ABSTRACT
A HOSPITAL dealing exclusively with psychoneurotics, has resulted from the necessity of coping with the ever increasing number of emotionally sick individuals. Until recently, the psychoneurotic patient found himself in a difficult situation when he came to look for treatment. If he was well-to-do he had the option of either out-patient therapy, or he could enter one of the many private psychiatric hospitals which cater for the neurotic and psychotic patient. If he was unfortunate enough to lack sufficient means, he had to content himself with visits to his general practitioner. If his condition was more severe, then he could apply to one of the mental hospitals for admission as a voluntary patient. In many instances he may have been able to attend an out-patient psychiatric department at one of the more progressive general hospitals. To-day this state of affairs has greatly altered for the better, and there are several neurosis centres in the United Kingdom. On the Industrial Neurosis Unit at Belmont Hospital, we are attempting to apply psychotherapeutic methods of treatment, but are meeting with tremendous difficulties. Firstly, the type of patient we admit—mostly severe character disorders with poorly integrated personalities—does not offer good material for psychoanalysis or for any form of psychotherapy. Then the patients stay in hospital for an average of four months, and each doctor has a case load of twenty to thirty patients, so that no time is available to apply a psychoanalytic technique to more than one or two selected patients. Finally, the problem of psychotherapy for inpatients is fundamentally different to the treatment of out-patients. These treatment difficulties are discussed in this paper and particular attention paid to the complications which arise when treatment is carried out on hospital patients.
