The framework of psychoanalytically oriented psychotherapy with traumatised patients and the institution

Abstract

Lindbom-Jakobson M, Lindgren L. The Framework of Psychoanalytically Oriented Psychotherapy with Traumatised Patients and the Institution. Int Forum Psychoanal 1997;6:217-224. ISSN 0803-706X.

Psychotherapies performed at multidisciplinary institutions will be influenced by the ongoing dynamics and inevitable group processes of the institution. The difficulties of these processes become extremely hard to handle when the patient category is a severely traumatised one. The prerequisite of psychoanalytically oriented psychotherapy, the illusion of the sealed room and fixed framework, gets disturbed by the information flow in an institution. The institutions for these patients tend to become stages on which the patients as well as staff can perform and repeat their intrapsychic and interpersonal conflicts, non-adaptive defences and disturbed object relations. The predominant dynamic that arises around tortured refugees as a patient category is sado-masochistic relating.