THE TREATMENT of the hospitalized psychiatric patient remains one of the most challenging and complex of clinical activities. The pioneer work of Simmel1 and Menninger2 in applying the principles of psychoanalysis to the treatment of hospitalized patients helped to establish the scientific basis for such treatment.
Simultaneously, the strongest advantage and greatest danger of hospital care is its intensity. The potential impact of the hospital's influences are enormous since they go on 24 hours a day. In addition the patient has decompensated to the point that he requires institutional care and in general is more vulnerable to these influences than he otherwise would be. In an address delivered in 1918, Freud3 admonished us that a hospital must prepare a patient for life outside and warned of the danger of the doctor's imposing his personal values on the patient.