Psychoanalytical teamwork in a day hospital: revisiting some preconditions for patients' subjective appropriation

Psychoanalytical 'teamwork' may be recommended for dealing with a particular kind of transference that characteristically occurs during the institutional treatment of young patients presenting psychotic or behavioural symptoms. In such cases, the degree of alienation is such that repetition is usually induced in other people (the therapists), filling in for fantasy construction that seems to be lacking in the patient's psyche. A case like that of 'Angel' can give some idea of this phenomenon, wherein several caregivers have to harbour fragmented and incompatible elements of the case's particular history, which are in need of more mental representation. Any subjective restitution and appropriation of these elements by the patient would require a sort of detour (often a trying one!) by way of the psychical space of caregivers whose initial task will be to 'work it through' among themselves.