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Therapy or coercion: a clinical note on personal change in the therapeutic community

R.D. Hinshelwood (Professor, Centre for Psychoanalytic Studies, University of Essex, UK. He was based at St Bernards Hospital, Southall, UK, when the article was written)

Therapeutic Communities: The International Journal of Therapeutic Communities

ISSN: 0964-1866

Article publication date: 24 September 2012

138

Abstract

Purpose

Psychiatry in its traditional form, often relegates the patient to a passive recipient, and removes his/her agency. The paper aims to examine the reasons for this and the value of it from a largely theoretical perspective.

Design/methodology/approach

The literature is examined on the responsibilities removed from patients by prescribing treatment, both medication, and psychotherapy.

Findings

The literature describes how humans in their collectives, groups or communities, generate commonly held attitudes, which may coerce patients into certain roles, and to give up their responsibilities and their agencies. It is postulated that this is possible in a therapeutic community where the unconscious dynamics could resemble those of psychiatric units.

Practical implications

The significance of the findings is that some degree of vigilance has to be maintained over what sets of attitudes develop in a community and especially the role that patients are assigned.

Originality/value

The findings suggest that the therapeutic community method should not be idealised but can go wrong, or can harbour coercive un‐therapeutic influences. There needs to be some continuing awareness of the development of such dynamics.

Keywords

Citation

Hinshelwood, R.D. (2012), "Therapy or coercion: a clinical note on personal change in the therapeutic community", Therapeutic Communities: The International Journal of Therapeutic Communities, Vol. 33 No. 2/3, pp. 133-138. https://doi.org/10.1108/09641861211291621

Publisher

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Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited

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