Psychosis and the Institution: On the Principles of Jean Oury’s Institutional Psychotherapy

This paper aims to address how the institution functions for the psychotic. People with a psychotic structure often have difficulties integrating into a community and functioning within a social bond. This means that on the level of treatment it is not immediately apparent how to build a lasting therapeutic relationship (and environment). Jean Oury’s institutional psychotherapy starts from this point, inspired by Marx’s analysis of social alienation. This paper focuses on the way in which an institution can be organised according to the principles of Oury’s institutional psychotherapy, taking into account the phenomenon of social alienation. First the theory of the social alienation is described, then the praxis of Oury’s institutional psychotherapy is outlined.

Transference and Constellation as Institutional Psychotherapy

Reflecting on the past seventeen years, the author describes the vicissitudes of the notions of transference and constellation in the history of La Traversière. He does so on the basis of a consideration of the history of psychoanalytical theory on the work, via transference, with psychotic patients. In this sense, his story forms a plea for the recreation and safeguarding of the conditions under which we can work with dissociated transference by means of the constellation meeting, as introduced by Tosquelles in Institutional Psychotherapy.

The Invisible Difference: On the Sisyphusean Nature of Work with the Psychotic

This article is a reflection on institutional work with psychotic people. The myth of Sisyphus serves as a metaphor for the difficulties and possibilities one encounters in this work: on the one hand, the never-ending nature of the work, the laborious progress, the alienating dynamics of the institution; and on the other, the movement, the chances to meet one another. The movement of institutional psychotherapy offers tools for constant reinvention and endurance in this work. Clinical examples illustrate how this thinking tries to realise itself in the daily practice of the institution.

Daily Work in a Home with Non-Working People: A Continuous Search Process

The ideology of vzw Albe (a non profit organisation) is based on institutional psychotherapy (IP). A brief history of the institution explains why IP was chosen as a model. The authors link concrete everyday experiences with some basic principles. First of all they explain the principle of free circulation, giving an example of how different spaces can be created to enable freedom of movement. Another important principle is heterogeneity, meaning diversity in location, pathology, personnel and activities. The next issue treated in the paper is how to be present in everyday life. Finally the writers give an insight in an actual workshop to demonstrate how all these attitudes, as described above, are combined in an IP workshop. Throughout the discussion it becomes apparent that linking IP theory with its practical application is an ongoing process. The principles of IP and the ideas behind it are often considered to be complicated, however observing an IP workshop reveals a poetic simplicity.

Creating Space for the Encounter: Meeting the Impossible

The movement called Institutional Psychotherapy is grounded in the ongoing effort to install the necessary conditions of possibility for the liberation of the clinic from alienation. To care for psychotic and other suffering people, we need to create a supportive transferential field in which the human encounter is essential. This touches the Real and makes possible, in a moment of crisis, a transformation of the position of the Subject. The Collective, the pathic sculpting of the space-between-people, allows for the emergence of the singular, the unexpected, the impossible. The starting point of this article is the author’s experience in the psychiatric clinic of La Borde (France). Through a number of concrete examples and critical moments, it hopes to show the interweaving of the elaboration of conceptual tools and the therapeutic situation within an institution.

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