American Journal of Psychiatry

KATE FRANKENTHAL

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BECK, AARON T.; VALIN, SIGMUND

doi: 10.1176/appi.ajp.110.5.347pmid: 13104673

AARON T. BECK M. C. 1 , and SIGMUND VALIN Ph. D. 2 1 Chief, Closed NP Section, Valley Forge Army Hospital, Phoenixville, Pa. 2 Chief Psychologist, Territorial Hospital, Kaneoke, Oahu, Territory of Hawaii. 1. A clinical study was made of 5 soldiers who experienced psychotic depressive reactions after shooting and killing their buddies. 2. These patients showed many distortions in their basic character makeup which in most of the cases could be classified as predominantly hysterical with ingrained patterns of action-oriented behavior. 3. The patients uniformly revealed a history of borderline adjustment in civilian life, poor identifications, unstable family backgrounds, and highly ambivalent relationships with other people. 4. The severity of the reaction to the traumatic situation was explained as being related to the presence of unconscious hostility towards the buddy, which produced overwhelming guilt, and their poorly integrated, highly vulnerable personalities. The sources of the unconscious hostility were discussed. 5. The defense mechanisms utilized by the patients were discussed in terms of their efficacy, sequence, and dynamic significance.

CRUVANT, BERNARD A.

doi: 10.1176/appi.ajp.110.5.342pmid: 13104672

BERNARD A. CRUVANT M. D. 1 1 Chief, Psychiatric Service, Saint Elizabeths Hospital, Washington, D. C. When a group therapy program is instituted on a psychiatric service with patients who have in the past predominantly translated their emotional conflicts into antisocial behavior, the occasions may become "gripe" meetings rather than "group" meetings. This is particularly true when the administrative physician serves as the group therapist. Institution of administrative group meetings, led by the physician-in-charge, serves several purposes. 1. It exposes as diversionary maneuvers by various group members irrational distortions of the administrative physician as a surrogate authority. 2. The sessions uncover transference and resistance phenomena previously cloaked as reasonable "gripes," thus preventing stasis of therapeutic progress. 3. Jockeying for status with the group leader as an antithetical factor in the therapeutic group sessions is reduced. 4. Reality-determined conscious reluctance about revealing emotion-charged material for fear of provoking a restrictive reaction if the group therapist is also the administrator is attenuated. 5. The meetings furnish the administrator with valid information about what is really wrong with the conditions under which his patients are living and this enables him to correct many untoward environmental influences immediately, to plan for long-term correction of others, and to interpret to the group administrative difficulties and limitations. As often as necessary I take a copy of the hospital budget to the administrative meeting to explain exactly how the annual appropriation is spent in each category. 6. The administrative group experience can promote professional growth (and may also provoke acute anxiety) in the administrative psychiatrist. 7. The administrative group serves a valuable function in therapy by providing a contribution to increasing individual ego strength in the patients participating.

R. W. GERARD

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H. HOLLAND DEJONG

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EDGAR F. BORGATTA

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ANDRAS ANGYAL

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JOHN A. FRANK

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MILTON GREENBLATT

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C. B. F.

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