This critical analysis of both the foundation and the organisation of the psychiatric institution, and of the way in which staff function and patients are treated, shows that unconscious mechanisms of the human psyche rule the institution in the same destructive manner as they do in the outside world. The institution is not a rational construction nor is it run by special driving forces, but rather is a place where the repetition of psychic tragedies and the drama of Eros and Thanatos prevail. Further, it functions as an overall mothering and securing structure where, when things go wrong, the fatherly repressive side takes the upper hand. And what of the rights of the patient? What kind of humanity drives the work within an institution? The author argues that the psychoanalyst plays a permanent subversive role within the institution, in order to make new effects possible, provided that the specific ethics of the psychoanalytic discourse are taken into account.
This paper reviews the Freudian notion of the “Wiederkehr”, or “return”, as elaborated in Lacan’s Seminar on The Four Fundamental Concepts of Psychoanalysis. Futhermore, the author describes how the possibility of a return is implied in the psychoanalytic intervention strategy on a psychiatric ward for crisis intervention with drug addicts.
What can educators do with psychoanalysis in their daily institutional practice within a community? On the infantile roots of the desire of the educator.
The central focus of this article is the psychoanalytically orientated day-to-day educational work in an institution. We approach this problem from the concept of desire and pose two questions. The first concerns the transference of psychoanalysis in an institution. How can analysts transfer psychoanalysis to educators, nurses or other paramedics during their daily work in an institutional set-up? The desire of the analyst is the central axis of this problem. The core of the second question relates to the desire of the educator. How can psychoanalysis help us define our subjective position as educator in a community and in an institution? First, we question the relationship between desire and psychoanalytical formation. Secondly, we describe the infantile roots of our desire as an educator starting from our own particular life story.
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.
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.