You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This paper is written in the spirit of inquiry into working with therapeutic groups for psychotic patients. More specifically, I am interested in the feasibility of working with such patients on a deeper level than that of the “coffee and doughnuts” or socialization group. My own experiences in working with such groups in an out-patient clinic of a general hospital's psychiatry department has, in itself, evolved from wondering about insightful communication with such patients to the distinct feeling that reconstructive work is possible. However, I am not sure to what extent, since there is always uncertainty about the levels of the psychotic's psychic accessibility.
I have found myself approaching these patients with the basic philosophy that within every sane person there is a touch of madness, and that within every mad person there is a touch of sanity. It is my assumption (feeling, belief) that there is always the possibility that the psychotic patient can become less alienated from this touch of sanity and hence less alienated from his inner basic humanness. It is to this end that group psychoanalysis with psychotic patients can, I think, prove a useful tool.
In institutions, it is frequently the inexperienced therapist who gets the chronic psychotic patient to work with, while the senior staff opt for the “more workable” patients. Yet as early as 1921, work with schizophrenics in groups (the early “class” form of group work) was discussed positively by Lazell, who “found that many patients apparently absolutely inaccessible heard and retained much of the material even though they sat and phantasied or talked to themselves all the time the lecture was in progress.” A recent study by Karon and Vandenbos indicates the long-term usefulness of therapeutic work with psychotic patients. In a two-year follow-up study (after hospital discharge), they found that there was no marked decrease in the rehospitalization rate for those patients treated by psychoanalytic psychoth