On psychotherapy of patients with problems of hostility

Psychotherapy often involves the person's recognition of the hostility, the role of reaction formation to hurtful situations and relationships, and transferential expression--and for the therapist, countertransference. Generally, underlying hostility is the wish to be free of it, granted the difficulty of some paranoid patients. Ambulatory therapy may be inadequate, and other resources, including hospitalization, may be required. The ethical issue of social responsibility transcending the obligation of confidentiality may arise.