ABSTRACT In today’s culture of evidence-based treatment and managed care, psychoanalysis is mostly relegated to the private consulting rooms of psychoanalysts, no longer available in hospital settings for those who need more containment than a single psychotherapist can offer. At the Austen Riggs Center, we work with our patients in four-times-a-week individual psychoanalytic psychotherapy and use psychoanalytic ideas about groups and their processes to understand the individual’s role in social context, particularly within their family system. Working psychoanalytically within a larger system raises interesting questions about the role and nature of transference and countertransference when it is not solely emerging between patient and analyst, but rather with many people across situations. Whereas the consulting room remains a privileged space for the patient to work as an individual, the therapeutic community offers a different kind of consulting room, a social space where therapist or analyst also participates alongside his or her patients. Such a setting requires that one think about how to integrate experiences in the social realm into the fantasy space of psychoanalytic psychotherapy. This paper offers a window into the nuances of such a treatment in our hospital setting and illustrates the process of synthesizing the wealth of information gleaned from such an immersive treatment environment.

中文翻译：

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一个村庄长大的人：一个在医院环境中进行精神分析治疗的案例

摘要在当今基于证据的治疗和管理式护理的文化中，精神分析大多被归于精神分析员的私人咨询室，在医院中不再为那些需要比单一心理治疗师提供更多遏制能力的人提供服务。在奥斯汀·里格斯中心，我们与患者进行每周四次的个人心理分析心理治疗，并使用有关群体及其过程的心理分析思想来理解个人在社会环境中的作用，尤其是在家庭系统中。在较大的系统中进行心理分析工作时，有关转移和反转移的作用和性质不仅会在患者和分析人员之间出现，而且会引起许多情况下的人们提出有趣的问题。咨询室仍然是患者作为个人工作的特权空间，而治疗社区则提供了另一种类型的咨询室，即治疗师或分析员也与患者一起参与的社交空间。这种设置要求人们考虑如何将社会领域的经验整合到心理分析心理治疗的幻想空间中。本文为我们在医院环境中进行这种治疗的细微差别提供了一个窗口，并说明了从这种沉浸式治疗环境中收集到的大量信息的合成过程。这种设置要求人们考虑如何将社会领域的经验整合到心理分析心理治疗的幻想空间中。本文为我们在医院环境中进行这种治疗的细微差别提供了一个窗口，并说明了从这种沉浸式治疗环境中收集到的大量信息的合成过程。这种设置要求人们考虑如何将社会领域的经验整合到心理分析心理治疗的幻想空间中。本文为我们在医院环境中进行这种治疗的细微差别提供了一个窗口，并说明了从这种沉浸式治疗环境中收集到的大量信息的合成过程。