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At long sight is a report on a project at the Institute of Psychotherapy in Stockholm. It is an account and evaluation of the outcome of long-term psychotherapy with severely disturbed patients. The book centers around five case histories. The psychotherapies described have a frequency of one to two sessions a week, for a duration of four to six years. Clarence Crafoord, the editor and also one of the authors of this book, has been the leader of the project. Psychotherapists and co-writers are: Sonja Härdelin, psychoanalyst, Cecilia Andrae, Ulla Floberg, Inger Johansson and Kerstin Schewenius, all psychotherapists. David Titelman, psychoanalyst, has been scientific adviser and co-writer.
One incentive for effecting this project has been the experience that persons with severe personality disorders are unsatisfactorily understood and thus maltreated within the ordinary psychiatric care system. They are exposed to recurrent temporary treatment efforts, which in the long run lead to huge costs for the society, but to very little lasting reduction of suffering. They are treated in a manner that corresponds to a wish for immediate gratification — medication and/or hospitalization. This may be sufficient for some, but for others, it will be a repetition of the failure of the environment to respond in a way that promotes psychic growth. From that perspective, the report can be seen as a contribution to the debate on quality and efficiency of psychiatric care.
Clarence Crafoord has, as a psychoanalyst and as a psychiatrist within the Swedish medical system, extensive knowledge of the personality structure of this category of patient. He also has extensive knowledge of how they are received and treated when seeking psychiatric help. As the head of several large psychiatric units during the seventies and eighties, he contributed to reforming and humanizing Swedish psychiatry. Unfortunately, during this last decade, the wind has blown in a different direction.
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