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Donati, F. (1989). A Psychodynamic Observer in a Chronic Psychiatric Ward. Brit. J. Psychother., 5(3):317-329.

(1989). British Journal of Psychotherapy, 5(3):317-329

A Psychodynamic Observer in a Chronic Psychiatric Ward

Flavia Donati

The everyday life of a ward for chronic psychotics was sampled in regular weekly sessions and the observations analysed to discover the unconscious interactions and shared defences that explained its social structure.

Outwardly there was boredom, monotony, and an absence of interactions, emotions and events but underneath there were pervasive anxieties defensively subdued especially by the staff. Even tiny moves by patients to alter this atmosphere were instantly nullified. These anxieties had two sources:

(a)  a massive impotence in face both of chronicity and of identification with the patients as social rejects,

(b)  lurking fear of madness stagnation and cmptiness.

(c)  This typical psychiatric facility for chronic patients functions as a defensive system that makes change and development safely impossible and demoralises the staff. Some remedial suggestions are offered.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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