ABSTRACT
Research into the working alliance in psychotherapy owes much to complex new understandings of the meaning of the emotional vulnerability of persons who can later develop dissociative and psychotic ways of coping with early traumatic experiences, and to new understandings offered by neuroscientific discoveries. Psychotic symptoms dominate their clinical pictures. While the first medical contact for the acutely psychotic patient is usually one-to-one, groups are also inevitably present: family, medical and social professionals, including police and emergency medical services, and other patients from the psychiatric unit. Considering the group characteristic of human nature, patients with acute psychotic decompensation on an acute inpatient psychiatric unit, should be met by a well structured acceptance of their unthinkable fears, anxiety and feeling that his/her life is endangered. To regulate distance in relationship with paranoid and very agitated patients is part of routine work in an acute inpatient psychiatric unit.
