[Psychiatric establishments--an institutional defense system--II]

As already described in Part I, the rigid structures of treatment in psychiatric hospitals were largely abandoned in the course of a sociopsychiatric experiment. This released initially both in the patients and in the psychiatric ward personnel (physicians and nurses) of the new hospital organization trends towards a common and highly pathological groups process aiming at reshaping or recreating the entire institution. This could be partly interpreted as a replay of a schizophrenic family conflict and induced subconsciously motivated tensions with the parent institution. In order to escape the ensuing tangle which became eventually intolerable for the medical personnel, structures were then introduced which could be interpreted as a compromise between protective bureaucratisation on the one hand and institutional psychotherapy on the other. This compromise resulted from a conflict within the medical personnel team. The trend towards protective bureaucracy experienced by many individuals of the medical personnel was so pronounced as a result of the counter reactions-transference that the structures of the new hospital organization would have largely fallen in line of those of the parent institution if the group of psychotherapists had not been as strong as it proved to be. This led us to believe that psychiatric hospitals in their capacity as institutions are almost exclusively in the service of defence mechanisms against psychotic entanglement or involvement tendencies and that they are thus more or less petrified products of institutionalised defence that, however, no longer obviously display the repulsed elements or the functions of repulsion and defence.