ABSTRACT
This chapter demonstrates how clinical signs and family involvement, linked with material from the case history and from the patient's psychodrama, enable a systemic hypothesis to be made and to be tested by action at the ward level. Psychodrama can be useful in securing background information from psychotic patients who, when an ordinary case history is undertaken, are not able to associate present-day experiences with past events. Searching for a systemic hypothesis to account for Edith's relapse and for the form it has taken, the psychiatrist tried to link present-day family relationships with what had been learnt in the psychodrama. The hypothesis was made that when the sisters had their own troubles, they communicated with Edith and about Edith. The systemic meaning of Edith's mutism and the paradoxical nature of her catatonic signs could therefore be explained by her profound ambivalence towards her sisters and to being looked after in hospital.
