[The combination of analytic psychotherapy with directive and social measures--a contradiction? The dialectics of inner and external reality (author's transl)].

With reference to a case study, the author describes the possibility of combined analytic psychotherapy and directive and social measures. At the same time, it is shown that in the case of serious neuroses with various secondary social-impediments, the lasting success of a treatment can only be guaranteed if there is an approximately simultaneous change in the inner psychic state and the external social reality. This is achieved by a treatment setting which combines elements of a psychoanalytic psychotherapy with supportive and directive treatment techniques. The course of the treatment if discussed from both psychoanalytic and sociopsychiatric viewpoints; particular attention is paid to the interdependent conditions of inner and external reality.