ABSTRACT

Hospital treatments are for the sickest patients, those who cannot exist outside without danger to themselves or others. Self-care is disorganized, fragmented, unmotivated, or attacked, depending on the illness and its specific effects on ego functions. A regular, predictable, and highly organized milieu can be successful remarkably quickly for patients with organic brain syndrome ego dysfunction. Personality disorders are common in hospitalized patients because their severity may make the patient's behavior dangerous to himself or herself or others, or their behavior may have triggered a potential life-altering environmental reaction. Psychotic transference is organized by the characteristic ego problems of the patient's illness. The boundary between object relations in psychotic patients arouses strong countertransference when such boundary losses involve the therapist as a real object, causing delusional patient comments or behavior aimed at the therapist. The boundary problems, especially between the condensation and the rest of personality functioning, are the hallmark of near psychotic states.