[Psychiatric hospitals--an institutionalized defense system. I]

In the early beginnings of the constructional phase of a "sociopsychiatric satellite" of a rural psychiatric hospital where classical treatment parameters had been abandoned, signs were seen of trends towards a severely pathological group process which threatened to draw--induced by the patients--even the psychiatric attendants, nurses, helpers and physicians into the maelstrom of a mad interlock. At first, the sequence of events leading to this fateful climax remained largely below the threshold of consciousness. It became manifest by counter-transference reactions on the part of the psychiatric coworkers and generated creative powers which went beyond the processes described in literature in so far as they aimed at encompassing and sweeping along the institution as a whole. This prompts the author to suspect that the part played by the patients in the creation, shaping and routine reproduction of the institution known as "psychiatric hospital", has been underestimated up to now. After supplementary descriptions of the mutual involvement process in Part II, an attempt is made, in analogy to the concept of Mentzos, to describe the defence moves against such a pathological symbiosis as an essential part of psychiatric treatment institutions, especially of psychiatric hospitals or "asylums".