Re-activation of arrested development: a theoretical view of the patient-staff "community meeting"

The theoretical view presented here was derived from clinical observations of the "community meeting" process. This view addressed the therapeutic impact on arrested development of the community meeting as it operates within the milieu treatment system. The focus was on how, as a therapeutic agent, it replicates in the environment and re-activates in the individual an early crucial developmental task--the integration and consolidation of intrapsychic part-self, part-object representations into a structural unity. This particular developmental progression is considered nuclear to the treatment of schizophrenia since it is at these early developmental sites where a crucial transformation occurs. The transformation is from primitive unintegrated part-self, part-object representations toward their consolidation so that the maturation of mental structures and a differentiated self-identity can proceed. The re-activation of arrested development at the differentiation subphase of separation-individuation (Mahler, Pine, and Bergman, 1975) was thought to occur because of three factors: the unique relatedness ("innervation with the environment") that developmentally arrested patients have because of boundary failures; the intense incorporative "taking in" trends of the severely disordered; and the impact of separations on the activation of reconsolidation processes.