Response to Commentaries

I want to express my gratitude to the commentators. Because of the richness of their texts, I must limit my responses to a few central points. Some similar questions are raised by two of the commentators, and one commentator raises very different questions.

A few of the reactions to the picture of Chestnut Lodge that I have presented have made me aware that, because of my emphasis on intensive individual therapy, I may not have sufficiently described other aspects of the work there, such as Stanton and Schwartz's therapeutic community approach, Marian Chase's pioneering movement and dance therapy, innovative art therapy, occupational therapy (which included patients’ running their own shop), various levels of group therapy, the nature of the weekly all-hospital meeting in which patients raised questions of self-determination and suggested programs and activities, and a uniquely designed family program in which families stayed for a week at the Frieda Fromm-Reichmann cottage on the grounds. During these visits, intra- and extrafamilial interactions were observed. Families were given feedback, and the observations were discussed with the patients separately and in various family groupings. I have reported findings from these family programs in a paper coauthored with J.S. McDonald (Kafka and McDonald 1964). Some of the work went beyond traditional approaches. Together with the social worker and the chronically hospitalized patient, for instance, we visited the home in which the patient had grown up and in which the family still lived. Without this visit, we could never have guessed how bizarre were, and had always been, the family's sleeping arrangements, information useful in the therapy of the patient and the family.

While some patients were hospitalized for long periods, there was also an adjacent halfway house. Partial hospitalizations were sometimes arranged. Most important, however, discharged patients continued their therapy with the therapist who had treated the