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In The Spring of 1977 I set for myself the task of transforming lead into gold. As a psychologist assigned to two chronic wards in an adult psychiatric hospital I came to assume the rǒle of artifex and set about creating a viable treatment milieu from the ‘chaotic, heavy, sick condition’ which then existed. The resulting programme, known as the Social Adaptation Programme, is similar in operation to the therapeutic community described by Kernberg (KERNBERG 7). Broadly psychodynamic in orientation, emphasis is placed on the theories of Fairburn, Bowlby and Winnicott.
There are twenty-four patients in the ward ranging in age from eighteen to thirty-five years. Psychiatric diagnoses range from ‘borderline’ to ‘psychosis’ of one form or another, primarily schizophrenia. Emphasis is placed on the establishing of a therapeutic relationship between the patient and a single primary nurse rather than on the use of medication.
It is the responsibility of the programme's support staff (i.e., all staff other than nursing) to provide a protective capsule, a vas Hermetis, within which therapeutic union between nurse and patient can take place, a ‘Philosophical Garden in which our sun rises and ascends’ to use the poetic description of Philalethes (JUNG 5, p. 238, fn. 20). As in alchemical tradition, the vessel is sealed (locked) to provide containment and prevent contamination from outside the programme, acting as a uterus or matrix from which the lapis can grow.
The purpose of this paper is to explore the usefulness of a model derived from the alchemical literature for the understanding of the dynamics of therapeutic milieus using the Social Adaptation Programme to demonstrate the way in which it can be applied. While Jung's criticisms regarding the use of set theoretical models in analysis are well known, Fordham points out that it is impossible for a therapist to function without some sort of model in his mind based on his experiences (FORDHAM 3). He suggests that the