ABSTRACT
This chapter deals with therapeutic functions in the institutional setting of the hospital. It explores some ideas and experience on the possible significance of psychoanalysis in the context of a psychiatric hospital having a general, public remit: what specific conditions for psychotherapeutic processes arise from the structures of such institutions? The chapter considers this problem from the point of view of a kind of applied psychoanalysis, as a “psychanalyste sans divan”. Normally, decision-making on psychotherapy precedes process. In the non-selective hospital situation, psychotherapy appears at first not as a particular setting but “latently”, as a potential—an open possibility held out by the team and presented to patients as a prospect within a defined framework. The prime function of a hospital providing public psychiatric services is to accept severely regressed patients at all times and to supply them, at first unconditionally and physically, with containment and boundaries, simply because the hospital is already there.
