Isohanni surveys the range of possible meanings of medications used in an inpatient setting. He begins by considering some transference meanings of giving and taking drugs, and of the sensations the drugs produce, in terms of their oral, anal, or phallic significance. He considers the drug's role as a fetish and as a transitional object. In Kohut's idiom, he entertains ideas about the drug's effect on the patient's narcissistic balance, grandiosity, and idealization of the therapist. Isohanni sees medication as having the potential either to enhance the patient's self-regulatory capacities and to make exploratory work possible, or to interfere with the ego functions needed for improvement and integration. He considers the psychological meaning to the patient of both effects. He touches briefly on the countertransference meanings of medications, particularly on their part in enacting the therapist's aggression, sadism, or grandiosity. He notes that ward staff are particularly prone to medicate patients as a way to regulate their own anxiety.