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This paper presents the four-year forensic outpatient treatment of a male patient in his mid-30s who was diagnosed with a schizoaffective disorder and had previously been held on unlimited detention due to several assaults. At the beginning, several coercive measures had to be taken. Over time, both the therapeutic alliance and the patient's psychic structure improved remarkably. The patient explained at the end of therapy that, despite being forced into treatment, he also felt recognized and held while he had been in deep distress. Several explanations of how coercion and the therapeutic process may correlate are discussed: essentially, the complex and dialectical relationships between inner and outer reality, therapeutic space, and social structures are reflected. Cautiously but consistently introducing outer reality as well as validating the patient's realistic perceptions contributed to strengthening his ego functions.
The paper discusses Frieda Fromm-Reichmann's theoretical contributions on the psychotherapy of psychoses and refers it to other authors' views. Today widely accepted, she stressed transference and countertransference as es-sential issues in the treatment of severely disturbed patients. She disagreed with authors like Federn who interpreted the concept of regression in a way that to treat schizophrenics means to treat children of different ages. Different from Federn, she advocated interpretations also of the positive transference to show the patient where he stands in life. Later on, Fromm-Reichmann opposed John Rosen and his direct analysis interpreting first the contents of the psychotic's speech. She stressed the form of the interaction and of the everyday behaviour where she saw where the patient stands in the world. The discussion shows that Fromm-Reichmann developed her theories and practice in cooperation and discussion with other psychoanalysts working with psychotic patients.
The paper discusses Frieda Fromm-Reichmann's theoretical contributions on the psychotherapy of psychoses and refers it to other authors' views. Today widely accepted, she stressed transference and countertransference as es-sential issues in the treatment of severely disturbed patients. She disagreed with authors like Federn who interpreted the concept of regression in a way that to treat schizophrenics means to treat children of different ages. Different from Federn, she advocated interpretations also of the positive transference to show the patient where he stands in life. Later on, Fromm-Reichmann opposed John Rosen and his direct analysis interpreting first the contents of the psychotic's speech. She stressed the form of the interaction and of the everyday behaviour where she saw where the patient stands in the world. The discussion shows that Fromm-Reichmann developed her theories and practice in cooperation and discussion with other psychoanalysts working with psychotic patients.
The paper discusses Frieda Fromm-Reichmann's theoretical contributions on the psychotherapy of psychoses and refers it to other authors' views. Today widely accepted, she stressed transference and countertransference as es-sential issues in the treatment of severely disturbed patients. She disagreed with authors like Federn who interpreted the concept of regression in a way that to treat schizophrenics means to treat children of different ages. Different from Federn, she advocated interpretations also of the positive transference to show the patient where he stands in life. Later on, Fromm-Reichmann opposed John Rosen and his direct analysis interpreting first the contents of the psychotic's speech. She stressed the form of the interaction and of the everyday behaviour where she saw where the patient stands in the world. The discussion shows that Fromm-Reichmann developed her theories and practice in cooperation and discussion with other psychoanalysts working with psychotic patients.