A group analytic approach for treating psychotic inpatients in heterogenous groups

In the presented paper we try to describe the inpatient treatment setting t hat we developed working together in the Department of Rehabilitative Psych iatry and Psychotherapy of the Rothaarklinik (Bad Berleburg). Crucial is a psychoanalytic understanding of psychotic disorders, an understanding of ps ychotic symptoms as a result of psychotic defense mechanisms. We understand the whole of the members of the station as a therapeutic community establi shing the transitional space due to Winnicott. A priority of the paper is g iven to special aspects of the therapeutic altitude in the psychoanalytic g roup therapy with heterogeneous groups, i.e. groups in which neurotic and p sychotic patients are treated together. We illustrate the conflicts with th e frame of the treatment resulting from the psychotic defense mechanisms on clinical cases and demonstrate posibilities of managing these conflicts. F inally we describe patterns of transference and countertransference typical for the treatment of psychotic patients.