Psychotherapy, gratification and the mental hospital
Some patients in mental hospitals show, during their stay an increasing dependency and need for security, in addition to a decrease of personal responsibility. This tendency is facilitated by social laws and institutions. From the psychoanalytical point of view this need of gratification can be considered as a resistance in the psychotherapeutic process. This resistance has the form of a transference resistance, not to confuse with the derivates of the so called defense mechanisms. Using the technique and practice of psychoanalysis as a model, the author gives a description of the difficulties and complications for psychotherapy in a mental hospital. Because of the multiplicity of the 'therapist' in a mental hospital, there consists the langer, that a transference relation, for instance a need for gratification, develops at the wrong place or to the wrong person, so that workingthrough in a working relationship with a psychotherapist becomes impossible. The same can be said from acting-out, as a transference resistance. A second point concerns the therapeutic technique: the total process of confrontation, clarification and interpretation is a job, only for qualified psychotherapists. Nurses, hospital attendance, workers in the fields of industrial therapy, cultural therapy, pastoral service etc. have to restrict their interventions in relation to the behavior of patients to confrontation only.