In a General Hospital without psychiatric clinic, Consultation-Liaison Psychiatry (C/L) plays an exceptional role in the demand to develop and facilitate the collaboration between the patient and the doctors of each clinic in which the patient is nursed.
In a such “orphan” frame, complete psychiatric care and hospitalization are hardly attempted. Here I will present to you the way I worked as a psychiatrist of C/L, with a male schizophrenic patient in Orthopedic Clinic after a serious suicide attempt. The General Hospital in this particular case received a half-dead, bodily and mental, patient. His physical problem was attended intensively so as he could be directed to a Special Rehabilitation Centre for further improvement. At the same time, through the configuration and investment of suitable therapeutic frame, his “mental bleeding” stopped. Through this procedure and slowly by slowly, he learned to invest in a new human relation with the hope and prospect to “stand finally in his legs”.
The comprehension of countertranference was the key for the therapeutic approach of this patient.
The psychoanalytical theory and experience of clinical pioneers (e.g. Mentzos, Benedetti, Racamier) who dealt with the psychotherapy of psychosis are the support in the particular work.
It is worth mentioning that this patient received a psychoanalytical type approach. However, the technique and therapeutic frame suffered modifications so as to be adapted so much to his psychotic pathology as also to the conditions of his long- lasting hospitalization (5 months roughly) in the Orthopedic Clinic.