ABSTRACT
This chapter focuses on the role of the day hospital in the management of psychotic patients, especially in attempting to make emotional contact with those in seemingly inaccessible states, through the utilisation of analytic insights. The psychiatric day hospital can be regarded as one form of a therapeutic community. The clinical cases will illustrate just how helpful are his ideas in trying to understand psychotic functioning. The chapter describes the structure and functioning of the day hospital. A case has been made for the central Importance of psychoanalytic concepts in helping a group of staff working with the most difficult of patients in a day hospital setting. Three general psychiatrists shared the use of the day hospital, working in small teams with a clinical assistant, nurse and occupational therapist. A group of analysts subscribe to the view of a continuum model from neurosis to psychosis.
