Discussion

Hott has described the use of psychoanalysis in a clinic, and has portrayed its extension into individual therapy, group therapy, pediatric and family therapy. There can be no disagreement with him in regard to his practice and principles, and to his concepts of the changing role of psychoanalysis in the clinic.

I recall, however, in this very Karen Horney Clinic, some of the misgivings and questions which arose when I did the early screenings there for group therapy in early 1956. As we evaluated that group, it was with gratification and pleasure that we saw the dynamics of group process, transference, interpersonal relationships and growth. But, this is all a matter of record.

Dr. Hott has mentioned the psychoanalytic clinic, but this type is just one of a very few of the many psychiatric clinics which are in operation. Dr. Hott has few staff difficulties; he has a training school of psychoanalysis, a source of available staff, and he can choose his patients. Therapy can be given two, three or as many-times-weekly as he desires. He elects and selects a policy and controls the patient caseload as he sees fit.

But, let us examine the problems in the psychiatric and neuropsychiatric clinics of large general hospitals in this city. Dr. Vorzimer speaks of the Out-Patient Department as the “Siberia of Hospital Medicine,”¹ and in a sense this is so. Dr. Louis Alikakos² mentions in his article on analytic group treatment for the post-hospital schizophrenic, that the treatment of the schizophrenic continues to be inadequate, and that after-care services are in a primitive state of development almost everywhere.