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Chiesa, M.C. (1989). Different Origins and Meanings of Acute Acting-out in an Inpatient Psychotherapeutic Setting. Psychoanal. Psychother., 4(2):155-168.

(1989). Psychoanalytic Psychotherapy, 4(2):155-168

Different Origins and Meanings of Acute Acting-out in an Inpatient Psychotherapeutic Setting

Dr Marco C. Chiesa, M.D., MRCPSYCH

In this paper I describe four different sources of acute acting-out behaviour as may be observed in long-term hospitalised patients suffering from severe personality disorders. I hope to demonstrate that acute psychological distress does not happen in a vacuum, but that specific intrapsychic and interpersonal dynamics within the hospital setting are at the root of what appears overtly as nonspecific emotional and behavioural disturbance. I argue that the hospital team's correct insight into the factors underlying acute acting-out is crucial to the implementation of therapeutic interventions aimed to decrease the patient's disturbed state of mind.

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