ABSTRACT
In Chapter 15, psychoanalytic theory is applied in understanding and managing a psychiatric inpatient, not to suggest that she might benefit from psychoanalytic psychotherapy, but rather that incorporation of a psychoanalytic understanding of her leads to a more effective management approach, especially regarding dealing with staff reactions to disturbing patients. Psychodynamic formulation of a patient, considering attachment and affect regulation, self-image and internal object relations, and transference and countertransference implications, demonstrates how psychoanalytic principles can be applied in non-psychoanalytic settings. Consideration of the patient’s personality and recognition of the patient’s having a comorbid personality disorder appear important in her management, and have practical implications regarding staff members’ understanding of the patient and the consequent identification and handling of difficulties in patient–staff relations. Specific management approaches based on a psychoanalytic understanding of the patient are described.
