P02-348 - Cognitive Behavioral Wisdom Psychotherapy in the Treatment of Posttraumatic Embitterment Disorders

Abstract

Background: Negative life events can result in adjustment disorders. If there are feelings of having been treated unfair, been let down or been humiliated one type of reaction are prolonged states of embitterment, which has been described as Posttraumatic Embitterment Disorder, PTED. A new approach in the treatment of PTED is cognitive behavioral psychotherapy which uses special strategies based on wisdom psychology. Wisdom has been defined as the capacity to cope with unsolvable and serious problems and questions in life. Method: In a controlled clinical trial psychosomatic inpatients which suffered from PTED, were randomly assigned to "wisdom therapy" (N=28), which focusses on the reframing of the traumatic event and to "wisdom and headonia therapy " (N=29), which additionally encourages patients to focus on positive aspects in life. Another group of PTED patients (N=50) and patients with other mental disorders (N=50) received treatment as usual. Results: PTED patients who were treated with wisdom psychotherapy showed a reduction in the SCL-90-PST score of initially 55,7 and at the end of 40,1 and those treated with hedonia therapy of initially 58,7 and at the end of 41,3. Measures of therapist adherence showed that therapists in both groups used wisdom strategies. PTED controls started initially with a SCL-90-PST score of 52,2 and ended with 50,2. Other patients started treatment with 39,3 and finished with 25,9.

Coping and rumination as mediators in the development of reactive embitterment in the general population.

“…In relation to a treatment for PTED, Linden (2008, p. 7) developed wisdom therapy , which involves presenting the patient with case vignettes of unsolvable life problems and teaching patients to attain a change of perspective, distance from oneself, empathy with the aggressor, acceptance of unwanted emotions, emotional serenity, contextualism, value relativism, relativism of aspirations, and long-term perspectives. Considering that Linden, Baumann, and Lieberei (2010) reported wisdom therapy can be helpful in the treatment of adjustment and embitterment disorders, it might be useful for embittered people to take well-structured strategies in a different way from existing adaptive coping strategies.…”