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[The violent patient and institutional counter-violence]
1Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover.
Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany))
|October 1, 1994
Summary
Violent patient treatment requires institutional defense mechanisms, often leading to counter-aggression. Minimizing this institutional response is key to effectively treating aggressive patients.
Area of Science:
- Psychiatry
- Psychology
- Healthcare Management
Background:
- Treating violent patients presents significant challenges for both individual clinicians and psychiatric institutions.
- Effective management requires understanding and addressing institutional defense mechanisms against patient aggression.
Observation:
- Institutions develop "institutionalized systems of defense" to protect staff from frightening patient interactions.
- These defenses can manifest as counter-aggression, particularly under unfavorable conditions.
- Both custodial and reformed psychiatric settings exhibit subtle forms of counter-aggression.
Findings:
- Patient aggression and institutional counter-aggression can create a mutually reinforcing cycle.
- Subtle counter-aggression protects professional identity in liberal psychiatric environments.
- The desire to maintain a perception of "good" or non-violent psychiatry can hinder effective patient treatment.
Implications:
- Addressing institutional counter-aggression is crucial for improving the care of violent patients.
- Rethinking institutional defense strategies is necessary to reduce negative feedback loops.
- A shift in focus from maintaining a "non-violent" facade to actively managing aggression is needed.