unvorbereitetes Kirchenvolk getroffen ist. Der häufig als „laizistisch“ bezeichneten normativ prägenden Kraft der Moderne steht ein wehrloses (Kirchen)volk gegenüber. Aufgrund des vorausgegangenen kulturellen und sozialen Wandels der polnischen Gesellschaft sind nun viele Katholiken gesell-

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schaftlichen Strömungen ausgesetzt. Die Verbreitung eines gottlosen Lebensstils hat die fundamentalen Wertvorstellungen vieler Menschen verändert.

Diese neue Situation hat die Kirche in Polen zu einer Veränderung ihrer Positionsbestimmungen auf dem freien Markt der ethischen, kulturellen und religiösen Werte gezwungen. Wegen der Zunahme des Individualismus und der Pluralisierung aller Lebensbereiche müssen religiöse Werte nunmehr mit anderen Werten bzw. Wertsystemen konkurrieren. Die Einstellungen der Katholiken zum kulturellen Pluralismus in der heutigen Gesellschaft reichen von vollständiger Ablehnung bis zu kritikloser Akzeptanz. Bei gläubigen Menschen kann eine Befürwortung des Individualismus und der Privatisierung des Glaubens bisweilen auch einem intensiven Gefühl der Entfremdung in der modernen Kultur entspringen (Nosowski 2009, 28–29). Auf diesen Prozess hat bereits Paul VI. hingewiesen. Er sprach von einem Drama der Spaltung, das sich zwischen dem Evangelium und der modernen Kultur ereignet habe und das eigentliche Drama unserer Epoche sei: er Bruch zwischen Evangelium und Kultur ist ohne Zweifel das Drama unserer Zeit. DesD halb muss alles getan werden, um eine vollständige Evangelisierung der Kultur zu gewährleisten, oder richtiger der Kulturen. Letztere müssen durch die Begegnung mit dem Evangelium regeneriert werden.

(Paul VI. 1975, 20)

Das Wort „Bruch“ stimmt immer pessimistisch, was Backhaus treffend auf den Punkt bringt. Man denke in diesem Zusammenhang an einen „Achsenbruch“ und schon sehe man das allradgetriebene Fahrzeug einer evangelisierten Kultur tief steckenbleiben im morasti-

gen Übergangsgelände zum neuen Jahrtausend. Oder denkt man an den „Ehebruch“: nach siebzehn Jahrhunderten ist die heilige Allianz bedroht, nimmt sich doch der kultiviere Ehemann – während zu Hause das Evangelium in kleinkarierter Schürze die Hände ringt – das Recht zur midlife crisis, der Kirchgängerei überdrüssig, droht er, das Haushaltsgeld zu sperren, und kann den Verlockungen einer neuen Freiheit nicht länger widerstehen. Oder denkt man schließlich an den „Knochenbruch“, den das Evangelium sich zuzieht beim Versuch, kultiviert Schritt zu halten beim Übergang in eine neue Zeit.

(Backhaus 2000, 19)

Eine besondere Brisanz erhält dieser Bruch zwischen dem Evangelium des christlichen Glaubens und der modernen Kultur dadurch, dass das christliche Glaubensleben derzeit vor einem Epochenwechsel steht (Koch 2000, 201–02). Mit dem Schisma zwischen Evangelium und der modernen Kultur dürfen sich Christen nie abfinden, weshalb all ihre Bemühungen auf die Überwindung dieses Schismas zielen müssen. Papst Benedikt XVI. war der Ansicht, der dramatische Bruch zwischen dem Evangelium und der modernen Kultur ließe sich am besten auf dem Wege der Evangelisierung überwinden (Koch 2007, 213). Das bedeutet, dass die Kirche angesichts der kulturellen Strömungen unserer Zeit ihren kulturell engagierten Gläubigen ständig als Gesprächspartner zur Verfügung stehen muss (Aračić et al. 2001, 214).

Diese Forderung nach einem Dialog zwischen Kirche und Kultur unterstrich Papst Paul VI. bereits in seiner Enzyklika „Ecclesiam Suam“: „Die Kirche muss zu einem Dialog mit der Welt kommen. . . . Die Kirche macht sich selbst zum Wort, zur BotEJMH 8:2, December 2013

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schaft und zum Dialog“ (Paul VI. 1964, 65). In diesem Zusammenhang darf die missionarische Dimension des Dialogs nicht übersehen werden. Die Dialogfähigkeit der Kirche scheint auch eine wichtige Voraussetzung im Umgang der Kirche mit den Phänomenen der pluralistischen Kultur zu sein. K. Koch bezeichnet den Dialog als „Lebenselixier des Pluralismus“ (1996, 88), das auch der Kirche helfen könne, mit den Spannungen und Herausforderungen der pluralistischen Gesellschaft fertig zu werden.

Auch die Kirche in Polen hat diese Forderung nach einem Dialog mit der modernen pluralistischen Kultur verstanden. Auf besondere Weise um diesen Dialog bemüht war Bischof Życiński, der die im Dialog mit der Gesellschaft stehende polnische Kirche als „Kirche am Jakobsbrunnen“ (1996, 41–42) bezeichnete. Die mangelnde Dialogbereitschaft der Volkskirche kann gemäß Życiński zu Konflikten zwischen der Kirche und den Vertretern intellektueller Kreise führen. Wenn an die Stelle einer Atmosphäre von Dialog und Öffnung eine Festungsmentalität tritt, führt das im Endeffekt dazu, dass der Leerraum, den die Mutter Kirche hinterlassen hat, eilfertig von antiklerikalen „Adoptionsprofis“ besetzt wird (21).

Zuweilen wird der mangelnde Dialog zwischen Kirche und Kultur sogar als „vertane Chance“ bezeichnet. An die Stelle des Gesprächs traten in Polen nach der Wende Kampf und Propaganda ausschließlich politischer Art (Sabor 2009, 71). Wie es scheint, ist nicht das geschehen, was weiterhin unabdingbar erscheint: Die Begegnung derer, die Fragen stellen wollen, mit denen, die Antworten hören wollen (72).

Seitens der Hierarchie bemühte sich vor allem Bischof Życiński um eine Versöhnung zwischen der liberalen Kultur und der Kirche (Gowin 1995, 215). Viele waren und sind jedoch nach wie vor davon überzeugt, dass es das Gebot der Stunde ist, die Tendenzen zur Laizisierung mit allen Kräften zu bekämpfen. Polonia semper fidelis (Polen immerdar treu) bedeutet, dass Polen auch heute ein Brückenkopf des wahren Glaubens in Europa sein muss. Befürworter dieser Idee sind überzeugt: „Wir haben den Ansturm der Schweden überstanden, wir haben den Ansturm der Sowjets überstanden, wir werden auch den Ansturm des Liberalismus überstehen“ (Nosowski 2009, 31).

Die Kultur ist ein besonders wichtiges Anliegen. Unter Kultur versteht man alles, odurch der Mensch seine vielen körperlichen und seelischen Qualitäten entwickelt und w perfektioniert. Er bemüht sich durch sein Wissen und seine Arbeitskraft, die Welt selbst unter seine Kontrolle zu bringen (Gaudium et spes 1965, 53).

Kultur ist demnach die Frucht der Suche des Menschen nach der eigenen Identität und gleichzeitig der Versuch des Menschen, die Wahrheit über sich selbst zu sagen. Die durch verschiedene Kulturen geprägten Ausdrucksformen, die der Mensch entwickelt hat, äußern sich auch stets bei seiner Suche nach Gott (Koch 2007, 213).

Viele sehen darin eine große Chance für die Kirche, mit ihrer Kultur der christlich-ethischen Werte ein „Sauerteig“ für die heutige Gesellschaft zu werden. Um diese Aufgabe erfüllen zu können, muss die Kirche nach Ansicht von Zulehner

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und Tomka auch eine innere Wende vollziehen, die teils den Herausforderungen der Zeit entspricht, teils eine Bindung an die glaubwürdige Verkündigung ist (2000, 32). Christsein bedeutet in diesem Zusammenhang ganz wesentlich die Verpflichtung, in allen Lebensbereichen vom Evangelium Zeugnis abzulegen: in Familie, Gemeinschaft, Kultur und Wissenschaft, aber auch in Wirtschaft und Politik. Die christlichen Werte sind die charakteristische intellektuelle und geistige Leistung schlechthin, die die europäische Identität über Jahrhunderte geprägt hat. Sie gehören in die Schatzkammer der Kultur dieses Kontinents (Episkopat Polski 2004). Deshalb sollten die Menschen in der Kirche nicht nur ermutigt werden, das Evangelium in sich aufzunehmen, sondern auch dazu, ihre Kraft als gläubige Menschen in die Weiterentwicklung von Kultur und Gesellschaft einzubringen (Zulehner & Tomka 2000, 61). Diese Aufgabe scheint enorm wichtig zu sein, weil die Oberflächlichkeit in der heutigen pluralistischen und hektischen Gesellschaft das natürliche Bedürfnis nach Glauben und nach Durchdringung des Lebens durch das Geheimnis abgetötet hat. Diese gesellschaftliche Tendenz ist vielleicht auch damit verbunden, dass das Gespür für das Geheimnis mehr und mehr auf die Frage begrenzt wird, was für einen Geschmack der nächste Hamburger von McDonald’s haben wird (Życiński 1996, 37). Die gesellschaftlichen Erfahrungen nach der Wende zeigen eindeutig, dass eine Durchdringung des gesellschaftlichen Lebens durch die christlich geprägten Werte nicht leicht zu bewerkstelligen ist. Denn der Glaube in der heutigen Gesellschaft ist stark durch die Individualisierung beeinflusst, die der Faszination durch die Veränderungen der modernen Welt geschuldet ist. In der gegenwärtigen Kultur dominiert die Ansicht, dass Religiosität eine rein private Angelegenheit ist (Nosowski 2009, 28).

Wer sich aber mit der Privatisierung des Glaubens einverstanden erklärt, verzichtet darauf, auf die Kultur und das gesellschaftliche Leben Einfluss zu nehmen (31).

Der Weg der kirchlichen Auseinandersetzung mit dem Wertewandel und den Phänomenen der modernen Kultur ist ein Versuch, einen neuen Weg zwischen „dem Pfad von Simone de Beauvoir und dem Bokassaweg“ (Życiński 1996, 175) zu gehen. Und dieser Weg verlangt von der Kirche, den Mut aufzubringen, mit „neuzeitlichen Mitteln gegen die Neuzeit anzutreten“ (Stolz 1990, 378). In diesem Zusammenhang scheint es das Gebot der Stunde zu sein, „diesen Wertewandel nicht nur ernst zu nehmen, sondern auch im Rahmen des Möglichen zu steuern“ (Lobkowicz 1993, 290). Es bedeutet für die Kirche keinesfalls, s ich nicht an ihren durch Offenbarung und Tradition gegebenen Werten zu orientieren . . . [und] den Himmel vorwegnehmen zu wollen. Die gefundenen Lösungen sind nicht schon als Endlösungen, sondern als vielleicht für die konkrete Situation bestmögliche Lösungen zu betrachten, die aber der dauernden Anpassung und Verbesserung bedürfen.

(Neuhold 1993, 158)

Für die polnischen Verhältnisse bedeutet dies den Versuch, das Joch des atheistischen Nihilismus abzuschütteln, das Riff des Materialismus, der religiösen Gleichgültigkeit und des Relativismus zu meiden (Gowin 1995, 96). Dabei sollte auch die Shakespeare’sche Neigung zum Dramatisieren der Wirklichkeit (Życiński 1996,

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200) und der kontraproduktive Neid, der jeden „im Höllchen eigener Komplexe seine Trauer zelebrieren“3 lässt, gemieden werden (204).

Obwohl die Frohbotschaft des Christentums im Kern nicht identisch mit den einzelnen Kulturen ist, kann sie nur in diesen Kulturen leben (Gutheinz 1985, 110).

Deshalb ist die gegenseitige Beziehung zwischen Kultur und Glaube so wichtig. Der christliche Glaube vermag ohne konkrete Inkulturationen gar nicht zu leben. Hier drängt sich der Vergleich mit dem Alkohol auf: Wie dieser ohne Verbindung mit anderen Substanzen und Aromen verdunstet und sich auflöst, kann auch der christliche Glaube nicht leben, wenn er nicht in einer konkreten Lebenswelt der Menschen verwurzelt ist (Koch 1996, 217). Und die elementarste Provokation an die katholische Theologie, die den revolutionären Wandel von der ehemals allein europäischen und deshalb monokulturellen West-Kirche zur heutigen universal und deshalb kulturell polyzentrisch gewordenen Welt-Kirche sensibel wahrnimmt und denkerisch verbreitet, stellt das ganz grundsätzliche Problem dar, das gegenwärtig unter den Stichworten Inkulturation und Indigenisation verhandelt wird: Weil die Kirche wesentlich mit der Kultur und ihrer Krise verbunden ist, ist sie gewissermaßen auch dazu gezwungen, deren Schicksal zu teilen (Kehl 1994, 41, vgl. auch ausführlicher 1996).

Deshalb ist auch die Kirche in der heutigen Gesellschaft einem starken Erosionsprozess ausgesetzt, der in einem engen Zusammenhang mit der Situation der gesamten modernen und postmodernen Kultur steht: Die großen Kirchen sind massiv mit den gegenwärtigen Krisenphänomenen unserer neuzeitlichen Kultur verstrickt und teilen darum auf ihre Weise die Problematik dieser Kultur.

Die tiefe Verbundenheit zwischen Kirche und Kultur, das Bewusstsein des geistigen und kulturellen Erbes der vergangenen Jahrhunderte und dessen unauflösliche Verbindung mit dem Christentum bewirken, dass die Christen in Polen nicht auf das verzichten können und wollen, was einen unveräußerlichen Teil der nationalen und religiösen Identität ausmacht. Die Christen, die das Antlitz der geistigen Kultur über Jahrhunderte geprägt haben, wollen auch heute an der neuen europäischen Wirklichkeit gleichberechtigt mit anderen Europäern mitwirken. Sie müssen jedoch vorher eine wichtige Frage beantworten: ie kann man für die Dynamik und Expansion der neuen Kultur eintreten, ohne daß die W lebendige Treue zum überlieferten Erbe verlorengeht? Dies ist schon deshalb ein besonders drängendes Problem, weil die Kultur, die aus dem ungeheuren Fortschritt der Naturwissenschaft und der Technik entsteht, zur Einheit gefügt werden muß mit jener Geisteskultur, die von denjenigen Studien lebt, die entsprechend den verschiedenen Überlieferungen als klassisch gelten.

(Gaudium et spes 1965, 56).

3

igene Übersetzung. Originaltext: „piekiełko pełne kompleksów, gdzie każdy egoistycznie będzie celebrował E swoje własne smutki“.

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EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 232–264 DOI: 10.5708/EJMH.8.2013.2.4

Jozef Hašto* & Hana Vojtová

POSTTRAUMATIC STRESS DISORDER Bio-Psycho-Social Aspects, Eye Movement Desensitisation and Reprocessing and Autogenic Training in Persistent Stress** Case Study, Part 2 (Received: 10 October 2012; accepted: 05 December 2012) ‘There is one more thing I would like to add: It wouldn’t be bad if for once truth and love prevailed over lies and hatred.’

(Václav Havel, 1997, our trans.)1

In our case study, we illustrate the use of Eye Movement Desensitisation and Reprocessing (EMDR) and Autogenic Training (AT) in PTSD treatment. EMDR was used to manage the acute symptoms, while AT was used to enhance the resilience in persisting stress. Using the bio-psychosocial model of mental illness, we discuss the socio-political and socio-psychological aspects of this case that has put a burden on the relationship of two neighboring nations (Slovakia and Hungary) as well as on the relationship of the national majority and a minority within our country (Slovakia). Our patient consented to this report being published, and we hope that it will contribute to a more realistic evaluation of this event in society. *

**

1

orresponding author: Jozef Hašto, Psychiatric Clinic Pro mente sana, Palackeho 21, SK-91101 Trenčín, C Slovakia, j.hasto.tn@gmail.com.

This article was supported by the project OP VK named ‘Social determinants of health by socially and health disadvantaged and other groups of population’ (CZ.1.07/2.3.00/20.0063).

Original text: ‘Pravda a láska musí zvítězit nad lží a nenávistí.’ In a speech at a demonstration in Prague on 10 Dec 1989, shown live on the Czechoslovakian TV, Václav Havel said, ‘Truth and love must prevail over lies and hatred’ (our trans.). Later, it became one of Havel’s most famous remarks. His critics, however, ridiculed it for being naive, simplistic and childish. Years later (on 1 Jan 1997), Havel self-ironically alluded to this quote in another TV interview when his last words to the camera were: ‘There is one more thing I would like to add: It wouldn’t be bad if for once truth and love prevailed over lies and hatred’ (our trans.). Original text: ‘A ještě jeden pocit bych chtěl říct. Vůbec by nezaškodilo, kdyby tu a tam zvítězila láska nad lží a nenávistí.’

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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Keywords: posttraumatic stress disorder, bio-psycho-social model, therapy, psychotherapy, Eye Movement Desensitisation and Reprocessing, Autogenic Training, case study Posttraumatisches Stresssyndrom: Biologische und soziale Bezüge, Desensibilisierung durch Augenbewegungen und Erlebnisumstrukturierung sowie autogenes Training bei Dauerstress: Fallstudie, Teil 2: In unserer Studie beschreiben wir die Anwendung der Desensibilisierung durch Augenbewegungen (Eye Movement Desensitisation and Reprocessing – EMDR) bzw. des autogenen Trainings (AT) in der Behandlung des posttraumatischen Stresssyndroms (PTSD).

EMDR dient der Milderung der akuten Symptome, AT der Verbesserung des Widerstands gegen Dauerstress. Unter Anwendung des biopsychosozialen Modells der mentalen Probleme untersuchten wir die sozialpolitischen sowie sozialpsychologischen Aspekte eines Falles, der die Beziehung zweier benachbarter Länder (Slowakei und Ungarn) und das Verhältnis zwischen nationaler Mehrheit und einer der Minderheiten beeinträchtigt. Der Patient hat in die Veröffentlichung des Berichts eingewilligt, und nun hoffen wir, zu einer objektiveren Beurteilung des Falles in der Gesellschaft beitragen zu können.

Schlüsselbegriffe: Posttraumatisches Stresssyndrom, biopsychosoziales Modell, Therapie, Psychotherapie, Desensibilisierung durch Augenbewegungen und Erlebnisumstrukturierung, autogenes Training, Fallstudie

1. The case We are going to describe the case of the university student Hedviga Malinová, a citizen of the Slovak Republic of Hungarian nationality. She read Hungarian and German at the university. At the time of traumatisation, she was 23 years old. At the time of publication, she is 30 years old. She graduated from the university and obtained a Master’s degree, is married and a mother of two children. On account of this case study being public knowledge, and in order to prevent further complications, we do not withhold the patient’s identity. The patient has given us written and oral consent to publish information on her medical state and her history. Consent has also been given by her legal attorney. An overview of the case has also been published (in Slovak) by Marie Vrabcová (2009, 2010) and can be presently found at the websites www.tyzden.sk and www.fair-play.sk.

In order to make the information more transparent, we first briefly outline the traumatic events. Later we describe the case in more detail. Hedviga Malinová has suffered three serious mental traumata. Furthermore, several other long-term stressors resulted from these. First, she was attacked by two unknown men while walking to the university to take an exam in her course on Hungarian. The second traumatisation was the police interrogation regarding the attack. Finally, a stranger entered the apartment where Malinová and her partner lived, and thereafter she was threatened by a woman who presented her photographs of their messy apartment and a photograph of their car from below. Additionally, she was subjected to the pressures of ruling politicians, groundless prosecution and the media.

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2. Traumatic events On the morning of 25 August 2006 the patient was walking through a park by a road to take an exam in her course on Hungarian. In the park, she was assaulted by two bald men. Their first words were: ‘In Slovakia, in Slovak!’ She was violently dragged off the road; she was being abased and beaten. The last thing she remembered was that the men punched her stomach and she fell, hitting her head. She regained consciousness when the assailants had left. She felt nauseated and weak; she had a headache and difficulties realising what had happened and what she should do. When she arrived at the university, her colleagues and teachers discovered a sentence written on her blouse: ‘Hungarians behind the Danube, SK without parasites’. They called for medical help and the patient was treated at the hospital. On 9 September 2006 she was summoned for an interrogation and told it was for the identification of the offenders. However, this did not happen. During a strenuous six-hour interrogation, she was being pressured to falsely confess that she had lied and made the whole thing up. She did not give in. On 12 September 2006 the Prime Minister and the Minister of Interior Affairs gave a press conference claiming that ‘the incident did not occur’.

The case was a subject of intense media interest. However, the media failed to note that the Prime Minister, the Minister of Interior Affairs and the Chief of Police publically concluded Hedviga’s guilt before the investigation was legally closed.

The last of the three main traumatic events happened while the patient was receiving psychotherapy. On the night from 20 to 21 November 2006, unknown persons broke into the apartment where she lived with her partner. They left the furniture doors open, the drawers pulled out, and the entrance door was left open, too.

The keys that were originally in the lock from inside were placed on the doormat.

The door of the car of Hedviga’s partner was left open, too. He reported the event to the police; Hedviga took a bus to school. On the bus a woman sitting next to her was looking at A4 size photographs showing the apartment as they had found it that morning as well as photographs of the car taken from below. The woman was accompanied by another female person standing in the aisle, and after a while both women got off the bus. Hedviga was scared and uncertain how to react. Should she shout? Stay quiet? She was afraid something might happen to her partner. They might have done something to his car. He was about to travel. She tried to reach him on her cell phone, but it did not work although the battery was functioning. Later she tested it, and the phone was neither able to send text messages nor to receive texts or phone calls. It remained in this condition until 3 p.m. of that day when it started working again, without being repaired.

On 10 November 2006 the prosecutor formally opened a case against the patient. On 14 May 2007 the police accused Hedviga Malinová of false testimony and perjury. The case is still open as of November 2011, though the trial has revealed many abuses and falsehoods on the part of the police and the political representatives, as has been repeatedly emphasised by the patient’s attorney. Hedviga Žáková-

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Malinová has since married, but kept her maiden name in the hope that the case will be favourably resolved and her name cleared.

The public has been largely misinformed about the case, which has subjected Hedviga to further long-term stress. Instead of receiving support as a victim of violent crime, she has been ridiculed by a large part of the public. In our opinion, three factors have contributed to this public misperception: First, a mistrustful attitude towards Hungarians living in Slovakia; second, the energetic and misleading commentary by political representatives; and third – and this is perhaps the most troubling –, circumstantial DNA evidence against Hedviga’s telling of the events. Several days after the assault, Hedviga received an envelope from an anonymous sender containing stolen documents. The biological traces from under the postal stamp were analysed and the patient’s DNA was found. Hedviga provided the following explanation: After she was told by the police to bring the envelope in its original state, she discovered that the stamp had fallen off. To comply with the police’s order, she pasted the stamp back on the envelope with her finger and saliva. This explanation was not widely reported in the media. The suggestive strength of DNA evidence was consciously misused by the media, and several otherwise critically thinking individuals gave in to its power. We are going to discuss this and further misunderstandings in the conclusion in more detail. A comprehensive summary of the case can be found in Vrabcová (2009, 2010).

3. A short overview of the diagnosis and treatment The patient received outpatient psychiatric care from 2 November 2006 to 5 May 2008. Overall she had 47 diagnostic and therapeutic sessions, and each session lasted between 75 minutes and 3 hours 50 minutes. The intervals between the sessions were 4 to 38 days. Hana Vojtová MSc, a clinical psychologist and the co-author of this study, was present at the sessions as an observer and recorder. She also assessed the patient using several psycho-diagnostic tests and scales. First, we appointed a working diagnosis. After several hours of clinical interviews and psycho-diagnostic assessment, this working diagnosis was confirmed.

Diagnostic conclusion: Posttraumatic stress disorder F43.1 (ICD-10, WHO); 309.81 (DSM-IV, APA).

Factors influencing health status and contact with health services (‘Z codes’ according to ICD-10): Z65.4 Victim of crime or torture (Freedom of movement restricted by physical violence; being forced into unwanted behaviour – taking off her clothes and handing in her documents; punches into her face and other body parts; participating in a situ­ation where the consequences of her actions on further violence could not be foreseen; risk of potential rape – memory loss due to a concussion and a fresh haem­ atoma on the thighs.)

Z65.8 Other specified problems related to psychosocial circumstances (Libel from high political representatives, e.g. from Prime Minister Dr Robert Fico, MinisEJMH 8:2, December 2013

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ter of Interior Affairs Dr Robert Kaliňák, and Chief of Police Dr Ján Packa, and media pressure including disparaging disinformation and attacks in online discussions.)

Z65.3 Problems related to other legal circumstances, e.g. prosecution (She is being prosecuted for ‘false testimony’ by the Chief Public Prosecutor’s Office of the Slovak Republic, although the nature of her false testimony has never been specified.

At the same time, the investigation of the assault was suspended with the explanation that it ‘did not happen’.)

Z60.5 Target of perceived adverse discrimination and persecution (Verbal and physical assault on account of speaking Hungarian; the statement ‘In Slovakia, in Slovak’; the sentence ‘Hungarians behind the Danube, SK without parasites’ found on her blouse after regaining consciousness; the stressful police investigation while she was still in the role of a victim; the role changes from ‘victim’ to ‘perpetrator’ according to the Chief Public Prosecutor’s Office and the police; disparaging statements from the public; sophisticated intimidation from the unknown trespassers; invasion of her privacy and the hint that her partner might be in danger.)

Z60.8 Other problems related to social environment (She witnesses the suffering of her beloved ones, especially of her parents and partner, because of the problems she has to face but has not caused.)

Degree of disability according to the WHO scale (WHO-DS): A = 0; B = 2,5; C = 1; D = 2.

Therapy: supportive psychotherapy using specific methods of trauma processing (EMDR – Eye Movement Desensitisation and Reprocessing) and later autogenic training according to J.H. Schultz to increase and enhance resilience in persistent stress (Z65.3; Z60.8 and partially Z65.8).

4. Details of the diagnostics, therapy and catamnesis The patient was referred to one of the authors (J. H.) with the aim of establishing a diagnosis and considering therapeutic options. She was referred by psychiatrist and psychotherapist, senior consultant Peter Breier, M.D. who is also President of the League for Mental Health. He on his part had been consulted by Dr Roman Kvasnica, the patient’s future attorney.

4.1. Beginning of the therapy During the first examination, we learned that on 31 August 2006 the patient had visited an outpatient psychiatrist close to her domicile. According to the medical report she stated that she had been assaulted, threatened, and beaten. She could not remember certain events, she was afraid, was repeatedly being contacted by the media, although she only wished to forget everything. ‘I never thought I would need a psychiatrist.’ The psychiatrist noticed a higher anxiety level and attention focused EJMH 8:2, December 2013

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on the given event, and he diagnosed anxiety and depressive disorder. As for therapy, he recommended psychotherapy and prescribed 10 mg of the antidepressant Cipralex (s-citalopram) in the morning and 0.5 mg of the anxiolytic Xanax (alprazolam) twice a day, in the morning and in the evening. During her second visit on 9 September 2006, the patient stated that on Saturday morning at 7 a.m. she had been summoned by the police to identify the perpetrators. At the police station, however, this was not even mentioned. Instead, six policemen interrogated her, claiming that her story was a fabrication and that she would be taken into pre-trial custody. The psychiatrist observed decompensation due to the ‘police terror’ in the city of N. He described insomnia and anxiety. He augmented the pharmacotherapy by the hypnotic Stilnox (zolpidem). On 9 September 2006 the psychiatrist wrote that according to the patient, she had experienced the worst week of her life. ‘It is very difficult for me to cope with the lies I am being accused of, I know I am right, and I am trying to prove it, but the majority is against me, they claim I wasn’t beaten… I believe the truth will overcome, that is my only hope.’ The psychiatrist described depressive mood, fleeting lachrymosity, feelings of uncertainty, distrust, and disappointment. He also described ongoing insomnia and tension.

During our first informative psychiatric examination (2 November 2006), we found clear symptoms of posttraumatic stress disorder (PTSD). The patient suffered from flashbacks with very unpleasant emotional (anxiety, helplessness) and somatic (heart racing, uncomfortable feeling of warmth in her back and in her stomach, tremor, headaches and pain in her thigh) responses. These were usually triggered by situations resembling the assault. The patient later described these situations in detail, for example walking alone and seeing male figures behind her, especially if they were bald, or going from the bus stop to the university through the park. Other situations included leaving the house alone, entering the dormitory, as she imagined the assailants could be hidden there, or speaking among people, either in Slovak or in Hungarian. The patient also complained of irritability that she was not quite able to control. The irritability occurred in communication with close people, for ex­ample with her father and her partner, Peter, with whom she had had a good and stable relationship. Her sleep was fragmented, and she had problems concentrating, for example while studying. She tended to avoid all thoughts and situations resembling the traumatic event, and she could not remember some parts of the traumatic situation.

When hearing misinformation on TV, radio, or online, she felt restless and had an impulse to run out on the street and shout: ‘People, for God’s sake, don’t believe it, it is a lie!’ According to Malinová, this misinformation concerned questions of whether she did or did not make a phone call, whether her ATM card was or was not blocked, when and how the accident happened, the way her biological material got on the envelope, the manner in which the sentence was written on her blouse, and more.

All misleading information was either released by the Ministry of Interior Affairs or resulted from ‘findings’ of experts appointed by the police, and such statements could be easily identified as false. It is interesting to ponder whether the campaign of misinformation was produced deliberately, for political benefit, or whether wishful EJMH 8:2, December 2013

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thinking (Peters 2011; Ciompi 1997; Ciompi & Endert 2011), hostility and other motives played a role. We are going to consider this subject in more detail and in a broader context in the concluding remarks.

During the first examination in Trenčín (Trencsén) on 2 November 2006 the patient said: ‘I want to be strong, but I am not, when I am alone, I cry a lot… I keep living in stress, I especially hate the town and don’t go there very often… On Saturday I already feel stressed that I have to go there on Monday… Yes, before the attack, it was normal… I am afraid to go there, I am afraid to go out on the street, I might meet those two men, I don’t feel safe there, I am terribly afraid to go there… they might be waiting for me in the dormitory… I am always with a friend, I never go anywhere without her… a very good friend… I don’t feel safe there, I don’t go there alone… it has been like this for 9 weeks (from 8 August 2006). When I am going with my friend through the park, I try to think of something else, or I start singing, only in my head… sometimes it helps, but usually it doesn’t.’

We asked the patient to evaluate the distress caused by the negative emotions when remembering the event, using the Subjective Units of Disturbance Scale (SUDS). It is a scale of 0 to 10, where 0 means ‘no distress’ and 10 means ‘maximal distress’. The patient’s response was 7–8. The clinical symptoms included: anxiety, helplessness, the memory of the assault coloured by anger and disgust, unwanted reliving, repeated intrusive memories of the traumatic situation, mental distress in situations resembling the trauma as well as uncomfortable somatic symptoms when remembering it. There was a tendency to avoidance behaviour, conscious avoidance of thought and emotions connected to the traumatic event as well as conscious avoidance of activities and situations evoking memories of the trauma. Furthermore, we found inability to remember details of the traumatic event even apart from the memory loss due to the concussion diagnosed by a neurologist, ongoing hyper-arousal, difficulties falling and staying asleep, irritability, and attention and concentration deficits. Episodically, there was sadness and crying. The patient had full amnesia regarding the strikes which led to wounds on her nose and her left cheekbone, as well as the subsequent events over the next 15–20 minutes. For example, she could not remember why she had a haematoma on her thighs or how the assailants wrote on her blouse, nor did she remember her assailants leaving. Considering the PTSD diagnosis, we recommended further diagnostics and psychotherapy, since pharmacotherapy is seldom effective. We informed the patient that there were several options. She could either continue her treatment with her previous outpatient psychiatrist, or, in case he did not specialise in psycho-traumatology, she could find another psych­iatrist or clinical psychologist specialised in psychotherapy and psycho-traumatology close to her domicile. Travelling 127 kms from Dunajská Streda (Dunaszerdahely), her hometown, to Trenčín (Trencsén) might be difficult. After considering her options, however, the patient preferred to continue her treatment in Trenčín (Trencsén). She agreed with her father and Peter, her future husband that they would drive her.

During the first ten sessions, we focused on detailing the patient’s history and refining the diagnosis and symptomatology. We evaluated her premorbid personalEJMH 8:2, December 2013

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ity, degree of disability, intelligence, and her truthfulness and credibility. Simultan­ eously with the diagnostic process, we offered the patient stabilising interventions to compensate the uncontrollable traumatic memories.

4.2. Further medical findings and reconstruction of the traumatic event The following findings of physicians from the University Hospital in Nitra (Nyitra) come from medical reports or from deposition under oath. The emergency physician who cared for the patient on the day of the assault later testified, on 18 June 2008, on the basis of her medical records. She stated that on 25 August 2006 she came by ambulance to the patient who ‘was very scared and distraught, she had a full body tremor . . . her pupils . . . were widened to 4 mm’. The physician also found increased blood pressure (150/80) and increased heart rate (150/min). She noticed a wound on the patient’s face and a haematoma on her thighs. She administered 10 mg of diaze­ pam intramuscularly.

Physicians at the Department of Traumatology of the University Hospital in ­Nitra (Nyitra) found ‘facial oedema in the left zygomatic region and in the nose radix, pain on palpation of the oedematous areas . . . oedema and a small laceration of the lower lip left . . . dried blood from the earring holes on the earlobes, mild oedema bilaterally, pain on palpation in the jaw left, pain on palpation of the molars left . . .

Extremities: reddening and sensibility on palpation of anteromedial thighs.’

A neurologist who examined the patient found increased tension, anxiety, anterograde amnesia of approximately 15–20 minutes, oedema in the left zygomatic region. Diagnostic conclusion: Commotio cerebri, contusio faciei, contusio auriculae bilat, neurologically acute stress disorder of a mild degree, and further traumatological diagnoses. (Our comment: The patient had already been tranquilised by Diazepam 10 mg i.m.)

In the discharge summary from the Department of Traumatology on 25 August 2006 the following diagnoses are stated: Commotio cerebri, Contusio faciei l.sin. et nasi, Contusio mandibulae l.sin., Contusio et excoriation auricualae bilat., Contusio par. abdominis et reg. femoris bilat.

The computer tomography (CT) of the brain, thorax and abdomen was done on 25 August 2006 at 10.42 a.m. It showed ‘no clear signs of traumatic changes’. Specific CT projections focused on the soft facial tissues were not done, since the injury was clinically unambiguous. However, further analysis of the CT scan showed that ‘there is an oedema of the soft subcutaneous structures in the left zygomatic region – the thickness of the cutis and subcutis in this area is 21 mm and 17 mm collaterally.

Similarly, there is an oedema of the soft cutaneous and subcutaneous structures in the nose radix and facial regions.’ These findings come from a CT evaluation by a highly qualified radiologist, and are fully concordant with the clinical findings.

Based on the patient’s anamnestic information as well as on the findings from the University Hospital in Nitra (Nyitra) – especially the injuries of the left zygoEJMH 8:2, December 2013

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matic region and nose radix captured also on the CT scan –, we can hypothetically reconstruct the most probable course of events. The patient remembered that the men slapped her left cheek twice. This is probably how her lower lip got wounded. The patient also remembered seeing blood on her finger, falling to the ground after the second slap, and being punched in her lower abdomen. She did not remember what happened next. The next thing she did remember was getting up from the ground. The assailants had already left. We can assume that after being punched in her abdomen, the patient still stood up and got two other punches on her left cheekbone and her nose radix, probably with a fist. The other possibility is that she remained on the ground and was kicked twice in these areas. These last two punches probably led to the concussion and the short retrograde and anterograde amnesia with the estimated duration of 15–20 minutes. We can assume that it was during the time the patient suffered from a consciousness disturbance that the assailants wrote the sentence ‘Hungarians behind the Danube, SK without parasites’ on the back of her blouse. Even in free associations during the trauma processing, the patient could not remember anything about the assailants writing on her blouse. Neither was she able to recollect anything about the haematoma on her thighs. It is possible that in that transitional stage when her consciousness, which she was about to regain, was still in an altered state – LOC: level of consciousness (Malec 1999), clouded consciousness (Peters 2011) –, she spontaneously resisted a manipulation with her lower extremities.

For completeness’ sake we conclude this section with thoughts on differential diagnosis. A disturbance of consciousness followed by amnesia might also be caused by dissociative amnesia or by a vasovagal syncope. However, the persistence of the amnesia even during trauma processing indicates against dissociative amnesia. A vasovagal syncope might have been caused either by an emotionally induced parasympathetic hyperactivity or reflexively by the punches to the lower abdomen. If this was the case, the patient would have suffered the slaps to her left cheekbone and her nose radix while already unconscious. In our opinion, however, the global clinical findings as well as the results of the CT scan indicate rather the simplest explan­ation which is concussion. As mentioned previously, the neurologist shared this view, too.

This does not exclude a combination of a vasovagal syncope and a consecutive concussion caused by further punches.

4.3. Further diagnostic procedures The clinical assessment of the patient confirmed the PTSD diagnosis according to the International Classification of Diseases (ICD-10) (Smolík 2002) of the World Health Organisation (WHO). In the course of the first sessions, we also used the Structured Clinical Interview for DSM-IV (Margraf 1994). On 2 November 2006 we found 9 out of 17 possible symptoms, the diagnostic threshold being 6 symptoms. We also administered the Impact of Event Scale – Revised (IES-R) (Weiss & Marmar 1996). On 10 November 2006 the patient’s total symptom score was 44; EJMH 8:2, December 2013

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on 9 February 2007 it was 45, the maximal score being 88. The cutoff score is 35.

On 2 November 2006 we evaluated the degree of disability according to the WHO scale (WHO-DS) where 0 means ‘no disability’ and 5 means ‘serious disability’. The evaluation included the past 9 weeks. The patient’s scores were 0 for ‘self-care’, 2.5 for ‘work’, 1 for ‘family and household’, and 2 for ‘broader social context’. We also administered the Raven Progressive Matrices Test measuring general intelligence.

The results indicated above average intelligence.

Apart from the common clinical evaluation of the premorbid personality and of the personality development (Kind 1997; Dührssen 1998), we administered the Structured Clinical Interview-II (Fydrich et al. 1997). No premorbid personality disorder was found. The pedantry criterion was partially fulfilled, indicating an accentuation of this personality trait rather than its abnormal form or intensity. When assessing the family history, we did not find any neuropsychiatric conditions among consanguineous relatives. The patient’s father works in masonry, her mother is a clerk at the city council. Considering the personal history, the patient described her relationship to her parents as loving. She has many nice memories of her time with her grandparents. She has a 1.5 years younger sister who is a university student specialising in education. The relationship between the sisters is good. The patient has a stable relationship with her partner, Peter. The patient is a university student and studies Hungarian and German at the Faculty of Central European Studies at the University in Nitra (Nyitra). She likes studying, does not have any difficulties passing her exams, as she is always well prepared. She was also well prepared for the exam she should have taken on 25 August 2006, on the day of the assault. In the past, after graduating from high school, she worked as an au-pair in Germany. She had a positive relationship with her host family; they kept in touch and wrote each other postcards for holidays. They suggested she stay in Germany and go to university there, and were ready to help her out financially.

In the post-pubertal period she had aesthetic earlobe surgery. At university she went through a period of epigastric pain, and a peptic ulcer was diagnosed. She had to interrupt her studies. At no point of the diagnostic and therapeutic process did we have reason to doubt the patient’s credibility. On the contrary, all the subjective and objective information including direct observations during face-to-face meetings were concordant and contributed to the impressions of the patient’s veracity.

4.4. Stabilisation phase of the therapy During each of the first seven sessions, we used the guided mental imagery method, specifically establishing the reassuring image of a ‘safe place’ and that of a ‘helper’.

The patient was frequently reminded that it would be necessary to relive the traumatic situation, including negative emotions, at a later stage of the therapy, but that this would happen in a radically different and safe context. The aim was to process the traumatic memories so that they do not lead to severely disturbing emotions, as EJMH 8:2, December 2013

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though the trauma was happening again – activation of a ‘hot memory trace’ according to Fischer & Riedesser (1999). Instead, the memories ‘cool down’ and become just memories of a past event without interfering with the present life. We also explained in detail the procedure of EMDR exposure therapy. The patient agreed to the exposure method. This was then used during sessions 8–10.

From the professional point of view, therapeutic treatment in conditions of ongoing threat – for example, the tendency of state institutions to distort reality, ‘to present the beating as a lie’ (Zajac 2007) – is controversial. However, due to her numerous internal and external (social) resources, the patient was quickly able to acquire the stability needed for the confrontation therapy phase. She quickly obtained the ability to calm herself down and break away from traumatic memories whenever they were too overwhelming, and to maintain contact with the present safe environment when recalling the traumatic event.

4.5. Confronting the trauma Trauma reprocessing using EMDR – sessions 8–10 (Shapiro 1998; Hofmann 2006).

The eighth session lasted 3 hours and 50 minutes, the ninth 2 hours 35 minutes, and the tenth 93 minutes. During the first exposure session we worked with the trauma of the assault. The patient was asked to imagine herself standing in the weeds after her face had been slapped, seeing blood on her fingers and discovering her blouse was torn. While imagining this scene, her gestures became more agitated, her facial expression was visibly tense, and her posture was rigid.

Negative cognition is: ‘I am a victim; I am disappointed, helpless and angry.’

Positive cognition: ‘I am strong and balanced; what happened is the past.’

Emotions: uncomfortable feeling, fear Somatic sensations: sweating of the palms, unpleasant sensation warmth in the back, constricted stomach, heart racing For trauma reprocessing we employed rhythmic bilateral stimulation. First, the stimulation happened via eye movements (20–40 eye movements in one set), later, we used bilateral tactile stimulation of the palms. In the short breaks between the sets the patient described the spontaneous appearance of memories, thoughts, images, emotions and somatic sensations.

Here we describe an excerpt from a recording of the session on February 23, 2007. At this point, the patient was vividly recalling memories of the traumatic event as though it had been happening at that moment. In this transcription three dots (…) signify application of bilateral stimulus, at which time the patient is silent and observes the spontaneous development of associations, images, sensations etc. ‘On the way to the university… a weird sensation in my hands… chill; only trees and bushes; as though I was holding something in my hands, cold feet (she is moving her feet)… a head, then a tree, then a head again, then hands… I am standing in grass, EJMH 8:2, December 2013

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it is chilly, I see a head, a face, eyes, but also a whole face, but the eyes are shining, I looked at my hands and there was blood on them, not on my hands, but on my fingers… My head hurts, my hands are cold, so are my feet, my toes, I might take off my shoes (she is taking her shoes off)… My head hurts, my head is full of thoughts…

I want to leave… I want to leave, but I don’t know how, I am thinking how… there, I see the smaller one, a round face, big eyes… I am standing in front of him, I am cold, my head hurts, I see his mouth, he is telling me something, but I can’t hear him… the surroundings, that place, exactly, I saw that place from above, the trees, the bushes, the trail… I take my shoes off and start running on the trail, but I fall down and the two faces… a backpack… a woman with short hair who had that backpack… the faces again, round faces, big eyes… slap my face… he is standing in front of me, my head is so heavy that it threatens to fall, it is so heavy; I am terribly warm… they are pulling at my hair, terrible – I can’t move, it hurts and I see the hands, I see my shoes, but that is already on the trail… the fabric rips and that moment when they seize me… I take off the clothes he ordered me to, the jacket, the stockings, the earrings, I see earrings, my head is heavy, I have thousand thoughts in my head… how to get out… he is standing in front of me, who is the other one? I don’t know, probably behind my back, I can’t go right, I can’t go left… so many thoughts in my head, not thoughts, but images; the surroundings, the pit, the leaves, the trees, the bushes, it is so closed, I am warm and I am chilly, my head hurts, I want to cry… big eyes, it is not even possible for a human to have such big eyes, then my hands with blood on them, my head hurts so much… I feel my head, I feel them pulling at my hair, I can’t move, the trail, the woman with the backpack; my feet so cold, bare, dirty, I can see my feet walking on the concrete… an unpleasant sensation in my nose… as though my nose was broken… unpleasant warmth in my neck, cold feet… an unpleasant feeling in my mouth, like iron, it is disgusting, I am climbing out of the pit and my nails are so dirty, very-very dirty… my nails are disgustingly dirty… very cold feet, cold hands, my colleagues… they are telling me something, but I can’t hear them again, everyone is looking at me… slap in my face… something is itching… I probably bit my lip… because I can feel the itching… here, like this… the slap, I can’t see the slap, but I can feel it, it is unpleasant, something unpleasant in my mouth, it might be blood… they seize my hands, I am trying to slow down with my heels, but they are strong… the one with the short neck is standing in front of me, and I don’t know where the tall one is, he is certainly behind my back… I am just standing there… I am thinking… I want to do something and I am thinking… and I can’t think of anything… helplessness… I can’t go right and I can’t go left… I want to cry, I am thinking that it is better not to cry, it will be better if I don’t cry (her voice is weepy and there are tears in her eyes)… I feel my heart racing, I can feel it in my head, and I am terribly, terribly stressed out, and I keep looking for a way out… he is standing there and I can’t go there… I am thinking that if they want to rape me, I will fight back… I am losing my stability and I fall on my butt… something here in my underbelly on the left side… some pain, not very strong, I just feel sick… I can hear: in Slovakia in Slovak, a deep voice, a male voice… I am considering throwing my purse away because EJMH 8:2, December 2013

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they certainly want my purse… but here they are next to me… I want to stay calm because it might help, it might help to stay calm, the same voice again, asking where I am going… to the university, to take an exam… I can hear today: you are not going anywhere… and suddenly I feel very, very unpleasantly warm around my heart, and I can feel the warmth going to my head, my stomach is constricted, my hands started shaking, I feel pain in my head… he is pulling at my hair, I can’t see anything but the trees and the sky, I can’t move because they are holding me, and I am trying to slow down with my heels as much as I can… I don’t know how to get out… if I started screaming, someone might hear me, can I scream or not… (tears in her eyes), then I decide not to scream, I will give them everything I have… I have a lot of money in my wallet, over two thousand crowns, if I give it to them, they will certainly leave me alone… I am standing there, there is a lot of trash all around me, I want to tell them that I have money, that I will give it to them, I am so stressed out that I can’t think of the words in Slovak (tears) and I hear again my blouse ripping… it is that feeling of tears drying on your face, this time, I didn’t see anything, I just felt it, the same feeling of tears, of dry tears… I can see the girls… Štefi comes to me, and, and, they are stroking me and I am crying, I can’t say anything… I saw the ambulance, there I felt good, I certainly got something there (Diazepam intramuscularly – note of the authors), I am so calm, my head still hurts, but I am so calm.’ In this phase, the subjective distress measured by the SUD scale decreased from 9 to 3.

In the course of further EMDR treatments, feelings of disgust, anger and distaste appear. The patient remembers seeing one of the assailants on TV. Later there are feelings of fatigue and sadness. The subjective distress (SUD) decreases to 1–2.

When relaxing and imagining a ‘safe place’, the patient feels at ease, the headache fades, her hands and feet are warm, and the calm feeling lasts also after the relax­ ation. Considering the types of EMDR trauma reprocessing (Hofmann 2006), this is mainly an associative course of trauma reprocessing.

The ninth session was postponed for a week later than the original appointment. Subjective information from the patient: On the way here last week, their car broke down at a gas station. During the week, she felt more relaxed; there were few disturbing thoughts and images. The patient’s mother, Mrs Irena Malinová, who was present at the beginning of the session, said that her daughter was more balanced. The second week before the session, however, the patient had an unpleasant experience. In front of the dormitory in Nitra (Nyitra), two bald men sitting in a car shouted ‘Hedviga, Hedviga… bitch!’ She was already feeling better, she also sent a text message to her therapist saying she started feeling better, and something like that happened again. The unknown people broke into her apartment and threatened her in the bus ‘accidentally’ after the session during which she regained much of her stability. She texted her therapist that she was able to relax imagining a ‘safe place’ (her boyfriend’s room) as was her ‘homework’.

When we learned about this further harassment, it became clear that the therapeut­ ic process can be seriously hindered by continuing intimidation. Furthermore, it was not clear how far the threats could go. During the session we returned to what EJMH 8:2, December 2013

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remained from the traumatic event. The degree of subjective distress measured by the SUD scale while imagining the assault was 1–2. We continued to process the traumatic memories via EMDR. In the course of several EMDR sets (tactile stimulation) the emotion of anger appeared. ‘I don’t know why me, why it had to happen to me… it makes me sad, too.’ The anger was followed by a feeling that it is useless to be angry. ‘Emptiness, as though I’ve got rid of all the disgust, I am tired and empty… a pleasant tiredness.’ The degree of subjective distress temporarily increased to 2–3. After the desensitisation, the patient did not feel any tension at all; the subjective distress measured by the SUD scale was 0 meaning ‘no distress’. The patient gradually started experiencing positive cognition (‘I am strong and balanced; what happened is the past’). On the Validity of Cognition Scale (VoC) of 1 to 7, where 1 means ‘completely false’ and 7 means ‘completely true’, the patient repeatedly estimated the validity of her positive cognition 7. At the end of the session, following relaxation coupled with an imagination of a ‘safe place’, she feels great: ‘I am so light . . . I feel really good.’

During the tenth session, the patient said she had no troubles sleeping and was able to concentrate on studying ‘almost as well as before’. The memories of the police interrogation were not disturbing anymore. ‘It is over, at that time I was angry and humiliated…, but it is over now.’ The interrogation made it clear to her that she was not considered a victim of a violent act but an offender, and that the two assailants were protégés of the police. She remembered one of the policemen telling her in private: ‘Girl, it doesn’t really matter whether you are lying or telling the truth, you are doomed anyway.’ However, when remembering the strangers breaking into her partner’s apartment and being threatened on the bus, the patient still felt nervous and uncomfortable. We focused on processing this experience using EMDR. The patient described the most disturbing image in the following way: ‘I am sitting on the bus, that lady is sitting next to me looking at those photos… the car from below?’

Negative cognition: ‘I am a victim again; not only me but also Peter is in danger.’

Positive cognition: ‘They want to make my life unpleasant, it is a game, but I can handle it, I am sure it will end well.’ (VoC = 4).

Emotions: anger, disappointment, ‘when is it going to be over?’, nervousness (SUD = 3–4).

Somatic sensations: unpleasant warmth around the stomach, stress, warmth in the face and around the ears.

This time, we used tactile bilateral stimulation. There is a stream of memories, images and emotions; the patient is reliving the event and showing new attitudes: ‘everything is open… what does it mean, what happened… I am sitting in the bus and I see these photos… now I feel terribly warm, it is a very unpleasant feeling, I don’t know, I don’t know what to do, should I scream or should I stay silent or should I tell her something, what would be the best?… I would prefer to get off the bus… thousands of thoughts… how should I solve this… I don’t know whether she had something with her, whether she would want to harm me… she could have a knife, EJMH 8:2, December 2013

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if I screamed, I am not sure what she would do… a big problem and I don’t know how to get out, how to solve it… helplessness… I will call Peter to tell him not to get into his car, not to travel anywhere and they get off the bus and I can’t make a phone call… now I am truly desperate… I am running to the university… find some friend who could lend me a cell phone… call Peter to tell him not to get into his car… fear that there is an explosive in his car… what if it is too late… terribly cold hands but at the same time unpleasant warmth around my stomach and shivers down my spine…

I think I’m getting crazy… my cell phone doesn’t work (SUD score increased from 4 to 7)… the image of me sitting in the bus and seeing those photos, now I am angry, but at that time, I wasn’t angry… a feeling that my head bursts… terrible warmth in my head, terrible warmth and a feeling that I am getting crazy, that I can’t handle this, it is simply too much… I am trying to look at everything from above… a huge anger and disgust and filth, what people are able to do to each other; I am terribly angry… the helplessness mixed with anger… tiredness and anger… but the tiredness is stronger… I am thinking about the fact that it can happen anytime again (she moves her feet uneasily)… all I can feel is disgust… my head doesn’t hurt anymore… a little funny… when I am thinking of them (of the two women in the bus), I can see myself standing above them, they are under me, and what they did is very low, beneath dignity… I feel pride, energy and composedness, probably because it is so funny and childish… peace and composedness, self-certainty, an absolute peace…

I know they wanted to intimidate me… but they didn’t succeed, and now it is funny, what they did… what did they want to achieve, did they want me to get crazy or commit suicide?… I feel strong, I could run a marathon… now a pleasant warmth (SUD = 0)… the whole body.’

Body scan: We asked the patient to bring the original target image to her mind coupled with the positive cognition. She still felt calm and energetic. SUD = 0; VoC = 7. Thus, the reprocessing of the traumatic event was optimal.

In the following conversation Hedviga mentioned that her boyfriend had gone through a period when he could not sleep in his apartment. Now, however, it is all right. A policeman told him it was a ‘game’. During these EMDR sessions, the patient successfully processed all of her traumatic memories that had been the source of discomfort and posttraumatic stress symptoms. Now, we planned the next therapy phase focused on strengthening the resilience and stress coping strategies. The patient still had to face many stressors, for example the accusing and humiliating statements of the Prime Minister, the Minister of Interior Affairs, the Chief of Police and their speakers as well as of the Chief Public Prosecutor’s Office. There was still widespread misinformation in media, public verbal assaults and a risk of further physical assaults. Furthermore, the patient had to cope emotionally with the distress of her relatives caused by problems she did not choose to face.

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4.6. Integration and further development phase Sessions 11–25 were dedicated to strengthening and deepening the therapeutic effect. The aim was to enhance the patient’s emotional stability and resilience, and to improve her stress coping strategies. In case of facing new stressors, she should be able to recognise and stop the stress reactions. Therefore, the patient was taught the basic stage of autogenic training (AT) according to J.H. Schultz (Hašto 2006). She enjoyed the method and was progressing fast.

After she mastered all the six steps of the basic stage, we continued with teaching her the higher stage of autogenic training. It consists of meditation and imagination exercises, some of which focus on certain themes. – This training is strongly reminiscent of the mindfulness method (Kabat-Zinn 2005). During the exercises of the basic stage, she felt calm and composed. Her arms and legs were heavy and warm; her heart rate and breathing were calm. She described a pleasant sensation in her abdomen and feeling of a clear head. During the sessions, we used various interventions aiming at increasing her self-efficacy and self-confidence (Winston et al.

2006). Furthermore, we imaginatively modelled future possible ‘catastrophic’ situations and their management. We discouraged both the patient and her mother from reading online discussions of her court case, much of which included brutal and aggressive content. (After reading these discussions, the patient’s mother felt tense and had trouble sleeping. For a short period, we recommended her hypnotic medication.)

Since the patient became pregnant, we instructed her to further employ the calming effects of autogenic training and to enhance contact with the foetus. We taught her to use autogenic training during labour to increase the chances of an uncomplicated and natural childbearing. (This happens through the dismantling of the negative emotions that could disturb endocrine regulation mechanisms during labour.) A video appeared on YouTube showing a policeman shooting at a figure labelled Hedviga, but the patient was able to cope with it. Both pregnancy and childbirth progressed without complications.

4.7. Conclusion of therapy Following the trauma processing, the patient’s mental state was stable. Clinical evalu­ation was concordant with the results of the diagnostic scales. In March 2007 the patient showed almost no PTSD symptoms. According to Mini DIPS (Margraf 1994), she did not fulfil the PTSD diagnostic criteria. On 16 March 2007 her Impact of Event Scale (IES-R) (Weiss & Marmar 1996) was 8; on 23 March 2007 it was 4. (The maximum score is 88; the patient’s score at the beginning of the therapy was 44). On 16 March 2007 the degree of disability (WHO-DS) score was 0 on all the scales. The patient managed to integrate the psychological traumata into her life.

After the therapy ended, the therapist met the patient during several informal meetings. Hedviga Žáková-Malinová, her husband Peter and their daughter Emma EJMH 8:2, December 2013

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(born in 2008) gave an impression of being content and happy. After breaking the ice, the baby started exploring the therapist’s office. Hedviga talked to her daughter in Hungarian; her husband Peter in Slovak. The couple agreed on this since they wanted Emma to learn the mother tongues of both her mother and father.

During the therapy we had several short therapeutic and counselling sessions with the patient’s parents and her partner (future husband), since they were also subjected to great stress and experiencing feelings of helplessness and anxiety.

4.8. Concluding remarks to diagnostics and catamnesis The retroactive analysis of all the medical findings and the patient’s statements confirms the logical coherence of the objective and subjective information. In our opinion, the PTSD diagnosis was valid according to the criteria of both ICD-10 and DSM-IV. Direct observation of the patient’s behaviour during both the diagnostic and therapeutic sessions granted objective phenomena confirming her credibility.

(The complex evaluation takes into account not only the content of the words, but also the mimics and micro-mimics, the conjunctiva, the pupils, the voice, the movements of various body parts, the bodily sensations, the context and time consecutiveness, and so on.)

On 6 October 2010, I (the author, J.H.) had an unstructured follow-up telephone conversation with the patient. I learned that Hedviga Žáková-Malinová was feeling completely healthy. She was not experiencing any symptoms she had been treated for. She did not have any flashbacks of the trauma and described herself as happy. In 2008 she got her Master’s degree. She successfully defended her Master’s thesis­on the subject of Hungarian slang originating in Slovak. She is confronted with common everyday problems of a mother of already two children. Her daughter is at the time of publication 5, her son 3 years old. Both children are healthy. Besides temporary heartburn, the second pregnancy and childbirth were uncomplicated, too.

She continued employing the methods of autogenic training. Her husband continues to work for the same company. Her mother helps with the household and the two children. Her father, who owns a construction company, has built a house for the young family. Since Hedviga has always enjoyed learning foreign languages, she has started learning English. She continues to be sensitive to subjects connected to the traumatic event. When she speaks about the suffering she and her family had to face, she is usually worried, but able to let go and return to her everyday concerns. She is disconcerted about the fact that during the past 7 (!) years, her court case has still not been fairly resolved. She understands the political issues influencing her case, but her wish is to leave it behind.

She appreciates the fact that she was able to spend time with people she values, and that she had a chance to understand the phenomena of individual and social life.

She feels that during those years, she gained the experience of a 50-year-old person, although in reality she is only 30.

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5. Discussion 5.1. Diagnosis In our opinion, the diagnosis of PTSD is not difficult, if we take into account the reported feelings of shame, guilt and fear. The strong emotions and fear can prevent the patient from describing the traumatic event and his or her symptoms. Both authors have specialised in psycho-traumatology and gained experience in both diagnosing and treating traumatogenic disorders.

In Hedviga’s case, however, we had to be particularly careful and alert, and consider simulation, artificial or personality disorders. We even had to consider the possibility that she was an agent of a secret service. After all, the police had claimed that the ‘incident had not occurred’ and that Hedviga’s story was false. The Prime Minister (R.F.), the Minister of Interior Affairs (R.K.) and the Chief of Police (J.P.) appeared in the media and strongly suggested that the incident was a hoax. They pres­ented many emotionally manipulative arguments. These statements were later revealed to be distorted or false, consistently ignoring hard facts confirming Hedviga’s version of the events. The social and political context of Hedviga’s case is described in the book titled ‘National Populism in Slovakia and Slovak-Hungarian Relationships’ (Petőcz 2009; Petőcz & Kolíková 2010). A summary of the case (in Slovak) can be found in the text of the journalist Vrabcová (2010). Social and pol­ itical aspects of various segments of Slovak society are captured in comprehensive reports on the state of the society published by the Institute for Public Affairs under the leadership of the sociologist Martin Bútora and the political scientist Grigorij Mesežnikov (Kollár et al. 2008, 2009, 2010; Strečanský et al. 2010). Practically all questions that arose due to misleading statements by political representatives, were easily resolved in conversations with our patient. We gained an increasingly sound impression that she was credible and veracious, and the symptoms she was describing and those we found during the targeted exploration clearly confirmed the PTSD diagnosis. An experience of a traumatic event is a condition of PTSD. The patient’s description of the traumatic situation sounded fully credible. More than usually, we paid attention to every movement of her facial muscles, eyes, pupils, to the skin on her face, gestures of her hands, to her feet and her whole body. In various contexts we asked about her bodily sensations and were alert to our own feelings and emotions possibly reflecting our perception of her micro-mimics (Ekman 1989, 2004). Based on all this information, we concluded that the patient was describing events she had really experienced, as she remembered them and how they still interfered with her present life.

Furthermore, we saw Hedviga’s photographs shortly after the assault, as well as the CT scans confirming the oedema of the left zygomatic region and of the nose radix. These were in accordance with the local findings described by the traumatologist. We received some of these findings only later, during the diagnostic and the treatment. In the course of the whole diagnostics and therapeutic process and after EJMH 8:2, December 2013

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each session, we asked ourselves whether we had noticed anything contradicting the credibility of our patient, or anything conflicting with our knowledge and our hypotheses. Yet we did not find anything of the sort. On the contrary, we were discovering more and more information about the attempts of the police and the Chief Public Prosecutor’s Office to distort reality and prove that the ‘incident had not occurred’.

This was reflected also in the expert evaluation (MUDr. Š.K.) requested first by the police and later by the attorney’s office (Prof. MUDr. P.L.).

We considered the possibility of simulation, aggravation or artificial disorder (Praško 2008). However, Hedviga’s descriptions of the event were short and dispassionate. She visibly feared strong emotions. Details and strong displays of emotions only appeared during the trauma exposure, and the patient experienced them as obviously disturbing. We noticed a certain tendency to dissimulation in connection with the patient’s attempts not to burden her relatives and other people by her suffering.

To increase the probability that the patient would be telling the truth, we informed her of our commitment that everything we would learn from her would be subject to the patient-doctor confidentiality as legally ensured. We made sure she understood that without her consent and knowledge, we would not inform anyone of anything she mentioned. She understood we would not inform the police, the state organs, her parents, her partner, or her lawyer. We also asked her to warn us of facts she did not want us to include in her medical record. Later it became clear that for the sake of her safety, it was better to publish all the information she had given us.

This happened with her consent.

5.2. Risk and protective factors Considering the first and the third traumatic events (the assault and the stranger entering the apartment), the most important risk factors are the type and intensity of the trauma. The patient was losing her control over the course of the events; she was feeling fully helpless and desperate. For about 15–20 minutes, she lost consciousness, and later she found bloodstains on her garments. Therefore, she could not know what had happened to her; she might have been sexually assaulted. During the therapeutic process, we encountered the themes of disgust and filth. Hedviga’s cognitive unpreparedness for this type of assault represents another risk factor. She did not expect to be humiliated on account of her mother language, or to be phys­ically attacked, nor was she able to predict the extent of the violence and to know what had happened during the period of unconsciousness. Her upbringing and the relationships in her elementary family have all developed her attitude that she could trust people, and that people would not want to hurt and threaten her intentionally. After the first traumatic event, the police turned against her, she was being intimi­dated and had to face hostile information from the media and online discussions. This was probably the reason why the traumatogenic symptoms did not sponta­neous­ EJMH 8:2, December 2013

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ly disappear after the first trauma. It is questionable whether the benzodiazepines administered shortly after the assault contributed to the unfolding of the symptoms.

Some findings in the literature suggest that benzodiazepines might have a calming effect in the acute phase, but have a negative effect on the global symptom course (Hellmann et al. 2011).

Otherwise, there were several protective factors. Hedviga had support from her family and her partner. According to our clinical judgement, the patient, her parents and her partner had a safe attachment. In her early childhood, Hedviga did not experience a separation from her primary caregivers. If we do not consider the peptic ulcer, she had not suffered from any mental disorder prior to the assault. She had not been traumatised before. In her positive, warm and calming memories her grandparents played an important role, particularly her grandfather. The importance of a good relationship with grandparents for health is supported by empirical research and highlighted, for example, by Peter Tavel (Tavel et al. 2007; Tavel 2009). Her personality was stable; she had plenty of experiences of success and self-efficacy.

Obviously, we know nothing about the presence or absence of predisposing genes.

Considering the family history as well as the positive course of the therapeutic process in spite of the persisting stressors, however, we estimate that the role of these genes was small or none. Although there were massive and persisting stressors, the PTSD symptomatology did not culminate to its maximum. This is yet another proof of the patient’s premorbid resilience. Furthermore, the degree of disability in various areas of daily life was not paralysing.

5.3. Problem of therapeutic relationship and working alliance A trustful relationship with the patient was formed optimally. Our curious interest was combined with human sympathies towards her. Our own Slovak national identity did not represent an obstacle in forming a positive counter-transference towards a patient of Hungarian nationality living in Slovakia. On the contrary, we strongly identify ourselves with the concept of a free citizen. We perceived the primitive nationalism and populism of Robert Fico’s government as humiliating for our quiet patriotism, sensitivity for human and civil rights and liberties. The more Hedviga’s credibility was being confirmed, the more stable our positive counter-transference and our readiness to help her reduce the PTSD symptoms became. Our positive concordant transference (Wöller & Kruse 2011) enabled us to empathise with the whole spectrum of the patient’s emotions, including anxiety, helplessness, loss of control over her life, fear from the future, but also anger, disgust, contempt and the wish to live a normal, safe life.

From the beginning of the therapy, we realised the possible transference risks of the patient. She could have perceived the therapist as a potential aggressor, transgressor of her sacred boundaries, untrustworthy traitor, investigator, judge or controller on one hand, and as an indifferent witness or even as a potential victim of her agEJMH 8:2, December 2013

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gressive impulses on the other. The transference tendencies are known from supervisions and literature of psychoanalytically oriented psychotherapists (e.g. Levenson et al. 2005, 106). Therefore, three people were present in each of the sessions. Apart from the patient and the therapist (psychiatrist and psychotherapist), there was a cotherapist (clinical psychologist and psychotherapist) who administered some of the psycho-diagnostic tests and otherwise functioned as a rather passive recorder. This also increased our capacity for reflecting the diagnostic and therapeutic processes.

There are several reasons why these transference risks did not complicate the therapy. The patient had a good sense of reality, positive relationship experiences in her early childhood (with her parents, grandparents and her sister), a stable relationship with her partner and a good relationship with her lawyer, who had originally consulted one of our colleagues and referred Hedviga to our care. Based on the patient’s general communication style we concluded that her premorbid attachment was safe, and that she was able to ask for help, support, advice and therapy and to use them optimally for her own benefit. She perceived her communication partners as integral human beings with their real roles, not as partial objects.

We believe we were able to avoid the problematic intense counter-transference reactions. These could have included hostility, feelings of being emotionally overwhelmed and helpless, indifference or an exaggerated tendency to ‘save’ the patient (Horowitz 2003; Levenson et al. 2005). The most difficult emotionally was to endure the confrontation with the negative emotions during the exposure to the first trauma, the assault itself. This lasted for several hours, and for a long time the patient did not feel any relief. Finally, the expected relief came. Coping with the third traumatic event – a stranger entering Peter’s apartment and intimidating him – was also emotionally exhausting. We were experiencing mixed emotions. Anger towards the perpetrators, the organisers in the background and the politicians misusing their power was mixed with realistic concerns of how to accelerate the healing process, reduce the patient’s symptoms and enhance her resilience in case of further stressful events. We considered the idea of informing the public about our findings. We evaluated whether it could protect the patient from further assaults, or whether we could put ourselves at risk. We based our decision of ‘civil courage’ (Dahrendorf 2008; Vorländer 2010) on the bio-psycho-social model of health, illness and therapy (Engel 1977, 1980; Hašto 2005), as well as on attitudes of those we trust. Connections to several publicists, intellectuals, and the professionalism and civil courage of Hedviga’s lawyer facilitated our decision.

We attempted to avoid an exaggeratedly idealising transference towards the therapist coupled with disappointment from unfulfilled expectations. Therefore, we were continually harnessing the patient’s own healing resources we either anticipated or directly identified. We aimed at supporting the patient’s experiences of selfefficacy. We pointed out that a good lawyer is more important for the future development of the case than therapists are. We also paid attention to the patient’s family and her partner. We were aware of the burden the case represented for them as well as of their importance for the patient’s stability. At the beginning of each session, we EJMH 8:2, December 2013

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talked to them for at least a few minutes. Their cooperation was excellent. We also felt frustration at persistent flaws in our society. The state continues to be directly responsible for crimes or for protecting criminal perpetrators, starting from the first Slovak State in World War II, through the communist regime, up until the current post-communist government (Mikloško et al. 2001; Takáč 2001; Bútora 2010; Hradská 2010).

5.4. Therapeutic interventions After confirming the diagnosis, the patient was repeatedly educated about the logic of her symptoms, about her disorder, the possibilities of coping with them, therapeutic options and spontaneous courses. She accepted our suggestion to continue psychotherapy without pharmacotherapy. This decision was based on our positive experience with this option in case of traumatisation in adults. Self-relaxation exercises using imagery (safe place, inner helpers, etc.) were part of each of the sessions and represented an important stabilising intervention. We agreed on the content of each of the sessions. We pointed out that we would only start the EMDR trauma exposure after she began to feel strong enough. We also stressed that she could interrupt the exposure at any time by lifting her arm, and we would immediately understand that as a signal that she needed a break. We signalised to her, both verbally and nonverbally, our understanding and empathy as much as possible. We offered her the option to express herself in German (she majored in German) or Hungarian (her native language) in case she had difficulties finding a Slovak expression. As none of us speaks Hungarian, we were ready to note the Hungarian expressions phonetic­ ally and assess their meaning later. Although Hedviga never used this option, we considered it important as a display of our tolerance and regard towards her cultural and national identity. It was crucial to create a safe therapeutic framework as much different from the traumatic situation as possible. (Before the assault, she heard ‘In Slovakia in Slovak!’) Later, we discovered that she was using the autogenic training formulas in Slovak, although we encouraged her to translate them into Hungarian.

We understood it as a sign of a good therapeutic relationship, and of Hedviga’s ability not to generalise her negative emotions towards all Slovaks. This was important as her partner and future husband was Slovak.

In literature, trauma processing via exposure in case of persisting threat is considered relatively contraindicated (Shapiro 1998; Hofmann 2006). Nevertheless, with this patient we risked it, assuming it would be possible to create a clear differentiation between healing the symptoms caused by a former trauma and a rational and realistic avoidance of future risks. For the patient it was crucial to be able to free herself from the older traumatic memories in situations when new stressors arose.

This plan was confirmed as realistic both for the patient and the therapists.

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5.5. Therapeutic setting and process When we agreed on approximately 15 sessions, each lasting 90 minutes, we first considered a frequency of one session a week. However, during the exposure, we had sessions lasting several hours in order to reduce the negative emotions and avoid symptom exacerbations between sessions. These sessions turned out to be successful; the patient showed her strong will and perseverance. It was worth investing the effort. After each of the exposure sessions, the patient’s state improved. As the patient had obligations at the university and the distance of 127 kms between her city and our office made the commuting difficult, it was not possible to have one session a week as originally planned. At several occasions, there were several weeks between the sessions. In the second half of the therapy, the longer intervals between the sessions were intentional.

According to Hofmann (2006), there are 6 possible courses of EMDR trauma processing. These can be associative (successions of various, mostly retrospective associations where the time sequence does not have to correspond with the real sequence of events), imaginative (spontaneous imaginations), or bland (empty, with no marked changes). Hofmann considers these courses positive. Another possibility is abreaction that can be either positive or negative. Finally, there are two rather negative courses. These are flooding (the intensity of the emotions exceeds the patient’s capacity for information processing), and circularity (the same answers are being repeated, and the process does not lead to stress reduction). Hedviga’s therapy can be described as associative. A short phase of flooding could be controlled by ego strengthening interventions.

Already at the beginning of EMDR therapy it became evident that the patient preferred rhythmical alternating tactile stimuli to eye movements. According to our experience, this is not rare. Tactile or auditory bilateral stimulation is being used in EMDR as an effective alternative to eye movements (Shapiro 1998). Although their effectiveness has not yet been sufficiently studied, it has been confirmed in clinical practice. In spite of this, EMDR keeps its original historical name.

Even after trauma processing and symptom reduction, the risk of re-traumatisation remained high. There were still instances of misinformation in the media, verbal attacks in online discussions, discrediting statements by politicians, and the prosecution of the Attorney General’s Office under the leadership of LL. D. Trnka.

Therefore, in the next phase of the therapy, we aimed at increasing the patient’s stress tolerance.

From Hedviga’s history we knew that she had been able to experience inner peace, to see problems in broader context and to analyse them. These characteristics had been present, but were covered by the symptomatology and the existing stressors. First the basic and later the higher meditative stage of autogenic training helped her to revive them and to develop them further. Hedviga accepted this method with interest and she was able to make quick progress. She exercised systematically two to three times a day, usually for about 15 minutes. Although we had originally EJMH 8:2, December 2013

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planned 30 sessions, there were 47 of them, as we added sessions aiming at prevention and personality development. Hedviga shared her view of the therapy and her experience with the journalist Vrabcová, and they were published in a book titled Hedviga (2010).

5.6. Misinformation as a work method?

The strong and loving support the patient was getting from her close surroundings compensated the negative attitudes of the broader social environment. If this strong support had not been present, the lack of public understanding and the hostile reactions might have seriously complicated the course of the patient’s PTSD. It might have led to the chronification of the symptoms, to depression or other mental dis­ orders. It was mainly the media that influenced public attitudes. Even before the legal closing of the investigation of the assault, the Slovak Prime Minister, LL. D. Robert Fico, said during a press conference: ‘The Government of the Slovak Republic has to waste a huge amount of energy to uproot deceptions, manipulations and maybe even the fact that some lady wasn’t able to pass her exam, so she sacrificed the name of the Slovak Republic just to save her own name.’ (our trans.)2 As the Prime Minister was immensely popular with a major part of the population, such a statement influenced the public opinion of Hedviga as a victim of a violent crime negatively, and it made it easier to spread misinformation further. ‘We Slovaks are endangered by them, Hungarians (polarisation between us and them), therefore we have to unite under the leadership of a strong leader’ – this hypothetic statement interpreting the mentality of the former Prime Minister expresses the atmosphere influencing the public understanding of the case. It is a known phenomenon described by human ethology and social psychology. Some politicians seem to misuse it intentionally and cynically to gain the voters’ support. ‘The logic of affect’ (Ciompi 1997; Ciompi & Endert 2011) plays a role here. In another context, we will mention Stanley Milgram’s (1974) socio-psychological experiments enabling us to understand the suggestive strength of an authority.

At a press conference of the Minister of Interior Affairs and of the Chief of Police held before the legal closing of the investigation, the public and the media learned about the DNA found on the envelope with Hedviga’s documents. In our opinion, this argument strongly influenced the public opinion as well as the opinion of the media. It suggested that the documents had not been stolen, and that Hedviga had put them into the envelope herself. Hedviga was able to explain it. After obtaining the envelope, she handled it with her hands. After receiving the instruction to 2

riginal text: ‘Vláda Slovenskej republiky musí míňať také obrovské množstvo energie, aby vyvracala O podvody, manipulácie a možno aj to, že nejaká dievčina nebola schopná urobiť skúšku, tak obetovala meno Slovenskej republiky len preto, aby si zachránila svoju vlastnú koži…’ This statement is shown in a film made

by Anna Kratochvílová, Občan Hedviga (Citizen Hedviga), retrieved 30 Sept 2012 from http://video.tyzden. sk/redakcia/2010/06/08/obcanhedviga/.

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bring it to the police ‘as she got it’, she took it out of the trash and noticed that the stamp had fallen off. Therefore, she put her own saliva on her finger and used it to glue the stamp back on the envelope. The Minister of Interior Affairs claimed that the stamp was glued onto the envelope in a way that the part of the postal seal on the stamp and the part on the envelope constituted an uninterrupted line. However, according to the investigation file, this had never been examined.

In our opinion, the reference to the DNA analysis confused the critical thinking ability even of otherwise educated intellectuals, until they learned about the context.

The ‘DNA proof’ functioned as an ‘emotional attractor’ in the sense of Ciompi’s ‘affect logic’: ‘She is guilty’, ‘a liar’, ‘an anti-Slovak Hungarian’. This further influenced the evaluation of all other pieces of information and misinformation connected to the case. The expert evaluation was done by a physician ranking high in medical hierarchy. He is a professor of surgery and the dean of the medical faculty.

His expert opinion verifying that ‘the assault did not happen’ and ‘she was not hurt’ has similar strength of authority. A CT scan is a similarly highly valued proof. As a matter of fact, however, the CT scan on the day of the assault confirmed a cranial trauma.

We describe two instances of the misinformation in more detail. During her hospital stay after the assault, after a commotion, when she suffered from an acute stress reaction and had been administered benzodiazepines, she was interrogated and asked why she had been attacked. This happened in spite of the fact that the doctors had advised against her interrogation for the time being. At that time, Hedviga attempted logical reasoning. Since the assailants kept repeating ‘in Slovakia in Slovak’, she assumed that the reason for the attack was her speaking Hungarian. The next question was with whom she spoke. She answered that she either talked on her phone or she met someone. Later, she remembered that two people asked her how to get somewhere. When she was describing the situation to us she came up with an explanation why she thought of a phone call. She was already being late and considered calling her colleague to tell her she was on her way. Just as she was thinking that, she had been addressed by the two assailants. Since the police discovered that her phone was not used at the time of the assault, they used the uncertainty of Hedviga’s memory against her.

Another example: Hedviga said that after her documents including her credit card had been stolen, she contacted her mother and asked her to block the card.

According to the police, the card had never been blocked. The truth is that it had been blocked, but the police used an invalid, false confirmation that it had not been blocked. This confirmation is in the first investigation file. It is a request of the police to disclose the data about the bank account with a hand-written note that the card had not been blocked.

High state representatives publically described Hedviga’s case as an attempt to discredit the Slovak government or as an act of the Hungarian secret service. This belief, whether it was a self-deception or a conscious decision to deceive the public, subjectively justified their behaviour towards Hedviga as though she had actively EJMH 8:2, December 2013

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participated in some anti-Slovak conspiracy. They oversaw that it was their reaction (‘Hedviga is not a victim; she is an assailant!’) that created the problem.

5.7. Socio-political aspects I am often asked what, in my opinion, is ‘behind this case’. There are sufficient indications allowing us to formulate certain hypotheses. Again, I am referring to the book of Vrabcová (2010) containing interesting information from LL. D. Roman Kvasnica. Here, I will add only some thoughts helping us to understand the seemingly incomprehensible failure of the state structures.

Considering the assault itself, there are, in our opinion, two possibilities. The first is that the assault was planned. On that day, about ten students of Hungarian nationality were supposed to come to the university to take an exam. This could easily be found online on the university website. The second possibility is that the attack was random, perpetrated by several extremists who happened to encounter a woman of Hungarian nationality. Subsequently, the police, the prosecution, and the government followed the principles of nationalistic populism, and the victim became the culprit. The official version sounded like this: ‘She was not beaten; she is a liar; the incident did not occur; she is trying to discredit the government of the Slovak Republic.’ Here, we can ask several questions: What role did ‘intoxication by power’ play here? Were there feelings of narcissistic triumph and grandiosity (Henseler 1976; Kohut & Wolf 1980) on the part of representatives who had won the election thanks to their populism and deceiving of the public? How much did the attitudes of the Prime Minister and the Minister of Interior Affairs influence the police and the prosecution? What was the role of the inborn tendency to obey high authority (EiblEibesfeldt 2005)? This tendency, studied experimentally by Milgram, allows us to comprehend the psychological mechanisms which allow the arbitrary and undeserved abuse of a citizen. If we consider the human tendency in Milgram’s experiments to give up our own superego as well as the whole spectrum of intrapsychic and interpersonal defence mechanisms (Kaščáková 2007), we see the human potential to self-deception. In his experiments, Milgram was trying to answer the question how common people could participate in the killing of civilians during World War II (Browning 2002). In his experiments, Philip Zimbardo (2007) divided healthy volunteers into two groups: a group of criminals imprisoned for a crime they committed, and a group of guardians overseeing the order of the prison. He showed the effects such a polarisation between ‘us’ and ‘them’ have on human behaviour. Such a polarisation of roles with no other controlling mechanisms quickly leads to destructive behaviour, to misuse of power and to violence.

Then there is the other possibility. There are several indications that the assault was not incidental but planned. Furthermore, someone in the background did not have to rely on the aforementioned dynamics, but could beforehand indoctrinate the key representatives with the misinformation that the claimed assault EJMH 8:2, December 2013

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was an attempt to discredit the government by ‘evil Hungarians’. When the relationships between Slovakia and Hungary deteriorate, the Slovak nationalists can thrive. We can naturally ask who among the Slovak nationalists has connection with persons capable of such a massive campaign of misinformation and propaganda, on the level of a graduate from the ‘KGB University’. And who was interested in deteriorating the relationships between Slovakia and Hungary? Possible answers can be found in a book analysing the post-Soviet development in Russia (Lucas 2008). But is it possible that even the physicians who had been asked for an expert opinion allowed to be pulled into this fraud? It is difficult to believe it. The figure of a physician or a healer represents a positive archetype. In our opinion, however, if physicians had participated in Milgram’s experiments, they would have acted in the same way as other healthy subjects. Although Milgram did not specifically examine the behaviour of physicians, we know that during the Third Reich (Schneider 2011; Cranach & Schneider 2010), all Jewish phys­ icians were excluded from the Medical Chamber, and this decision was made by ­German physicians. Protests against this decision are not known. When Hitler rose to ­power, a law about prevention of hereditary illnesses was passed. Schizophrenia and manic depression, among others, belonged to this group. The healthy ‘body of the nation’ was not allowed to be burdened by these and other ailments. All phys­ icians were obliged to report so-called hereditary illnesses to the officials. Based on this law, more than 360 thousand citizens were selected and forcefully ster­ ilised. More than 6 thousand people died during these medical interventions. On 1 September 1939, Hitler ordered the so-called ‘Euthanasia’ action. It was an order to kill patients who were mentally or physically ill or mentally retarded. At least 250–300 thousand people were murdered by injections of Phenobarbital, morphine, or scopolamine. Furthermore, they served as test subjects in experiments with starvation and the deadly effects of gas. All of these processes were controlled and carried out by physicians, often psychiatrists. About 50 selected experts, some of them well-known psychiatrists, evaluated the reports, and made decisions about life and death. Experiences with the action named ‘T4’ were later used in concentration camps during the murdering of millions of ‘Untermenschen’. There was a certain resistance against the injustice in medicine and especially in psychiatry.

However, more than 50% of the physicians were members of the national socialist organisations (NSDAP, SA, or SS). Formulated positively, almost half of the physicians were not members of these organisations. This shows that there were some possibilities of resistance, and it did not always have private consequences. Some of the physicians did resist. But they were few. Very few (Schneider 2011). The way German psychiatrists nowadays deal with this failure during Hitler’s regime deserves our admiration. It is very instructive for physicians worldwide.

The current (2010) President of the German Society for Psychiatry, Psychotherapy and Neurology (DGPPN) said: ‘Except for several individuals, the majority of German psychiatrists and members of our community including its leaders participated in research, planning, executing and scientific legitimisation of selection, EJMH 8:2, December 2013

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sterilisation and murder’ (Schneider 2011, 31). At a different place and after apologising to the victims, Professor Schneider says: ir Psychiaterinnen und Psychiater sollen keine Werturteile über Menschen fällen, wir W lehren, forschen, behandeln, begleiten und heilen. Die unantastbare Menschenwürde ist immer die Würde des einzelnen Menschen und kein Gesetz und kein Forschungsziel dürfen (37) uns dazu anleiten, diese zu missachten.3

We see that the archetype of a doctor, a healer, of a powerful and well-meaning figure helps strengthen the hope and increases the placebo effect of a treatment, but it should not prevent us from thinking critically and acting assertively (Alberti & Emmons 2011).

The winning party in the 2006 elections, the social democratic ‘Smer’, formed a coalition with the Slovak National Party known for its primitive nationalism. The Socialist International uniting socialist parties criticised this move and suspended the membership of Smer. News about the attack on a student of Hungarian nationality must, at the time, have been unpleasant for the Smer leaders. The Prime Minister and the Minister of Interior Affairs started to deny the reality of the attack and to claim that ‘the incident had not happened’. They interpreted the assault as an attempt to discredit the government. Even if top politicians had been mistaken, after discovering the real nature of the case, they should have been able to apologise. They should have apologised to Hedviga, to her relatives, to Hungarians living in Slovakia and to the Slovak public. There are several possible reasons why they failed to do so. Some of them might be political (fear from losing the admiration of the nationalists); some of them are probably connected to group dynamics (we must hold together). Personality structures of the main protagonists certainly play a role too.

5.8. Socio-political context of psycho-traumatology In the history of scientific research of mental trauma, the attitudes of the society towards mental trauma as well as towards its victims are remarkably ambivalent.

There are helpless victims on the one side and powerful assailants on the other. In psycho-traumatology, the question of power is crucial. The power rank of the assailant, either his/her political or parental influence (Miller 1998) strengthens the tendency of the witnesses to draw away from the victim. Due to the character of the posttraumatic symptoms (fragmentation of memories, emotional overload, and the neurobiologically based ‘indescribable’ nature of the trauma), victims of trauma might make an untrustworthy impression. According to J.L. Herman, one of the modern pioneers of psycho-traumatology research and co-author of the definition of complex PTSD, these socio-political aspects complicate the status of both mental 3

‘ We psychiatrists cannot judge the human value; we teach, treat, accompany and heal. The untouchable human dignity is always the dignity of a specific human being. There is no law and no research goal that can mislead us to disrespect it.’ (Our trans.)

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trauma victims and experts helping them. In her book subtitled The Aftermath of Violence – from Domestic Abuse to Political Terror, she writes: I n order to escape accountability for his crimes, the perpetrator does everything in his power to promote forgetting. Secrecy and silence are the perpetrator’s first lines of defence. If secrecy fails, the perpetrator attacks the credibility of his victim. If he cannot silence her absolutely, he tries to make sure that no one listens . . . The perpetrator’s arguments prove irresistible when the bystander faces them in isolation.

(2001, 8)

A witness dealing with the trauma must ‘combat the tendency to discredit the victim or to render her invisible’, fight the doubts whether ‘patients with posttraumatic conditions . . . are genuinely suffering or malingering, whether their histories are true or false and, if false, whether imagined or maliciously fabricated’ (8). This might be observed in victims of political terror as well as those of domestic abuse.

We must realise that not only the traumatic event itself but also the reactions of the social environment contribute to the symptomatology and PTSD chronification. The victim’s isolation and the inability to share his/her experience strengthen the suffering. Our clinical experience confirms that victims of violence often do not receive support in their social environment, and are often described as untrustworthy, inadaptable and overly complicated. The victim might be proclaimed an assailant by those in power if there are not enough witnesses able and willing to intervene.

F. Neuner, M. Schauer, and T. Elbert, the authors of narrative exposure therapy, a new promising psychotherapy method for treating traumatogenic dis­ orders, also stress the socio-political aspect of psycho-traumatology. ‘For therapists of victims of political violence, political attitudes protecting human rights and the victims of state violence might be helpful. The meaning of the therapy might then be interpreted as targeted support of human rights’ (2009, 39).

This therapeutic attitude corresponds to Václav Havel’s quote that is the motto of this article. During the communist regime, the attitude of many psychiatrists was that they should not get publicly involved in social and political issues. Such an attitude was understandable, but often exaggerated. Psychiatry was expected to deal only with its narrow specialisation. Bio-psycho-social understanding of psychiatry was therefore reduced, and some psychiatrists contributed to the status quo of the totalitarian regime out of fear. Sometimes they cooperated when a person with anticommunist attitudes had to be hospitalised because he/she might disturb, for example, the celebration of May Day. The Psychiatric Section of the Slovak Medical Society also hindered the free development of psychotherapy in Slovakia. Therefore, psychotherapy was developing among semi-illegal conditions and in various camouflaged ways. Luckily, there were several psychiatrists who were readily helping those persecuted and threatened by the regime. And many of them also found ways of educating themselves in the newest trends.

Using the terminology of transactional analysis, Hedviga was lucky because positive interactions with her parents and grandparents allowed her to interiorise the figure of a good parent. This component of her personality became a source of

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strength, stability and resilience at the time when the state represented by specific people treated her and her homeland as a controlling parent with no respect towards her need of safety, justice, dignity, and freedom.

6. Conclusion In the last two decades, the therapy of posttraumatic stress disorder has substantially developed. As a result, effective help is now available for PTSD patients. This includes both pharmacotherapy and specific psychotherapy, and, in more serious cases, their combination. The diagnostic classification of PTSD in the American classification system of mental disorders as DSM III, 30 years ago, has helped therapy development. In our opinion, diagnosing PTSD is not especially difficult if the therapist is adequately trained and does not have an unconscious tendency to avoid the diagnosis resulting from dramatic experience and from strong negative emotions. At the same time, the patient may have the tendency to avoid certain topics, too. This means that the therapist has to respect the patient’s fear from strong emotions, his/her embarrassment or irrational guilt that can burden spontaneous communication.

Therapy of PTSD requires a specific attitude. It has to take the main characteristics of PTSD into account: the central nervous system’s disturbed capacity to process information adaptively, dysfunctional traumatic memories, and inability to experience safety. Therefore, the therapy of a mental trauma has three phases: stabilisation, exposure and integration, and new orientation. In all of the phases, it is crucial to strengthen the patient’s own resources.

In our case study, we describe EMDR therapy of PTSD as well as AT in enhancing the patient’s resilience in a persisting stress condition. The case study of the patient who gave us her consent to disclose her real name tells a lot about the sociopolitical dimension. The philosopher Nicolai Hartmann understood people as beings with several ‘levels’. In order to study them, several scientific disciplines are needed: physics, chemistry, biology, psychological and social sciences (Hašto 2005). The bio-psycho-social model formulated by Engel (1977, 1980) adequately describes this complex attitude towards diagnostic and treatment in medicine and psychiatry.

Acknowledgements We are profoundly grateful to Hedviga Žáková-Malinová, MSc, her husband Peter Žák, and her closest family members: Irena Malinová, Karol Malina, and Renáta Malinová, who have been tirelessly supporting her since the beginning of the case.

They have also contributed to the positive outcome of the therapy. Hedviga’s lawyer, LL. D. Roman Kvasnica, an excellent professional and a free citizen, has been another great source of support not only to Hedviga, but also to her whole family. We would feel very alone without the professionalism and support from many commitEJMH 8:2, December 2013

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ted individuals. We cannot name them all; it would be a long list. It would begin with the journalists Eugen Korda and Štefan Hríb, the musician, journalist and promoter Michal Kaščák, the literary theorist Peter Zajac, the activist Zuzana Wienk, the sociologist Martin Bútora, the psychologist Gustáv Matijek, the philosopher Egon Gál, the psychiatrist László Sárközy, and the journalist Marie Vrabcová. It would then continue with names of other great people working in various professions including journalists, physicians, psychiatrists, psychologists and psychotherapists, sociologists, political scientists, lawyers, philosophers, university teachers and critically thinking citizens.

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EJMH 8:2, December 2013

BOOK REVIEWS / REZENSIONEN

European Journal of Mental Health 8 (2013) 267–271 DOI: 10.5708/EJMH.8.2013.2.Rev.1

Ákos Tóth

SALUTOGENESIS IN TRANSCULTURAL MANAGEMENT Theory and Hypothesis Building Mayer, C.-H. (2011) The Meaning of Sense of Coherence in Transcultural Management: A Salutogenic Perspective on Interactions in a Selected South African Business Organisation (Münster: Waxmann) 24x17 cm, 455 pp., ISBN 978-38309-2553-8, €44.90.

Globalisation and the economic crisis makes managers face growing challenges.

They are subject to increased work demands, and in transcultural work situations and international organisational structures, they are required to manage diverse inter­actions; specific new stress sources emerge. All these might present a danger from the perspective of preserving managers’ well-being and health. In order to cope with difficulties and preserve their health, managers have to possess specific qualities and strategies. The basic question – what keeps people healthy – which the author herself asks in her study and which she strives to answer is the same as the basic question of the salutogenic model that bears Antonovsky’s name. However, she further extends it with the question of how we can make people gain the ability – especially in a special surrounding (transcultural industrial company), and on a special level of company hierarchy (managers) – to preserve their health and well-being.

Based on a comprehensive overview of the technical literature on this subject matter, the author places the Sense of Coherence (SOC) of Antonovsky’s concept (1979, 1988, 1996) into the focus of her research. ‘A strong SOC supports well-­being and health and is directly related to aspects of successful living, such as effective work performance, effective interpersonal relationships, community involvement, religious expression and economic and political functioning’ (23). She investigates the linking points of SOC with other constructs of the salutogenic paradigm as well as theoretical approaches such as the theory of ‘fortitude’ (Strümpfer 1995), ‘in­ ternal locus of control’, or ‘resilience’ (Lefcourt 1976).

For studying the salutogenic perspective in a transcultural milieu, the author opted for a South-African business organisation (automotive industry), where the signs and consequences of globalisation and economic crisis are concentrated. She implements a deep-reaching study in the circle of managers within this transcultural organisation. The author is familiar with this research field, having functioned as an intercultural trainer and advisor in economic organisations in South African countries. During this time, a continuous research work accompanied her practical activity, she published several theoretical and practice-oriented works (see her 23 studies, published from 2001 to 2010, as listed in the references of this book).

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Briefly, the aim of this volume, as summarized by the author herself in the abstract of her work, is to answer the following questions: ‘How are SOC, identity, organisational culture and transcultural conflict (management) interlinked in an inter­national organisational management context in South Africa? How could managers be qualified to increase their ability to activate resources and develop SOC in a challenging transcultural organisational setting?’ Here, she has a double aim: to enrich the salutogenic concept with theoretical knowledge through implementing it in a special field (transcultural organisation) on the one hand, while on the other hand, through and by means of exploring the connections within the managers’ sense of coherence, self-evaluation of health, identity and value system, to thereby elaborate an integrated mental health development intervention model that includes counselling, a managerial training series, a team mentoring approach as well as facilitator training.

Methodologically: ‘This study employed the phenomenological (hermeneutic) research paradigm, which is subjectivist, interpretative and constructivist in its approach’ (123). It employed quantitative methods by using three quantitative questionnaires (again): Antonovsky’s (SOC), Schwartz Values Survey (SVS) and organ­ isational culture (OCP). Furthermore, ‘Qualitative methods comprised the use of indepth interviews, observation, and field notes, as well as document and text analysis to collect, analyse and interpret data’ (Abstract). She outlines quantitative data only on a descriptive level. She applies a wide arsenal of methods; nevertheless, her statements and conclusions cannot be generalised: ‘this study is limited to a single case study and is a product of the time and context: post-Apartheid South Africa in times of financial crisis in the automotive industry’ (391).

As a matter of fact, the study has the nature of a problem diagnosis; it leads to the formulation of hypotheses. It contrasts its hypotheses with theoretical knowledge, gaining much valuable insight, and although attempting to support its conclusions also with qualitative data, this could not succeed due to the relatively small number of cases and the questionable representativity of the examined sample (respondents).

Therefore this research can be regarded as a pilot study. As such, however, it is a valuable one, although – as a result of certain careless methodological lapses which we have to point out below, urged by our researcher’s conscience – some of her main theses are questionable, although we must emphasise her strong points nonetheless.

The study provides a rich overview of technical literature within almost all subject matters, and it offers a thorough, all-embracing review of the field regarding research methodology as well as the theoretical background of the research. It refers to a sum of approximately 4,500 volumes, a large part of which is constituted by expounding the results of South-African researches. But within the given subject, she refers to German, British and especially American technical literature as well as reaching back to the beginning of theories.

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Contents Chapter 1 describes in detail the general orientation and subject matters of the volume, the aim of the study, and it gives an overview of the qualitative and quantitative research questions. It outlines the research methods as well as the primary and secondary data sources. It draws both the theoretical and methodological demarcation lines and gives a draft of the structural setup of the whole volume.

Chapter 2 discusses the context of the study, introducing the broader and narrower contexts of the automobile industry, the company’s historic development within the global and the actual South-African environment, emphasising the effects of the economic crisis presenting more and more challenges during the time of research.

Chapter 3 and Chapter 4 expound the theoretical background of the research on 72 pages. Corresponding to the double aim of the research, Chapter 3 expounds the paradigm of salutogenesis in detail, describing and discussing Antonovsky’s concept. It introduces its components (such as comprehensibility, manageability and meaningfulness), emphasising the four appraisals of the construct, namely perception, cognition, behaviour and reappraisal. It defines the idea of General Resistance Resources (GRR) touching upon the salutogenic vs. fortigenic paradigm. The volume displays a comprehensive knowledgeability regarding technical literature. It deserves mentioning that here the author offers a criticism of Antonovsky’s concept.

The chapter provides the necessary arguments and reasons for the necessity to intervene physically and psychologically in order to develop SOC in individuals.

Chapter 4 focuses on the concerns of cross-cultural management and on their theoretical approaches, later shifting the emphasis more and more from theoretic­ al approaches to practical orientation. It discusses the peculiarities of transcultural and international management, emphasising the managerial competence in conflict management. The management has rather important competencies with regard to personal identity as well. The chapter also expounds organisational and personal intervention strategies, and establishes the new intervention model whose essence is to incorporate salutogenesis and transcultural conflict management competencies with identity and value work.

In Chapter 5 the author introduces the research methodology in detail as well as the applied quantitative and qualitative methods. She describes in detail the validity, creditability, reliability, and objectivity criteria of these methods and the principle of triangulation and crystallisation. Furthermore, she mentions ethical considerations.

Then she expounds the aspects of concrete choice of sample, the applied means of research (questionnaires) and the five-step procedure of qualitative data analysis as well as the method of interview evaluation per person.

In this South-African company employing 1,005 persons, 101 out of the 184 members of the leadership were identified as managers, and 27 out of these participated in the interviews (26.7%). The researchers used ‘natural sampling procedures’ to choose the sample (138) which method is frequently employed in the field of busiEJMH 8:2, December 2013

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ness research. The volume presents the research results from Chapter 6 onwards. The socio-demographical data (nationality, position in the organisation, mother tongue and culture, i.e. cultural background) of the 27 persons constituting the managers’ sample display a rather great variety.

Unfortunately, there is no way to discover to what extent this variety reflects the corresponding composition of those who did not take part in the research (constituting almost three fourths of the managers), which means there is no information on the representativity of the sample. Therefore it is questionable how much the research results are valid even for the managers of the given company. The presentation of results is abundant but displays a lot of redundancies. The author displays all the value scores of respondents in the charts which were gained by the SOC, SVS and OCP questionnaires. She makes a note of every single person in the charts. In the text she provides the value scores of those respondents who achieved the five highest scores and the five lowest scores respectively. Regarding these she describes their culture group, sex, age group and managerial level one by one. These are interesting and thought-provoking pieces of information but, as a matter of fact, they do not allow­a conclusion regarding any of the influencing factors.

Chapter 7 contains the results of the in-depth interviews, ordered according to the given subject matters as well as the researcher’s questions, in full detail. Just as until this point, the chapter introduces the contents of the interviews in a didactic structure, summarising and evaluating first the experiences, then the comments.

Chapter 8 discusses the above, going over the quantitative and qualitative research results, attempting to illustrate the complex chain of connections with a multi­ tude of charts. The chapter contains the conclusions drawn from research results and their embodiment into the integrated MEHTO (Mental Health in Transcultural Organisations) intervention model.

The conclusions regarding managers and manager groups ordered according to different aspects (376–77), drawn from data gained by both quantitative and qualitative surveys, are generalisations whose justification was not accomplished in the study in question. The author herself refers to this on pages 391–92, in the chapters bearing the titles ‘Limitation of this study’ and ‘Methodological limitations’. The ‘data can neither be used to make quantitative predictions, nor be statistically projected across target groups’, as well as ‘this study only captured “subjective data” and emic perspectives of the selected individuals and did not evaluate “objective data” ’. She offers a suggestion of how to overcome the limitation in future research.

For example, in order to make generalisation possible, the research should be implemented simultaneously within different companies, with larger sample element numbers. She also suggests planning follow-up research projects to examine the effects of intervention programs. In judging physical health, more metric types should be applied (for example, testing blood pressure, breathing frequencies, etc.). Regarding the establishment of a research project and the fulfilment of these criteria, the results of this study offer valuable information.

In spite of the above, the intervention model (MEHTO) (8.5.) for improving EJMH 8:2, December 2013

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mental health recommended for mental hygiene professionals which builds on the salutogenic concept in a transcultural milieu will most certainly widen the circle of those means which may prevent the consequences of the several health-damaging stress factors that are present in transcultural management. Regarding the physical form of the volume, the often unjustified detailing of data and the redundancy makes reading rather tiresome, and the information content of certain segments does not account for the more than 400 pages of the full volume.

All in all, Professor Meyer’s book is instructive. We agree with Strümpfer in that the volume is ‘in large part a highly informative work’, but it is also true that ‘it is not a book without problems’. And although ‘the results are not at all generalisable’, ‘[d]espite ambiguity, this is a book that ought to be available in any university or research institute where work is done on the topics indicated above’ (2012). The bibliography of this volume as well as its didactic structural setup and methodology (Chapters 1–5) might serve as an example for students attending PhD courses, and certainly for the persons recommending the book, emphasising the generalisation limits of case studies, and precisely drawing the line between the accidental and the general.

References Antonovsky, A. (1979) Health, Stress, and Coping (San Francisco: Jossey-Bass).

Antonovsky, A. (1988) Unraveling the Mystery of Health: How People Manage Stress and Stay Well (San Francisco: Jossey-Bass).

Antonovsky, A. (1996) The Salutogenic Model as a Theory to Guide Health Promotion (San Francisco: Jossey-Bass).

Lefcourt, H.M. (1976) Locus of Control: Current Trends in Theory and Research (New Jersey: Erlbaum).

Strümpfer, D.J.W. (1995) ‘The Origin of Health and Strength: From Salutogenesis to Fortigenesis’, South African Journal of Psychology 25, 81–89.

Strümpfer, D.J.W. (2012) ‘C.-H. Mayer, The Meaning of Sense of Coherence in Transcultural Management: A Salutogenic Perspective on Interactions in a Selected South African Business Organisation (2011) [Review]’, Management Revue 23, 310–14.

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ABSTRACTS / ZUSAMMENFASSUNGEN (Croatian, Czech, English, German, Hungarian, Polish, Rumanian, Russian, and Slovakian Abstracts / Kroatische, Tschechische, Englische, Deutsche, Ungarische, Polnische, Rum채nische, Russische und Slowakische Zusammenfassungen)

European Journal of Mental Health 8 (2013) 275–276 DOI: 10.5708/EJMH.8.2013.2.Abs.HRO

CROATIAN ABSTRACTS KROATISCHE ZUSAMMENFASSUNGEN APSTRAKTI Máté Joób & Paavo Kettunen (str. 163) Ispovjed s gledišta iskustva onih koji traže pomoć: Empirijska studija o ispovjednoj praksi Finaca i Mađara: Članak prikazuje ispovjedno iskustvo polazeći s gledišta ispovjedanika. Iskustva ispovjedi i ispovjedanika ispituje na temelju dviju ranijih studija. Izvorom ovih studija bila su pisma ispovjedanika kojima su tražili ublažavanje stresa. Pošto je sakupljanje i analiza materijala obavljena na sličan način, omogućena je usporedba zaključaka dviju studija. Polazeći od pisama finskih i mađarskih ispitanika autori su ispitivali više tema: očekivanja ispovjedanika, kriterije iskustava odrješenja, odnos ispovjedanika i ispovjednika, i utjecaj ispovjedi na duhovni život ispovjedanika.

Ključne riječi: ispovjed, ispovjedna praksa, ispovjednik, ispovjedanik, odrješenje, strah, grijeh, tuga Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (str. 187) Motivacijska pozadina ciljeva učenja i povezanost iste s mentalnim zdravljem kod osoba srednje i starije dobi: Razvoj čovjeka je jedan kompleksni proces, praćen dobitcima i gubitcima, koji traje cijeli život. Među poteškoćama razvoja u odrasloj dobi vrijedno je posebnu pažnju posvetiti problemima srednje životne dobi, pošto se tijekom dugog prijelaza iz mladosti u stariju dob osoba mora boriti s brojnim gubitcima, i s time suočiti s osebujnim psihološkim zadaćama prilagođavanja novim situacijama. Cilj našega istraživanja je da otkrijemo ciljeve – u prvom redu ciljeve učenja – i povezanost između psiholoških i fizioloških pokazatelja u srednjoj i starijoj životnoj dobi. Prema našim hipotezama one osobe, koje u drugom dijelu života prožive krizu, postaju otvoreniji za izobražavanje u svezi s fizičkim i mentalnim zdravljem. Pretpostavili smo i to da su osobe s intrinzičnom (unutarnjom) motivacijom motiviraniji za samouko učenje, kao i to da se pojavljivanje intrapersonalnih ciljeva može povezati s većim stupnjem otvorenosti prema trening-programima koji se odnose na mentalno zdravlje. Uzorak koji smo ispitivali sastoji se od 585 osoba (životne dobi u prosjeku 50,6 godina, raspršenošću 8,5). Uzorak smo prema Levinsonu razdijelili na šest dobnih skupina. Naši rezultati su potvrdili da su osobe srednje i starije dobi otvorene za programe izobrazbe koji razvijaju funkcije samoupravljanja. Nasuprot našoj hipotezi, ne čine nas otvorenijima za takve programe kriza koja se veže za samnjeno fizičko i mentalno zdravlje, nego nove životne situacije izazvane dobrim fizičkim zdravljem i opterećenjem životnih događaja. Pored toga potreba za programima samousavršavanja jača je u onih kod kojih su u motivacijskom sustavu u većini intrinzični ciljevi (povezani s osnovnim psihološkim potrebama).

Ključne riječi: starenje, srednja životna dob, osobni ciljevi, ciljevi učenja, psihološko blagostanje, andragogija

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Robert Biel (str. 212) Ateizacija kulture u komunističkoj Poljskoj i njezine posljedice na sadašnjost: S prosvjetiteljstvom je u Europi započela kritika vjere u modernom smislu. Mnoge ateističke misli nastale u to vrijeme očuvale su utjecaj do naših dana, te utječu na život i kulturu mnogih naraštaja. Taj je proces u komunističkim zemljama doveo do ateizacije kulture, koja se prilično zamjetno pojavila u Narodnoj Republici Poljskoj. Poljska crkva već je prije nekoliko stoljeća preuzela na sebe ulogu zaštitnice kulture, što je bilo posebno važno u razdoblju takve političke ovisnosti kao što je podjela i okupacija zemlje. Preuzimanje vlasti od strane komunista dovelo je do stavljanja kulture pod skrbništvo i njezino podvrgavanje, i to prema strukturalnim i političkim načelima komunističke partije. Zbog toga je glavni poziv kulture bio u službi komunizma. Marginaliziranje kulture prema namjerama komunističke vlasti sve više dovodilo je do getoizacije kršćanske kulture i umjetnosti.

Posebno od uvođenja izvanrednog stanja u Poljskoj (1981) rezultiralo je takozvanom unutarnjom emigracijom umjetnika i bojkotom poljskog radija i televizije. Posljedicom toga procesa može se smatrati nastanak neslužbenog sustava kulture, čime je ublažena potreba velikog dijela stanovništva. Neslužbeni sustav kulture činili su oni stvaratelji i nosioci kulture, koji nisu bili pdložnici državnih vlasti, a ako i jesu, onda su uživali takav autoritet i slobodu, da su mogli prenositi vrijednosti, norme i oblike ponašanja, koji su se razlikovali od postojećeg sustava kulture. Tako su crkve i prostorije župnih ureda poslužile i za mjesto kazališnih i drugih predstava. Neslužbeni sustav kulture značajno je doprinjeo integraciji društva i pomagao očuvanje nacionalnog identiteta. Stanje društva koje je nastupilo nakon preokreta poticalo je crkvu na to da ponovo odredi svoj položaj na slobodnom tržištu etičkih, kulturnih i vjerskih vrijednosti i da doprinese ukidanju ponora između evanđelja i moderne kulture. Prodorno ispreplitanje crkve i kulture uslijed duhovnog i kulturnog naslijeđa prošlih stoljeća kršćani u Poljskoj ne mogu i ne žele se odreći onoga što čini nepromjenjivi dio nacionalnog i vjerskog identiteta. Kršćani, koji su tijekom više stoljeća obilježili oblik duhovne kulture, i danas na ravnopravan način s drugim europljanima žele posredovati u oblikovanju nove europske stvarnosti.

Ključne riječi: država i crkva, Poljska, komunizam, državni socijalizam, povijest, diktatura, osvrt, ateistička ideologija, crkva, politički preokret, kultura Jozef Hašto & Hana Vojtová (str. 232) Posttraumatski stresni sindrom: Biološki i sociološki odnosi, Eye Movement desenzitizacija i ponovna prerada, kao i autogeni trening pod neprekidnim stresom: Studija slučaja, 2. dio: U našoj studiji prikazat ćemo uporabu Eye Movement desenzitizacije i ponovne prerade (Eye Movement Desensitisation and Reprocesssing-EMDR), odnosno autogenog treninga (AT) u liječenju posttraumatskog stresnog poremećaja (PTSD). EMDR je poslužio za ublažavanje akutnih simptoma, AT pak za pojačavanje otpora protiv neprekidnog stresa. Primjenivši bio-psiho-socijalni model mentalnih problema, ispitali smo veze dviju susjednih država (Slovačke i Mađarske), odnosno socijalno-političke, kao i socijalno-psihološke odnose slučaja koji je zasjenio odnose nacionalnotvorne većine i jedne manjine u našoj domovini (Slovačkoj). Naš pacijent je dao pristanak na objavljivanje izvješća, mi pak vjerujemo da možemo doprinjeti objektivnijem društvenom prosuđivanju.

Ključne riječi: postraumatski stresni poremećaj, bio-psiho-socijalni model, terapija, psihoterapija, Eye Movement desenzitizacija i ponovna prerada, autogeni trening, studija slučaja

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European Journal of Mental Health 8 (2013) 277–278 DOI: 10.5708/EJMH.8.2013.2.Abs.CZ

CZECH ABSTRACTS TSCHECHISCHE ZUSAMMENFASSUNGEN ABSTRAKTY Máté Joób & Paavo Kettunen (s. 163) Zpověď z pohledu zkušeností lidí hledajících pomoc: Empirická studie o zvyklostech Finů a Maďarů při zpovědi: Článek popisuje zpověď vycházeje ze zorného úhlu zpovídajícího se. Zkušenosti zpovídajícího ze zpovědi zkoumá na základě dvou dříve vypracovaných studií. Zdrojem těchto studií byly listy zpovídajících psány za účelem uvolňování stresu. Jelikož sběr a analýza materiálů se uskutečnily v obou případech podobným způsobem, závěry těchto dvou studií se mohly porovnat. Vycházejíc z listů finských a maďarských respondentů autoři prozkoumali několik témat: očekávání zpovídajících se, kritéria prožívání rozhřešení, vztah mezi zpovídajícím se a zpovědníkem, vliv zpovědi na duchovní život zpovídajícího se.

Klíčová výrazy: zpověď, zvyklosti u zpovědi, zpovědník, zpovídající se, rozhřešení, úzkost, hřích, vina, smutek Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (s. 187) Motivační zázemí vzdělávacích cílů a jejich souvislosti s duševním zdravím středně starých a starých lidí: Vývoj lidské bytosti je komplexní, celoživotní proces doprovázen přínosy i ztrátami. Mezi obtížemi vývojového období v dospělosti bychom měli vyzvednout a věnovat zvláštní pozornost problémům středního věku, protože během zdlouhavého procesu stárnutí musí člověk čelit různým ztrátám a zvládnout tak specifické psychologické úkoly spojené s přizpůsobováním se novým situacím. Cílem našeho výzkumu je, abychom prozkoumali souvislosti mezi cíli – a to zejména vzdělávacími cíli – a ukazateli duševního a fyzického zdraví u středně starých a starých lidí. Naší hypotézou bylo, že jedinci, kteří přežijí krizi v druhé polovině svého života, budou otevřenější školením souvisejících s fyzickým a mentálním zdravím. Také jsme předpokládali, že jednotlivci s vnitřní cílovou motivací mají větší motivaci k seberozvoju, a že výskyt interpersonálních cílů souvisí s větší otevřeností k tréninkům, které souvisejí s mentálním zdravím.

Náš vzorek tvoří 585 osob (průměrný věk 50.6 let, standardní odchýlka 8.5). Vzorek jsme podle klasifikace Levinsona rozdělili do šesti věkových skupin. Naše výsledky potvrdily, že lidé ve středním a starším věku jsou otevření k programům rozvíjejícím sebeovládací funkce. Na rozdíl od naší hypotézy jejich otevřenost však není způsobena krizí spojenou s klesajícím fyzickým a mentálním zdravím, ale novými životními situacemi provokovanými dobrou fyzickou kondicí a stresujícími životními událostmi. Přitom zájem o vzdělávací programy osobního rozvoje je větší u těch, kteří mají ve svém motivačním systému převahu vnitřních cílů (spojených se základními psychickými potřebami).

Klíčová výrazy: stárnutí, střední věk, osobní cíle, vzdělávací cíle, psychická pohoda, andragogika

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Robert Biel (s. 212) Ateizace kultury v komunistickém Polsku a její důsledky pro současnost: Osvícenstvím v Evropě začala kritika náboženství v moderním slova smyslu. Mnoho ateistických myšlenek, vytvořených v té době, ovlivňuje život a kulturu mnoha generací. Tento proces vedl v komunistických zemích k ateizaci kultury, což bylo v Polské lidové republice dobře vidět. Polská církev byla po staletí mecenášem kultury, což bylo zvláště důležité v dobách politické závislosti, například v době rozdělení či okupace země. Komunistický převrat přinesl poručnictví a podřízení kultury stukturálním a politickým principem komunistické strany. V důsledku toho bylo hlavním posláním kultury sloužit komunismu. Záměrná marginalizace křesťanské kultury stále více vedla k izolaci křesťanské kultury a umění. Obzvlášť po zavedení výjimečného stavu v Polsku (1981) byly vytvořeny nepříznivé podmínky pro křesťanskou kulturu, což způsobilo tzv. vnitřní exil umělců a bojkot polského rozhlasu a televize. Za výsledek tohoto procesu můžeme považovat vznik neoficiálního systému kultury, který mohl uspokojit požadavky značné části obyvatelstva. Neoficiální systém kultury tvořily ti tvůrci a nositelé kultury, kteří nebyli podřízení státní moci, nebo pokud ano, tak měli takovou autoritu a svobodu, že byli schopni předat hodnoty, normy a způsoby chování, které se lišily od stávajícího kulturního systému. Prostory kostelů a farností se tak staly místem divadelních a jiných představení. Neoficiální systém kultury značně přispěl k integraci společnosti a pomohl v zachování národní identity. Společenská situace po převratu vedla polskou církev k tomu, aby znovu definovala svou pozici na volném trhu etických, kulturních a náboženských hodnot a přispěla k odstranění propasti mezi evangeliem a moderní společností. Křesťané, vědomi si staletí prolínání duchovního a kulturního dědictví se nemohou a nechtějí vzdát nezměnitelné součásti své národní a náboženské identity. Křesťané v průběhu staletí vytvářeli obraz nehmotné kultury a budou pokračovat ve snaze dosáhnout pozici rovnocenných a plnohodnotných partnerů při vytváření nové evropské reality.

Klíčová výrazy: stát a církev, Polsko, komunismus, státní socialismus, dějiny, diktatura, retrospektiva, ateistická ideologie, církev, politický zvrat, kultura Jozef Hašto & Hana Vojtová (s. 232) Posttraumatická stresová porucha: Bio-psycho-sociální aspekty, desenzibilizace pomocí očních pohybů a restrukturalizace (EMDR) a autogenní trénink při přetrvávajícím stresu: Případová studie, část 2.: V kazuistické studii se ilustruje použití metody EMDR a autogenního tréninku (AT) v léčbě PTSP. EMDR se použilo na zvládnutí akutních symptomů, zatímco AT na posílení odolnosti při přetrvávajícím ohrožení. Opírajíce se o bio-psycho-sociální model psychických onemocnění diskutují autoři sociopolitické a sociálně-psychologické aspekty tohoto případu, který zatížil vztahy mezi dvěma sousedícími národy a vztah národní majority a menšiny v naší zemi (Slovensko). Pacientka dala souhlas k publikování zjištění a úvah autorů a věříme, že to přispěje k realističtějšímu chápání tohoto případu ve společnosti.

Klíčová výrazy: posttraumatická stresová porucha, bio-psycho-sociální model, terapie, psychoterapie, desenzibilizace pomocí očních pohybů a restrukturalizace (Eye Movement Desensitisation and Reprocessing), autogenní trénink, případová studie

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 279–280 DOI: 10.5708/EJMH.8.2013.2.Abs.GB

ENGLISH ABSTRACTS ENGLISCHE ZUSAMMENFASSUNGEN ABSTRACTS Máté Joób & Paavo Kettunen (p. 163) Confession from the Point of View of the Experience of the People Seeking Help: An Empirical Study about Confessional Practices in Finland and Hungary: The article presents confession practice from the point of view of the confessants. The practice and experiences of the confessants are presented based on two earlier research studies. The source material of both researches was based on letters written by the confessants themselves with the need of stress relief.

As the collection and analysis of the material was conducted with a similar method, there is also a possibility to compare the findings of the two research studies. Based on letters from Finnish and Hungarian respondents, the authors look at several topics: expectations from the confessants, criteria of experiencing absolution, the relationship between confessant and confessor and the effect of confession on the spiritual life of the confessant.

Keywords: confession, confessional practice, confessor, confessant, absolution, anxiety, sin, guilt, distress Krisztina S. Petik, Anikó Kézdy& Fruzsina Kocsis (p. 187) Learning Projects and Their Background Motivations: Relationships with Mental Health in Midlife and Later Life: Human development is a life-long, complex process accompanied by gains and losses. Among the difficulties of adult development, midlife calls for special attention, for, during the long transition from youth to old-age, one has to face several losses, and, as a result of that, the special psychological tasks of accommodating to new circumstances. The purpose of the study was to explore the relationship between projects – especially projects concerning learning – and indicators of psychological and physical health in midlife and later life. We hypothesised that individuals who are experiencing crises in the second half of their lives would be more open towards educational programmes on physical and mental health. We also expected that individuals with intrinsic goal motivation would be more motivated for self-developing learning, and that intrapersonal goals would be connected with a greater openness to training programmes on mental health. The sample consisted of 585 people (M = 50.6, SD = 8.5). For further analysis the sample was divided into six age groups on the basis of Levinson’s classification. The results confirmed that the middle- and the old-age generations are open to educational programs that develop self-directing functions. Contrarily to our hypothesis, it is not a crisis linked with decreased physical and mental health that makes one open to such programmes, but good physical health and new life situations presented by stressful life events. Besides, the need to participate in educational programmes aimed at self-development is stronger in the case of individuals whose motivational system is dominated by intrinsic goals (goals related to basic psychological needs).

Keywords: aging, midlife, personal projects, learning projects, psychological well-being, andragogy

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Robert Biel (p. 212) The Atheisation of Culture in Communist Poland and Its Present-Day Repercussions: The Age of Enlightenment marked the beginning of modern religious criticism in Europe. Several atheistic ideas born at that time have maintained their influence and affected the life and culture of many generations. This process, which clearly manifested itself in the People’s Republic of ­Poland as well, led to the atheisation of culture. The church in Poland has been acting as the patron of culture for centuries and this role was especially important at times of political dependence such as the division or the occupation of the country. Under the Communist rule culture was given a subordinate status based on the structural and political principles of the Communist Party.

Consequently, culture was primarily expected to serve communism. The intention of authorities to marginalise Christian culture and art resulted in its increasing ghettoisation. Following the declaration of a state of emergency (1981) the ghetto conditions created for Christian culture contributed to the so-called internal emigration of artists and the boycott of the Polish radio and television. This process generated an unofficial system of culture, which could cater to the needs of the majority of citizens. This unofficial system comprised actors and trustees of culture who were not subservient to state power or had more authority and freedom to represent different values, norms or forms of behaviour than those of the dominant cultural system. For example, churches or parish community rooms hosted theatre shows and other performances as well. The unofficial system of culture contributed to social integration in a significant way and helped to preserve national identity. The social status quo following the political turn compelled the Polish church to re-define its position on the free market of ethical, cultural and religious values and played a role in eliminating the gulf between the Christian message and modern society. Since church and culture have been deeply intertwined and Christians are conscious of their centuries-long spiritual and cultural heritage, they cannot and do not want to give up this unalterable element of national and religious identity. Christians have been forming the image of intangible culture for centuries and they will continue to strive for a position as equal and full partners in constructing the new European reality.

Keywords: state and church, Poland, communism, state socialism, history, dictatorship, retrospection, atheist ideology, church, political turn, culture Jozef Hašto & Hana Vojtová (p. 232) Posttraumatic Stress Disorder: Bio-Psycho-Social Aspects, Eye Movement Desensitisation and Reprocessing and Autogenic Training in Persistent Stress: Case Study, Part 2.: In our case study, we illustrate the use of Eye Movement Desensitisation and Reprocessing (EMDR) and Autogenic Training (AT) in PTSD treatment. EMDR was used to manage the acute symptoms, while AT was used to enhance the resilience in persisting stress. Using the bio-psycho-social model of mental illness, we discuss the socio-political and socio-psychological aspects of this case that has put a burden on the relationship of two neighboring nations (Slovakia and Hungary) as well as on the relationship of the national majority and a minority within our country (Slovakia).

Our patient consented to this report being published, and we hope that it will contribute to a more realistic evaluation of this event in society.

Keywords: posttraumatic stress disorder, bio-psycho-social model, therapy, psychotherapy, Eye Movement Desensitisation and Reprocessing, Autogenic Training, case study

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 281–283 DOI: 10.5708/EJMH.8.2013.2.Abs.D

GERMAN ABSTRACTS DEUTSCHE ZUSAMMENFASSUNGEN ZUSAMMENFASSUNGEN Máté Joób & Paavo Kettunen (S. 163) Beichte aus der Perspektive der Erfahrungen Hilfesuchender: Empirische Studie über die Praxis der Beichte bei Finnen und Ungarn: Der Artikel stellt die Praxis der Beichte aus der Sicht der beichtenden Person, des Büßers, vor. Die Beichte und die Erfahrungen der Büßer werden von zwei früheren Studien ausgehend untersucht. Das Quellenmaterial dieser Studien bilden Briefe von Büßern mit dem Bedürfnis nach Stressreduzierung. Da die Materialsammlung und -analyse in beiden Studien auf ähnliche Weise erfolgte, konnten die Ergebnisse miteinander verglichen werden. Auf der Grundlage der Briefe von finnischen und ungarischen Untersuchungsteilnehmern haben die Autoren verschiedene Themen untersucht: Erwartungen der Büßer, Kriterien für das Erleben der Lossprechung, das Verhältnis zwischen Beichtvater und Büßer sowie die Wirkung der Beichte auf das spirituelle Leben des Büßers.

Schlüsselbegriffe: Beichte, Praxis der Beichte, Beichtvater, Büßer, Lossprechung, Angstzustände, Sünde, Schuld, Reue Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (S. 187) Der motivationale Hintergrund von Lernzielen und sein Zusammenhang mit der mentalen Gesundheit bei Personen im mittleren und hohen Alter: Die Entwicklung des Menschen ist ein mit Gewinnen und Verlusten verbundener, komplexer, lebenslanger Prozess. Von den unterschiedlichen Schwierigkeiten der Entwicklung im Erwachsenenalter verdienen die Probleme der mittleren Lebensphase besondere Aufmerksamkeit, weil Menschen während des langen Übergangs von der Jugend in ein höheres Alter mit zahlreichen Verlusten zu kämpfen haben und dabei mit besonderen psychischen Aufgaben der Anpassung an neue Situationen konfrontiert sind. Die Zielsetzung unserer Forschungsarbeit ist, den Zusammenhang zwischen Zielen – insbesondere Lernzielen – und den Parametern der psychischen und physiologischen Gesundheit in den mittleren und höheren Lebensjahren zu erschließen. Unserer Hypothese nach stehen Personen, die in der zweiten Lebenshälfte eine Krise durchgemacht haben, Schulungen im Bereich der körperlichen und mentalen Gesundheit offener gegenüber. Ebenso gingen wir davon aus, dass Personen mit einer intrinsischen Zielmotivation eher zu ihrer Persönlichkeitsentwicklung dienendem Lernen motiviert sind. Des Weiteren nahmen wir an, dass ein Zusammenhang zwischen dem Vorhandensein intrapersonaler Ziele und einer Offenheit gegenüber Trainings zur mentalen Gesundheit besteht. Die von uns untersuchte Stichprobe bestand aus 585 Personen (Durchschnittsalter 50.6 Jahre, Streuung 8.5). Auf der Grundlage der Klassifizierung nach Levinson haben wir die Probanden in sechs Altersgruppen eingeteilt. Unsere Ergebnisse bestätigen, dass Personen im mittleren und höheren Alter gegenüber Ausbildungsprogrammen im Bereich der Entwicklung der Selbststeuerungsfunktionen offen sind. Im Widerspruch zu unserer Hypothese entsteht diese Offenheit nicht als Konsequenz einer Krise durch nachlassende körperliche und mentale Gesundheit, sondern infolge durch belastende Lebensereignisse bei guter körperlicher Gesundheit ausgelöste

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neue Lebenssituationen. Darüber hinaus war das Bedürfnis nach Schulungen im Bereich der Persönlichkeitsentwicklung ausgeprägter bei Personen, in deren Motivationssystem intrinsische (im Zusammenhang mit grundlegenden psychologischen Bedürfnissen stehende) Ziele überwiegen.

Schlüsselbegriffe: Altern, mittlere Lebensphase, persönliche Ziele, Lernziele, psychologisches Wohlbefinden, Andragogie Robert Biel (S. 212) Die Atheisierung der Kultur im kommunistischen Polen und ihre Konsequenzen für die Gegenwart: Mit der Aufklärung hat in Europa die Religionskritik im modernen Sinn eingesetzt.

Viele der damals entwickelten atheistischen Gedanken haben ihre Wirkung bis in die Gegenwart behalten und beeinflussen bis heute das Leben und die Kultur vieler Generationen. Dieser Prozess führte in den kommunistischen Ländern zur Atheisierung der Kultur, was sich in der VR Polen deutlich zeigte. Die Kirche in Polen übernahm bereits vor Jahrhunderten die Rolle eines Mäzens der Kultur, was besonders in den Perioden der politischen Abhängigkeit, also bei Teilungen oder Besetzungen, von Bedeutung war. Die Machtübernahme durch die Kommunisten führte zur Bevormundung der Kultur und ihre Unterordnung unter die strukturellen und politischen Prinzipien der kommunistischen Partei. Forthin galt es als höchste Berufung der Kultur, im Dienste des Kommunismus zu stehen. Die von den kommunistischen Behörden geplante Marginalisierung der christlichen Kultur führte nach und nach zur Entstehung eines Ghettos der christlichen Kultur und Kunst. Besonders seit der Verhängung des Kriegsrechts in Polen (1981) führten diese für die christliche Kultur geschaffenen Ghetto-Verhältnisse zur sog. inneren Emigration der Künstler und zum Boykott des polnischen Rundfunks und Fernsehens. Als Konsequenz hieraus entstand ein inoffizielles Kultursystem, das die diesbezüglichen Bedürfnisse des größten Teils der Bevölkerung stillte. Das inoffizielle Kultursystem bildeten jene Kulturschaffenden, die im Bereich des Kulturlebens nicht der Staatsmacht unterstanden, oder ihr zwar unterstanden, aber so viel Autorität und Freiheit genossen, dass sie Werte, Normen und Verhaltensweisen überliefen konnten, die nicht mit dem geltenden sozialistischen Kultursystem übereinstimmten. In Kirchen und Gemeinderäumen wurden Theatervorstellungen und Vorlesungen durchgeführt. Das inoffizielle Kultursystem trug wesentlich zur gesellschaftlichen Integration bei und half die nationale Identität zu bewahren. Die neue gesellschaftliche Lage nach der Wende zwang die Kirche in Polen zu neuen Positionsbestimmungen auf dem freien Markt der ethischen, kulturellen und religiösen Werte und zur Überwindung der Spaltung, die zwischen dem Evangelium und der modernen Kultur erfolgt war. Aufgrund der tiefen Verbundenheit zwischen Kirche und Kultur und des Bewusstseins des geistigen und kulturellen Erbes der vergangenen Jahrhunderte können und wollen die Christen in Polen nicht auf das verzichten, was einen unveräußerlichen Teil der nationalen und religiösen Identität darstellt. Die Christen, die das Antlitz der geistigen Kultur über Jahrhunderte geprägt haben, wollen auch heute an der neuen europäischen Wirklichkeit gleichberechtigt mit anderen Europäern mitwirken.

Schlüsselbegriffe: Staat und Kirche, Polen, Kommunismus, Staatssozialismus, Diktatur, Geschichte, Rückblick, atheistische Ideologie, Kirche, Wendezeit, Kultur

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Jozef Hašto & Hana Vojtová (S. 232) Posttraumatisches Stresssyndrom: Biologische und soziale Bezüge, Desensibilisierung durch Augenbewegungen und Erlebnisumstrukturierung sowie autogenes Training bei Dauerstress: Fallstudie, Teil 2: In unserer Studie beschreiben wir die Anwendung der Desensibilisierung durch Augenbewegungen (Eye Movement Desensitisation and Reprocessing – EMDR) bzw. des autogenen Trainings (AT) in der Behandlung des posttraumatischen Stresssyndroms (PTSD).

EMDR dient der Milderung der akuten Symptome, AT der Verbesserung des Widerstands gegen Dauerstress. Unter Anwendung des bio-psycho-sozialen Modells der mentalen Probleme untersuchten wir die sozialpolitischen sowie sozialpsychologischen Aspekte eines Falles, der die Beziehung zweier benachbarter Länder (Slowakei und Ungarn) und das Verhältnis zwischen nationaler Mehrheit und einer der Minderheiten beeinträchtigt. Der Patient hat in die Veröffentlichung des Berichts eingewilligt, und nun hoffen wir, zu einer objektiveren Beurteilung des Falles in der Gesellschaft beitragen zu können.

Schlüsselbegriffe: Posttraumatisches Stresssyndrom, bio-psycho-soziales Modell, Therapie, Psychotherapie, Desensibilisierung durch Augenbewegungen und Erlebnisumstrukturierung, autogenes Training, Fallstudie

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 284–286 DOI: 10.5708/EJMH.8.2013.2.Abs.H

HUNGARIAN ABSTRACTS UNGARISCHE ZUSAMMENFASSUNGEN ÖSSZEFOGLALÓK Joób Máté & Paavo Kettunen (163 o.)

Gyónás a segítséget igénylők tapasztalatainak szemszögéből: Empirikus tanulmány finnek és magyarok gyónási gyakorlatáról: A cikk a gyónási gyakorlatot a gyónó szemszögéből kiindulva mutatja be. A gyónás és a gyónó tapasztalatait két korábbi tanulmány alapján vizsgálja. E tanulmányok forrásanyagát a gyónók stresszenyhítést igénylő levelei szolgáltatták. Mivel az anyagok gyűjtése és analízise hasonló módon történt, lehetővé vált a két tanulmány megállapításainak összevetése. Finn és magyar válaszadók leveleiből kiindulva a szerzők több témát vizsgáltak: a gyónók elvárásait, a feloldozás megtapasztalásának kritériumait, a gyónó és gyóntató viszonyát és a gyónás hatását a gyónó lelki életére.

Kulcsszavak: gyónás, gyónási gyakorlat, gyóntató, gyónó, feloldozás, szorongás, bűn, vétek, bánat S. Petik Krisztina, Kézdy Anikó & Kocsis Fruzsina (187 o.)

A tanulási célok motivációs háttere és ennek összefüggése a mentális egészséggel közép- és időskorúaknál: Az ember fejlődése egy nyereségekkel és veszteségekkel kísért, élethosszig tartó, komplex folyamat. A felnőttkori fejlődés nehézségei között érdemes kiemelt figyelmet szentelnünk a középső életkor problémáinak, mivel a fiatalságból az időskorba való hosszú átmenet során a személynek számos veszteséggel kell megküzdenie, és ezáltal szembesülnie kell az új helyzetekhez való alkalmazkodás sajátos pszichológiai feladataival.

Kutatásunk célja, hogy feltárjuk a célok – elsősorban a tanulási célok – és a pszichológiai és fiziológiai egészség mutatói közötti összefüggést a középső és idős életkorban. Hipotézisünk szerint azok a személyek, akik az élet második felében krízist élnek át, nyitottabbak lesznek a fizikai és mentális egészséggel kapcsolatos képzésekre. Azt is feltételeztük, hogy az intrinzik célmotivációval rendelkező egyének motiváltabbak az önfejlesztő tanulásra, valamint hogy az intraperszonális célok megjelenése összefüggésbe hozható a mentális egészségre vonatkozó tréningprogramokkal szembeni nagyobb fokú nyitottsággal. Az általunk vizsgált minta 585 főből áll (átlagos életkoruk 50,6 év, a szórás 8,5). A mintát Levinson osztályozásából kiindulva hat korcsoportra bontottuk. Eredményeink igazolták, hogy a közép- és időskorúak nyitottak az önirányítási funkcióikat fejlesztő képzési programokra. Hipotézisünkkel ellentétben nem a csökkenő fizikai és mentális egészséghez köthető krízis tesz nyitottá az ilyen programokra, hanem a jó fizikai egészség és a megterhelő életesemények provokálta új élethelyzetek. Emellett az önfejlesztő képzési programok iránti igény erősebb azoknál, akik motivációs rendszerében többségben vannak az intrinzik (az alapvető pszichológiai szükségletekkel kapcsolatos) célok.

Kulcsszavak: öregedés, középső életkor, személyes célok, tanulási célok, pszichológiai jóllét, andragógia

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Robert Biel (212 o.)

A kultúra ateizálódása a kommunista Lengyelországban és ennek következményei a jelenre: A felvilágosodással kezdetét vette Európában a modern értelemben vett valláskritika. Sok annakidején kialakult ateista gondolat a jelenkorig megőrizte hatását, és befolyásolja sok nemzedék életét és kultúráját. Ez a folyamat a kommunista országokban a kultúra ateizálásához vezetett, ami a Lengyel Népköztársaságban jól észrevehetően jelent meg. A lengyelországi egyház már évszázadokkal ezelőtt magára vállalta a kultúra pártfogójának szerepét, ami különösen fontos volt a politikai függőség olyan időszakaiban, mint az ország felosztása vagy megszállása. A kommunisták hatalomátvétele a kultúra gyámkodás alá helyezéséhez és alárendeléséhez vezetett, mégpedig a kommunista párt strukturális és politikai elvei alapján. Ebből következően a kultúra fő hivatásának a kommunizmus szolgálata számított. A keresztény kultúrának a kommunista hatóságok szándéka szerinti marginalizálása egyre inkább a keresztény kultúra és művészet gettósodásához vezetett. Különösen a lengyelországi szükségállapot bevezetése (1981) óta a keresztény kultúra számára teremtett gettóviszonyok a művészek úgynevezett belső emigrációját és a lengyel rádió és televízió bojkottját eredményezték. E folyamat következményének tekinthető a kultúra nem hivatalos rendszerének létrejötte, amely csillapította a lakosság nagy részének igényeit. A kultúra nem hivatalos rendszerét a kultúra azon alkotói és hordozói képezték, amelyek nem voltak az államhatalom alárendeltjei, vagy ha mégis, olyan autoritást és szabadságot élveztek, hogy képesek voltak értékeket, normákat és magatartásmódokat átadni, amelyek különböztek a fennálló kulturális rendszertől. Így a templomok és plébánia helyiségek színházi és egyéb előadások helyszínéül is szolgáltak. A kultúra nem hivatalos rendszere jelentősen hozzájárult a társadalom integrációjához és segítette a nemzeti identitás megőrzését. A fordulat után beállott társadalmi helyzet arra késztette a lengyelországi egyházat, hogy újra határozza meg helyzetét az etikai, kulturális és vallási értékek szabad piacán és járuljon hozzá az evangélium és a modern kultúra közötti szakadék felszámolásáhot. Az egyház és a kultúra mélyreható összefonódása, az elmúlt évszázadok szellemi és kulturális örökségének tudata következtében a lengyelországi keresztények nem tudnak és akarnak lemondani arról, ami a nemzeti és vallási identitás megváltoztathatatlan résztét alkotja. A keresztények, akik évszázadokon keresztül a szellemi kultúra arculatát meghatározták, ma is, más európaiakkal egyenrangú módon, közre akarnak működni az új európai valóság alakításában.

Kulcsszavak: állam és egyház, Lengyelország, kommunizmus, államszocializmus, történelem, diktatúra, visszatekintés, ateista ideológia, egyház, politikai fordulat, kultúra Jozef Hašto & Hana Vojtová (232 o.)

Poszttraumás stressz szindróma: Biológiai és szociális vonatkozások, szemmozgásos deszenzitálás és élményátstrukturálás, valamint autogén tréning folyamatos stressz alatt: Esettanulmány, 2. rész: Tanulmányunkban bemutatjuk a szemmozgásos deszenzitálás és élményátstrukturálás (Eye Movement Desensitisation and Reprocessing – EMDR), illetve az autogén tréning (AT) használatát a poszttraumás stressz szindróma (PTSD) kezelésében. Az EMDR az akut tünetek enyhítésére, az AT pedig a folyamatos stresszel szembeni ellenállás fokozására szolgált. A mentális problémák bio-pszicho-szociális modelljét alkalmazva megvizsgáltuk a két szomszédos ország (Szlovákia és Magyarország) kapcsolatát, illetve hazánk (Szlovákia) nemzetalkotó többsége és egyik kisebbsége viszonyát beárnyékoló eset szociális-politikai, valamint szociális-pszichológiai vonatkozásait. Páciensünk hozzájárult a jelentés EJMH 8:2, December 2013

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közzétételéhez, mi pedig bízunk benne, hogy elősegíthetjük az eset tárgyilagosabb társadalmi megítélését.

Kulcsszavak: poszttraumás stressz szindróma, bio-pszicho-szociális modell, terápia, pszichoterápia, szemmozgásos deszenzitálás és élményátstrukturálás, autogén tréning, esettanulmány

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 287–289

DOI: 10.5708/EJMH.8.2013.2.Abs.PL

POLISH ABSTRACTS POLNISCHE ZUSAMMENFASSUNGEN ABSTRAKTY Máté Joób & Paavo Kettunen (s. 163) Spowiedź w ujęciu osób potrzebujących pomocy: Empiryczne studium o praktyce sakramentu pokuty wśród Finów i Węgrów: Artykuł przedstawia praktykę spowiedzi z punktu widzenia penitentów. Spowiedź i doświadczenia spowiadających się bada na podstawie dwóch wcześniejszych prac. Źródłem materiałów do tych prac były listy penitentów poszukujacych ulgi w stanie stresu. Ponieważ zbieranie i analiza materiału przebiegała w podobny sposób, możliwe było porównanie wniosków sformułowanych w obu pracach. Na podstawie listów od fińskich i węgierskich respondentów autorzy badali kilka tematów: oczekiwania penitentów, kryteria doświadczania rozgrzeszenia, stosunek pomiędzy spowiednikiem a spowiadającym się i wpływ spowiedzi na życie duchowe penitenta.

Słowa kluczowe: spowiedź, praktyka spowiedzi, spowiednik, penitent, rozgrzeszenie, niepokój, grzech, przewina, żal Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (s. 187) Kontekst motywacyjny celów podejmowania nauki i jego związek ze zdrowiem psychicznym u osób wieku średnim i starszym: Rozwój osoby ludzkiej jest nieustannym, towarzyszącym przez całe życie, złożonym procesem, w którym zyski przeplatają się ze stratami. Spośród trudności rozwoju osób dorosłych szczególną uwagę należy poświęcić problemom wieku średniego, ponieważ w ciągu długiego okresu przejściowego pomiędzy młodością a wiekiem starszym człowiek musi się pogodzić z licznymi stratami i rozwiązać specyficzne zadania psychiczne wynikające z potrzeby przystosowania się do nowych sytuacji życiowych. Celem naszych badań było rozpoznanie związku pomiędzy celami – związanymi przede wszystkim z podjęciem nauki – a wskaźnikami dotyczącymi zdrowia fizycznego i psychicznego u osób w wieku średnim i starszym. Zgodnie z naszą hipotezą osoby, które w drugiej połowie życia przechodzą kryzys, są bardziej otwarte na podjęcie kształcenia dotyczącego zdrowia fizycznego i mentalnego. Wychodziliśmy z założenia, że jednostki posiadające wewnętrzną motywację do osiągnięcia celu chętniej podejmą naukę związaną z samorozwojem oraz że pojawienie się celów intrapersonalnych może być związane z większą otwartością na programy treningowe z dziedziny zdrowia mentalnego.

Grupa badana przez nas składała się z 585 osób (średnia wieku 50.6 lat, rozrzut 8.5 roku). Na podstawie klasyfikacji Levisona, podzieliliśmy grupę na sześć podgrup wiekowych. Wyniki badania potwierdziły, że osoby w wieku średnim i starszym chętnie uczestniczą w programach rozwojowych dotyczących funkcji samosterowania. Stwierdziliśmy natomiast wbrew naszej hipotezie, że zwiększenie zainteresowania takimi programami wywołuje nie kryzys związany z osłabieniem stanu zdrowia fizycznego i psychicznego, lecz nowe sytuacje życiowe, podejmowane z związku z dobrym zdrowiem fizycznym lub sprowokowane trudnymi przeżyciami. Ponadto zainteresowanie programami dotyczącymi samorozwoju jest silniejsze u osób o systemie motywacyjnym z priorytetem potrzeb psychologicznych.

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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Słowa kluczowe: starzenie się, wiek średni, cele osobiste, cele dydaktyczne, dobrobyt psychiczny, andragogia Robert Biel (s. 212) Ateizowanie kultury w komunistycznej Polsce i jej konsekwencje dla współczesności: Oświecenie było w pewnym sensie okresem narodzin krytyki religii w Europie, we współczesnym tego słowa znaczeniu. Wiele zainicjowanych wówczas ateistycznych poglądów zachowało swoją aktualność i wpływ na życie i kształtowanie kultury kolejnych pokoleń. Proces ten w krajach komunistycznych prowadził do ateizowania kultury, co było wyraźnie zauważalne zwłaszcza w Polskiej Rzeczypospolitej Ludowej. W Polsce Kościół od wieków pełnił rolę mecenasa kultury, co było szczególnie ważne w okresach politycznego zniewolenia jak choćby w czasie rozbiorów lub okupacji. Przejęcie władzy przez komunistów prowadziło do stopniowego podporządkowania kultury ideologicznym i strukturalnym zasadom partii komunistycznej. Zatem najważniejszym zadaniem stawianym przed twórcami kultury tamtych czasów była służba na rzecz rozpowszechniania idei komunizmu. Zaplanowana i propagowana przez władze komunistyczne marginalizacja chrześcijańskiej kultury doprowadziła do powstania swoistego getta kultury i sztuki chrześcijańskiej.

Takie działania władz – szczególnie w okresie wprowadzonego w 1981 roku stanu wojennego – sprawiły, że wielu twórców kultury zdecydowało się na tzw. wewnętrzną emigrację i bojkot publicznego radia i telewizji. Proces ten doprowadził z kolei do powstania nieformalnego, niezależnego od komunistycznych władz systemu kultury, który zaspokajał potrzeby znaczącej części chrześcijańskiego społeczeństwa. Nieformalny system kultury kreowali twórcy i artyści, którzy nie podporządkowali się aktualnej władzy państwowej lub cieszyli się autorytetem i poczuciem wolności pozwalającym na przekazywanie wartości, norm i wzorców zachowania różniących się od istniejącego systemu kulturowego. Szczególnie pomocny okazał się w tym Kościół udostępniając swoje parafie do celów propagowania kultury. Nieformalny system kultury przyczynił się znacznie do integracji społecznej i zachowania tożsamości narodowej. Nowa sytuacja społeczna zaistniała po przełomie politycznym skłoniła polski Kościół do ponownego zdefiniowania swojej pozycji na wolnym rynku moralnych, religijnych i kulturowych wartości oraz do podjęcia starań o zlikwidowanie próżni powstałej między Ewangelią a nowoczesną kulturą. Głęboka więź między Kościołem a kulturą, świadomość duchowego i kulturowego dziedzictwa minionych wieków sprawiają, że polscy chrześcijanie nie potrafią i nie chcą zrezygnować z tego, co od wieków stanowi nierozłączną część ich religijnej i narodowej tożsamości. Dlatego chrześcijanie, którzy przez stulecia kształtowali oblicze kultury duchowej, dziś także, na równi z innymi Europejczykami, chcą mieć prawo do tworzenia nowej europejskiej rzeczywistości.

Słowa kluczowe: państwo i kościoł, Polska, komunizm, państwowy socjalizm, dyktatura, historia, przegląd historyczny, ateistyczna ideologia, kościół, czas przełomu, kultura Jozef Hašto & Hana Vojtová (s. 232) Syndrom stresu posttraumatycznego: Warunki biologiczne i socjalne, desensytyzacja ruchu gałek ocznych i przekształcenie struktury przeżycia oraz trening autogenny podczas trwałego stresu: Studium przypadku, część 2: W naszej pracy przedstawiamy desensytyzację ruchu gałek ocznych i przekształcenie struktury przeżycia (Eye Movement Desensitisation and Reprocessing – EMDR) oraz zastosowanie treningu autogennego (AT) podczas leczenia trwałego stresu posttraumatycznego (PTSD). EMDR służy łagodzeniu trwałych objawów, natomiast EJMH 8:2, December 2013

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AT wzmocnieniu oporu wobec trwałego stresu. Stosując model bio-psycho-socjalny problemów mentalnych zbadaliśmy zagadnienia socjalno-polityczne i socjalno-psychologiczne, utrudniające związki pomiędzy dwoma sąsiadującymi krajami (Węgry i Słowacja) oraz stosunki pomiędzy większością ludności a mniejszością etniczną w naszym kraju (Słowacja). Nasz pacjent wyraził zgodę na opublikowanie naszej pracy, a my mamy nadzieję, że uda nam się pomóc ukształtować bardziej rzeczową ocenę tego przypadku.

Słowa kluczowe: syndrom stresu posttraumatycznego, model bio-psycho-socjalny, terapia, psychoterapia, desensytyzacja ruchu gałek ocznych i przekształcenie struktury przeżycia, trening autogenny, studium przypadku.

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 290–291 DOI: 10.5708/EJMH.8.2013.2.Abs.R

RUMANIAN ABSTRACTS RUMÄNISCHE ZUSAMMENFASSUNGEN ABSTRACTE Máté Joób & Paavo Kettunen (pag. 163) Spovedania din prisma celor care au nevoie de ajutor: Studiu empiric privind practica spovedaniei finlandezilor şi maghiarilor: Articolul prezintă practica spovedaniei pornind de la punctul de vedere al penitentului. Experienţele spovedaniei şi ale penitentului sunt examinate pe baza a două studii precedente. Sursa de date a acestor studii constituie scrisorile penitenţilor care poartă semnul dorinţei de ameliorare a stresului. Deoarece culegerea şi analiza datelor s-a desfăşurat în mod asemănător, a devenit posibilă colaţionarea celor două studii. Pornind de la răspunsurile finlandezilor şi maghiarilor la scrisori, autorii au cercetat mai multe teme: aşteptările penitenţilor, criteriile experienţelor dezlegării, relaţia dintre penitent şi duhovnic şi repercusiunea spovedaniei asupra vieţii duhovniceşti a penitentului.

Cuvinte cheie: spovedanie, exerciţiul spovedaniei, duhovnic, penitent, dezlegare, nelinişte, păcat, penitenţă Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (pag. 187) Fundalul motivaţiei scopurilor de învăţare şi corelaţia acesteia cu sănătatea mentală în cazul persoanelor de vârstă mijlocie şi de vârstă înaintată: Evoluţia omului este un proces complex, plin de reuşite şi eşecuri, care ţine până la sfârşitul vieţii. Dintre greutăţile evoluţiei în perioada vârstei adulte, merită să acordăm o atenţie deosebită problemelor vârstei mijlocii, deaorece pe parcursul perioadei de trecere din tinereţe în bătrâneţe persoana trebuie să se lupte cu multe eşecuri, şi prin aceasta să se confrunte cu sarcinile psihologice specifice ale adaptării la situaţiile noi. Scopul cercetării este să dezvăluim corelaţia dintre obiective – în primul rând obiective de învăţare – şi indicatorii sănătăţii psihologice şi fiziologice, în cazul persoanelor de vârstă mijlocie şi de vârstă înaintată. În ipoteza noastră, persoanele care în a doua parte din viaţa lor trec printr-o criză, vor fi mai deschişi faţă de instruirile în legătură cu sănătatea fizică şi mentală. Am presupus de asemenea că, persoanele care deţin o motivaţie-obiectiv intrinsecă sunt mai motivaţi pentru autoînvăţare, respectiv că, apariţia obiectivelor interpersonale se poate pune în raport cu un comportament mai deschis faţă de programele de training referitoare la sănătatea mentală. Grupul studiat conţine 585 de persoane (vârsta medie fiind 50.6 de ani, dispersare 8.5). Conform categorizării lui Levinson, grupul a fost împărţit în şase categorii de vârstă. Rezultatele au demonstrat că persoanele de vârstă mijlocie şi cele de vârstă înaintată sunt deschise la programele de instruire de dezvoltarea funcţiilor de autoconducere. În antiteză cu ipoteza noastră, nu criza provocată de scăderea sănătăţii fizice şi mentale duce la acceptarea acestor programe, ci condiţiile fizice favorabile şi noile situaţii de viaţă provocate de evenimente împovărătoare. Pe lângă aceasta, exigenţa faţă de programele de instruire de autodezvoltare este mai puternică în cazul persoanelor, în a căror sistem de motivaţii sunt majoritare obiectivele intrinsece (legate de nevoile psihologice de bază).

Cuvinte cheie: îmbătrânire, vârstă mijlocie, obiective personale, obiective de învăţare, bunăstare psihologică, andragogie ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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Robert Biel (pag. 212) Ateizarea culturii în Polonia comunistă şi consecinţele acesteia pentru prezent: În Europa odată cu apariţia iluminismului a apărut şi critica religiei interpretat în sens modern. Multe dogme ateiste din aceea perioadă au repercusiuni până în prezent, şi au influenţat viaţa şi cultura generaţiilor de-a lungul timpului. Acest proces în ţările comuniste a dus la ateizarea culturii, iar acest fenomen în Polonia a apărut în mod foarte vizibil. Biserica poloneză cu secole în urmă a acceptat rolul de protector al culturii, ceea ce a fost deosebit de important în perioadele dependenţei politice, ca şi dezmembrarea sau asuprirea ţării. Preluarea puterii de către regimul comunist a atras după sine preluarea sub tutelă şi asuprirea culturii, toate acestea în concordanţă cu principiile structurale şi politice ale partidului comunist. Drept urmare, menirea principală a culturii a fost deservirea comunismului. Marginalizarea culturii creştine conform planului autorităţilor comuniste a condus din ce în ce mai mult la ghetoizarea culturii şi artei creştine. Îndeosebi după instalarea stării de urgenţă în Polonia (1981), condiţiile de ghetou create pentru cultura creştină au avut ca rezultat emigraţia internă a artiştilor şi boicotarea radioului şi televiziunii poloneze. Datorit acestui proces s-a înfiinţat sistemul neoficial al culturii, care a ameliorat setea de cultură a majorităţii populaţiei. Sistemul neoficial al culturii a fost realizat de către creatorii şi purtătorii culturii care nu au fost subordonaţi puterii de stat, sau dacă totuşi erau, s-au bucurat de o autoritate şi libertate, prin care au fost în stare să transmită valori, norme şi moduri de conduită diferite de cele dictate de sistemul cultural existent. Astfel bisericile şi parohiile au asigurat loc şi pentru spectacole de teatru şi alte spectacole. Sistemul neoficial al culturii a contribuit în mod însemnat la integrarea naţiunii şi a promovat păstrarea identităţii naţionale. După schimbarea regimului politic, noul statut social a determinat biserica poloneză să-şi stabilească din nou poziţia pe piaţa liberă a valorilor etice, culturale şi confesionale, şi să contribuie la eliminarea prăpastiei dintre evanghelie şi cultura modernă. Drept urmare a împletirii profunde dintre biserică şi cultură, a cunoştinţei moştenirii spirituale şi culturale a secolelor trecute, creştinii din Polonia nu ştiu şi nu doresc să renunţe la ceea ce constituie parte neschimbabilă a identităţii naţionale şi confesionale. Creştinii, care de-a lungul secolelor au determinat imaginea culturii spirituale, doresc şi astăzi să colaboreze cu alţi europeni, ca parteneri egali, în formarea realităţii europene noi.

Cuvinte cheie: stat şi biserică, Polonia, comunism, socialism statal, istorie, dictatură, retrospectivă, ideologie ateistă, biserică, schimbare politică, cultură Jozef Hašto & Hana Vojtová (pag. 232) Sindromul de stres posttraumatic: Referinţe biologice şi sociale, desensitizare prin mişcarea ochilor şi restructurarea experienţei sufleteşti, respectiv training autogen în stresul continuu: Studiu de caz, partea a 2-a: În acest studiu prezentăm desensitizarea prin mişcarea ochilor şi restructurarea experienţei sufleteşti (Eye Movement Desensitisation and Reprocessing – EMDR), respectiv aplicarea trainingului autogen (AT) în tratamentul sindromului de stres posttraumatic (PTSD). EMDR este folosită pentru ameliorarea simptomelor acute, iar AT pentru intensificarea rezistenţei împotriva stresului continuu. Aplicând modelul bio-psiho-social al problemelor mentale, am examinat relaţia dintre cele două ţări vecine (Slovacia şi Ungaria), precum şi aspectele social-politice respectiv socio-psihologice ale cazului care a umbrit relaţia dintre populaţia majoritară şi una din populaţiile minoritare din ţara noastră (Slovacia). Pacientul nostru a contribuit la publicarea raportului, iar noi sperăm să putem favoriza judecarea socială mai obiectivă a cazului.

Cuvinte cheie: sindrom de stres posttraumatic, model bio-psiho-social, terapie, psihoterapie, desensitizare prin mişcarea ochilor şi restructurarea experienţei sufleteşti, training autogen, studiu de caz

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 292–294 DOI: 10.5708/EJMH.8.2013.2.Abs.RU

RUSSIAN ABSTRACTS RUSSISCHE ZUSAMMENFASSUNGEN РЕЗЮМЕ Máté Joób & Paavo Kettunen (стр. 163) Исповедь с точки зрения опыта просящих о помощи: Эмпирическое исследование практики исповеди финнов и венгров: Статья представляет практику исповеди с точки зрения исповедующегося. Опыт исповедующегося исследуется на основе двух прежних научных статей. Источником для этих исследований послужили письма исповедующихся, просящих помощи в снижении стресса. Поскольку сбор материалов и анализ данных осуществился подобным образом, возможным стало противопоставление выводов двух исследований. Исходя из писем финнских и венгерских опрошенных, авторы исследовали несколько тем: ожидания исповедующихся, критерии душевного состояния после отпущения грехов, отношение между исповедующимся и исповедником и влияние исповеди на духовную жизнь исповедующегося. Ключевые слова: исповедь, практика исповеди, принимающий исповедь, исповедующийся, отпущение грехов, тревога, грех, вина, покаяние Krisztina S. Petik, Anikó Kézdy & Fruzsina Kocsis (стр. 187) Мотивационный фон целей обучения и его взаимосвязь с психическим здоровьем у людей среднего и пожилого возраста: Развитие человека является комплексным пожизненным процессом, сопровождаемым выигрышами и потерями. Среди трудностей развития в период взрослости следует уделять особенное внимание проблемам среднего возраста, поскольку во время длительного перехода из молодости в старость личности приходится претерпевать много потерь, при этом ей предстоит сталкиваться с особыми психологическими задачами приспособления к новым ситуациям. Цель нашего исследования – обнаружить взаимосвязь между цельями – в первую очередь цельями обучения – и показателями психического и физиологического здоровья в среднем и пожилом возрасте. Согласно нашей гипотезе люди, пережившие кризис во второй половине их жизни, становятся более открытыми для курсов, связанных с укреплением физического и психического здоровья. Мы предполагали и то, что люди с интринсивной мотивацией достижения являются более мотивированными для саморазвивающего обучения, а также что появление межперсональных целей можно связывать с более высоким уровнем открытости для программ-тренингов психического здоровья. Проанализированная нами выборка состоит из 585 человек (средний возраст 50.6 лет, дисперсия 8.5). Исходя из классификации Левинсона (Levinson), мы разбили выборку на шесть возрастных групп. Наши результаты подтверждают, что люди среднего и пожилого возраста открыты для программ, развивающих функции самоконтроля. Вопреки нашим предположениям не кризис, связанный со снижающимя уровнем физического и психического здоровья делает человека открытым для таких программ, а хорошее физическое здоровье и новые жизненные ситуации, вызванные трудностями жизни. При этом, спрос на программы саморазвития больше у тех, в мотивационной системе которых

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преобладают интринсивные (связанные с основными психологическими необходимостьями) цели. Ключевые слова: старение, средний возраст, личные цели, цели обучения, психологическое благосостояние, андрагогия Robert Biel (стр. 212) Атеизация культуры в коммунистической Польше и её последствия на настоящее: Критика религии в современном смысле в Европе началась с просвещения. Множество атеистических идей, сформировавшихся в те времена, сохранило своё влияние и до наших дней и оказывает воздействие на жизнь и культуру многих поколений. Этот процесс в коммунистических странах привел к атеизации культуры, что в Польской Народной Республике проявилось очень заметным образом. Польская церковь взяла на себя роль покровителя культуры уже много столетий тому назад, что имело особое значение при такой политической зависимости, как разделение или оккупация страны. Приход к власти коммунистов привел к взятию культуры под опекунство и к её подчинению структурным и политическим принципам коммунистической партии. Вследствие этого, главным предназначением культуры считалась служба коммунизму. Маргинализация христианской культуры по намерениям коммунистических властей всё больше приводила к геттоизации христианской культуры и искусства. Особенно с момента введения чрезвычайного положения (1981) условия гетто, созданные для христианской культуры обусловили так называемую внутреннюю эмиграцию художников и бойкот польского радио и телевидения. Возникновение системы неофициальной культуры, утоляющей запрос большинтва населения, можно считать последствием этого процесса. Неофициальную систему культуры составляли авторы и носители культуры, которые не являлись подчиненными государственной власти, а если и были таковыми, то пользовались столько авторитета и свободы, что они были способными передавать ценности, нормы и способы поведения, отличающиеся от господствующей культурной системы. Таким образом церкви и помещения приходов стали местом театральных и других представлений. Неофициальная система культуры в значительной степени способствовала интеграции общества и помогла сохранить национальную идентичность. Общественное положение, возникшее после переворота, вынудило польскую церковь заново определить свою позицию на свободном рынке нравственных, культурных и религиозных ценностей, и способствовать ликвидации разрыва между евангелием и современной культурой. В результате глубочайшего переплетения церкви и культуры и осознания духовного и культурного наследия прошедших столетий, христианам в Польше невозможно и неохотно отказаться от того, что составляет неизменимую часть национальной и религиозной идентичности. Христиане, столетиями определяющие облик духовной культуры, и в наши дни желают участвовать в формировании новой европейской действительности на равных правах с другими европейцами. Ключевые слова: государство и церковь, Польша, коммунизм, государственный социализм, история, диктатура, ретроспекция, атеистическая идеология, церковь, политический поворот, культура

EJMH 8:2, December 2013

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RUSSIAN ABSTRACTS / RUSSISCHE ZUSAMMENFASSUNGEN

Jozef Hašto & Hana Vojtová (стр. 232) Посттравматическое стрессовое расстройство: Биологические и социальные отношения, десензитизация с движением глаз и переструктурирование переживаний, и автогенный тренинг под влиянием непрерывного стресса: Анализ конкретной ситуации, часть 2-ая: В статье представляется использование десензитизации и переработки движением глаз (Eye Movement Desensitisation and Reprocessing – EMDR), а также автогенного тренинга (AT) в лечении посттравматического стрессового расстройства (PTSD). EMDR служил для снижения острых симптомов, а AT для увеличения устойчивости к постоянному стрессу. Используя био-психо-социальную модель психических проблем, мы рассмотрели взаимоотношения двух соседних стран (Словакии и Венгрии), а также социально-политические и социально-психологические аспекты одного случая, который бросил тень на взаимоотношения народа, образующего национальное большинство нашей родины (Словакии) с одним из национальных меньшинств. Наш пациент дал согласие на публикацию доклада, мы же надеемся на то, что сможем способствовать наиболее корректному общественному истолкованию происшедшего. Ключевые слова: посттравматическое стрессовое расстройство, био-психо-социальная модель, терапия, психотерапия, десензитация и переработка движением глаз, автогенный тренинг, изучение случая (Case Study)

EJMH 8:2, December 2013

European Journal of Mental Health 8 (2013) 295–296 DOI: 10.5708/EJMH.8.2013.2.Abs.SK

SLOVAKIAN ABSTRACTS SLOWAKISCHE ZUSAMMENFASSUNGEN ABSTRAKTY Máté Joób & Paavo Kettunen (str. 163) Spoveď z pohľadu skúsenosti ľudí hľadajúcich pomoc: Empirická štúdia spovednej praxe vo Fínsku a Maďarsku: Článok prezentuje spoveď z pohľadu spovedajúcich sa. Prax a skúsenosti spovedajúcich sa sú prezentované na základe dvoch predchádzajúcich výskumných štúdií. Zdrojom oboch výskumov boli listy spovedajúcich sa písané s cieľom zbavenia sa napätia.

Nakoľko oba výskumy a analýzy materiálov boli uskutočnené podobnými metódami, je možné porovnať výsledky oboch výskumných štúdií. Na základe listov fínskych a maďarských spovedajúcich sa sa autori zamerali na niekoľko oblastí: očakávania spovedajúcich sa, kritériá prežívania rozhrešenia, vzťah medzi spovedníkom a spovedajúcim sa a účinok spovede na duchovný život spovedajúceho sa.

Kľúčové pojmy: spoveď, zvyklosti pri spovedi, spovedník, spovedajúci sa, rozhrešenie, úzkosť, hriech, vina, smútok Krisztina S. Petik, Anikó Kézdy& Fruzsina Kocsis (str. 187) Motivačné zázemie vzdelávacích cieľov a ich vzťah k duševnému zdraviu v strednom veku a starobe: Vývin človeka je celoživotný komplexný proces sprevádzaný ziskami i stratami. Spomedzi ťažkostí vývinu v dospelosti si zvláštnu pozornosť zaslúži obdobie stredného veku, pokrývajúce dlhé obdobie od mladosti až po starobu, v ktorom človek čelí viacerým stratám a v ich dôsledku aj špecifickým psychologickým úlohám prispôsobovania sa novým okolnostiam.

Cieľom výskumu bolo preskúmať vzťah medzi cieľmi – a to najmä vzdelávacími cieľmi – a indikátormi psychického a fyzického zdravia v strednom veku a starobe. Predpokladali sme, že jednotlivci, ktorí zažívajú krízu v druhej polovici svojho života, budú viac otvorení pre vzdelávacie programy zamerané na psychické a telesné zdravie. Tiež sme očakávali, že jednotlivci so zvnútornenou motiváciou zameranou na cieľ budú viac motivovaní k vzdelávaniu zameranému na sebarozvoj a ich intrapersonálne ciele budú spojené s väčšou otvorenosťou voči tréningovým programom zameraným na duševné zdravie. Výskumnú vzorku tvorilo 585 ľudí (priemerný vek = 50.6 rokov, štandardná odchýlka = 8.5). V ďalšej analýze bola vzorka rozdelená na šesť vekových skupín na základe Levinsonovej klasifikácie. Výsledky potvrdili, že ľudia v strednom veku a starobe sú otvorení pre vzdelávacie programy, ktoré rozvíjajú sebaovládacie funkcie. Na rozdiel od našej hypotézy, ich otvorenosť nebola spôsobená krízou spojenou s klesajúcim fyzickým a duševným zdravím, ale dobrým fyzickým zdravie a novými životnými situáciami prezentovanými stresujúcimi životnými udalosťami. Okrem toho potreba zúčastniť sa na vzdelávacích programoch zameraných na sebarozvoj je silnejšia v prípade jednotlivcov, u ktorých v motivácii dominujú zvnútornené ciele (spojené so základnými psychologickými potrebami) Kľúčové pojmy: starnutie, stredný vek, osobné ciele, vzdelávacie ciele, duševná pohoda, andragogika

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Robert Biel (str. 212) Ateizácia kultúry v komunistickom Poľsku a jej dôsledky pre súčasnosť: Osvietenstvom sa v Európe začala kritika náboženstva v modernom zmysle slova. Mnoho ateistických myšlienok, vytvorených v tej dobe, si udržalo svoj vplyv a ovplyvňuje život a kultúru mnohých generácií.

Tento proces, ktorý sa jasne manifestoval v Poľskej ľudovej republike, viedol k ateizácii kultúry.

Poľská cirkev bola po stáročia mecenášom kultúry, čo bolo obzvlášť dôležité v dobách politickej závislosti, napríklad v časoch rozdelenia či okupácie krajiny. Komunistický prevrat priniesol poručníctvo a podriadenie kultúry štukturálnym a politickým princípom komunistickej strany.

V dôsledku toho sa od kultúry očakávalo, že bude slúžiť komunizmu. Zámerná marginalizácia kresťanskej kultúry viedla k izolácii kresťanskej kultúry a umenia. Nepriaznivé podmienky pre kresťanskú kultúru, vytvorené obzvlášť po zavedení výnimočného stavu v Poľsku (1981), spôsobili tzv. vnútorný exil umelcov a bojkot poľského rozhlasu a televízie. Tento proces vygeneroval neoficiálny systém kultúry, ktorý mohol uspokojiť požiadavky väčšiny občanov. Neoficiálny systém kultúry tvorili tí tvorcovia a nositelia kultúry, ktorí buď neboli podriadení štátnej moci, alebo mali takú autoritu a slobodu, že boli schopní odovzdať hodnoty, normy a spôsoby správania, ktoré sa líšili od existujúceho kultúrneho systému. Priestory kostolov a farností sa tak stali miestom divadelných a iných predstavení. Neoficiálny systém kultúry značne prispel k integrácii spoločnosti a pomohol pri zachovaní národnej identity. Spoločenská situácia po prevrate viedla poľskú cirkev k tomu, aby znovu definovala svoju pozíciu na voľnom trhu etických, kultúrnych a náboženských hodnôt a prispela k odstráneniu priepasti medzi evanjeliom a modernou spoločnosťou. Kresťania, vedomí si stáročí prelínaného duchovného a kultúrneho dedičstva, sa nemôžu a nechcú vzdať nezmeniteľnej súčasti svojej národnej a náboženskej identity. Kresťania v priebehu stáročí vytvárali obraz nehmotnej kultúry a budú pokračovať v snahe dosiahnuť pozíciu rovnocenných a plnohodnotných partnerov pri vytváraní novej európskej reality.

Kľúčové pojmy: štát a cirkev, Poľsko, komunizmus, štátny socializmus, dejiny, diktatúra, retrospekcia, ateistická ideológia, cirkev, politický zvrat, kultúra Jozef Hašto & Hana Vojtová (str. 232) Posttraumatická stresová porucha: Bio-psycho-sociálne aspekty, desenzibilizácia pomocou očných pohybov a reštrukturalizácie (EMDR) a autogénny tréning v pretrvávajúcom ohrození: Prípadová štúdia, 2. časť: V prípadovej štúdii je ilustrované použitie EMDR a autogénneho tréningu pri liečbe posttraumatickej stresovej poruchy. EMDR bolo použité pri zvládaní akútnych symptómov a autogénny tréning na posilnenie odolnosti pri pretrvávajúcom ohrození.

S využitím bio-psycho-sociálneho modelu psychických ochorení autori diskutujú o sociálno-politických a sociálno-psychologických aspektoch tejto kauzy, ktorá zaťažila vzťahy dvoch susediacich národov (Slovenska a Maďarska), ako aj vzťahy majority a národnostnej menšiny v našej krajine (Slovensko). Pacientka súhlasila s publikovaním tejto správy a dúfame, že prispeje k realistickejšiemu zhodnoteniu tejto udalosti v spoločnosti.

Kľúčové pojmy: posttraumatická stresová porucha, bio-psycho-sociálny model, terapia, psychoterapia, desenzibilizácia pomocou očných pohybov a reštrukturalizácie (Eye Movement Desensitisation and Reprocessing), autogénny tréning, prípadová štúdia

EJMH 8:2, December 2013

CONTRIBUTORS TO THIS ISSUE/ AUTOREN DIESES HEFTES

Dr. habil. Robert J. Biel Papieska Akademia Teologiczna w Krakowie Wydział Teologiczny Sekcja w Tarnowie Urszulańska 9/6 PL-33-100 Tarnow Poland/Polen rbiel@diecezja.tarnow.pl Gyombolai-Kocsis Fruzsina Sapientia Szerzetesi Hittudományi Főiskola Pszichológia tanszék H-1052 Budapest Piarista köz 1.

Hungary/Ungarn kocsis.fruzsina@sapientia.hu Dr. Jozef Hašto Psychiatricka ambulancia Pro mente sana Palackeho 21 SK-91101 Trenčín Slovakia/Slowakei j.hasto.tn@gmail.com Dr. Joób Máté Semmelweis Egyetem Egészségügyi Közszolgálati Kar Mentálhigiéné Intézet H-1089 Budapest Nagyvárad tér 4., 19. em.

Hungary/Ungarn joob.mate@public.semmelweis-univ.hu

Dr. Kézdy Anikó Sapientia Szerzetesi Hittudományi Főiskola Pszichológia tanszék H-1052 Budapest Piarista köz 1.

Hungary/Ungarn kezdy.aniko@sapientia.hu Dr. Somogyiné Petik Krisztina Sapientia Szerzetesi Hittudományi Főiskola Pszichológia tanszék H-1052 Budapest Piarista köz 1.

Hungary/Ungarn somogyi.k@signum.hu Dr. Tóth Ákos Pécsi Tudományegyetem Természettudományi Kar Testnevelés- és Sporttudományi Intézet H-7624 Pécs Ifjúság útja 6.

Hungary/Ungarn totha@gamma.ttk.pte.hu Hana Vojtová Psychiatrický a psychoterapeutický stacionár Palackeho 21 SK-91101 Trenčín Slovakia/Slowakei hanavojtova@gmail.com

Prof. Paavo Kettunen Itä-Suomen yliopisto Filosofinen tiedekunta Teologian osasto P.O. Box 111 FI-80101 Joensuu Finland/Finnland paavo.kettunen@uef.fi

ISSN 1788-4934 © 2013 Semmelweis University Institute of Mental Health, Budapest

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ARCHIVES OF PSYCHIATRY AND PSYCHOTHERAPY Volume 15 Issue 1, March 2013

ARCHIVES OF PSYCHIATRY AND PSYCHOTHERAPY – The neutralPsychiatric stimuli detection deficits in delusion-prone individuals Polish Association quarterly international journal in English Katarzyna Różycka offers broadProchwicz, spectrumJagoda of research reports – from biological psychiatry to social – The therapeutic relationship and patients experience of interpersonal bonds research psychiatry and psychotherapy

conducted in outpatient mental health care Małgorzata Sosnowska, Katarzyna Prot-Klinger, Marta Scattergood, Maria Paczkowska, Aleksnadra Smolicz, Małgorzta Ochocka In the current issue you will find among others: –– ASelected psychological traits and on body image characteristics in females suffering quantitative/qualitative study metaphors used by Persian depressed patients from binge eating disorder Hossein Kaviani, Robabeh Hamedi Bernadetta – The impactIzydorczyk of anxiety disorders on the quality of compliance among patients – with Psychometric properties of Polish version ofconditions: the Childrensthere Eating Test co-morbid psychiatric or medical areAttitudes many questions but Maciej Wojciech Pilecki, Małgorzata Kowal, Agnieszka Woronkowicz, Łukasz Kryst, where can we find the answers?

Jan Sobiecki Rafał Jaeschke, Marcin Siwek, Dominika Dudek – Psychological masculinity, femininity and tactics of manipulation in patients with – Davanloo’s Intensive Short-term Dynamic Psychotherapy. Application and unborderline personality disorder derstanding the theroretical and technical principles of this method in treatment Eugenia Mandal, Dagna Kocur of resistant patients.

– A study of the similarity between three models of interpersonal functioning of Mirosław Bilski-Piotrowski patients with borderline personality disorder – Neuropsychological of post-traumatic Klüver-Bucy LyaneTrepanier, Johncharacteristic Christopher Perry, Annett Koerner, Constantina Syndrome Stamoulos, Stanisław Kwiatkowski, Starowicz, Olga Milczarek Amanda Sheptycki, MartinAnna Drapeau – The disruptive behavior disorders and the coexisting deficits in the context of theories describing family relation E-mail address: Marta Nowak, Agnieszka Gawęda, archives@psychiatriapolska.pl Ireneusz Jelonek, Małgorzata Janas-Kozik

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Published biannually in June and December by the Institute of Mental Health, Faculty of Health and Public Services, Semmelweis University, Budapest 

This interdisciplinary periodical represents the view that mental health promotion must not be limited to the protection and improvement of the individual’s mental health but must be extended to include the community, and through the cooperation of all human services it must contribute to the emergence of a mentally healthy society. The journal publishes theoretical and research-oriented articles as well as work-in-progress papers, short communications and the descriptions of efficient practices with original approaches.

Its further aim is to provide a ground of dialogue for experts in all parts of Europe.

For further details, please, visit our website at www.ejmh.eu. 

Abstracted/indexed in EMBASE, Index Copernicus, Google Scholar, PsycINFO, and Scopus. 

Editorial correspondence should be addressed to Dr. Gábor Ittzés Secretary of the Editorial Board Institute of Mental Health, Faculty of Health and Public Services, Semmelweis University POBox 91, H-1450 Budapest, Hungary Phone: (+36 1) 459 1500 x 56 551 or (+36 1) 266 1022 Fax: (+36 1) 214 5685 E-mail: ejmh-editor@public.semmelweis-univ.hu Web: www.ejmh.eu · www.mental.usn.hu 

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We interpret mental health promotion to include every effort and all manner of individual and communal endeavour to realise principles and ideals of mental health at a social level. This means approach and attitude, praxis and theory, fields of activity and institutional systems alike. This approach to mental health promotion always requires cooperation and communal efforts, these days not only between individuals, specialists and groups but also between states, nations and research groups.

East Central Europeans must therefore strive to find each other and come closer together, but certainly not at the price of the hard-won contacts between the two halves of an all too long divided continent. On the one hand, our common history, the many similarities in our past pave the way for cooperation both rationally and emotionally; on the other, we all share a vision of a truly common European future, hopes and goals that unite us. Between past and future, our situation, our problems and experiences are similar but not identical. They can mutually complement and enrich each other and contribute to the achievement of our common goals, the reduction of harmful factors and the promotion of mental health. For mutual and deep understanding, however, we must develop a common language, common forums and organs in which we can share our experiences and reflect on them together. This journal seeks to contribute to that effort with its abstracts in 9 languages in order to serve, through the emergent dialogue, a colourful and many-faceted reality which consists not so much of education, social work, health care, religion, mass media, political activity and legislation as of individuals, families, communities and societies.

www.ejmh.eu

Volume 8  Number 2  Dec European Journal of Mental Health Volume 8  Number 2  Dec 2013

Founding member and first president of the

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INSTITUTE OF MENTAL HEALTH FACULTY OF HEALTH AND PUBLIC SERVICES

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SEMMELWEIS UNIVERSITY

mental health promotion  multidisciplinary approaches  individual, family, community, society