Belmont Hospital : report of the physician-superintendent 5th July, 1948, to 4th July, 1949 / [Louis Minski].

  • Minski, Louis.
Date:
[1949?]
Catalogue details

Licence: In copyright

Credit: Belmont Hospital : report of the physician-superintendent 5th July, 1948, to 4th July, 1949 / [Louis Minski]. Source: Wellcome Collection.

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    4 those who are asocial, shy and poor mixers. In this way patients are made to recognise the greater importance of the group or society in which they live than the individual or self. Psychodrama is used in the industrial unit as part of group therapy. Moreno has used drama for psychotherapeutic purposes since 1921 and Dr. Maxwell Jones, who is in charge of the unit, first used these group methods at Mill Hill Emergency Hospital in 1942. A play is presented weekly which is written by a patient and presents his own problem or that of another patient. He then chooses his own cast from the other patients, while the play itself is attended by patients and staff in the unit. The play does not offer a solution to the patient’s problem, but afterwards the group tries to help the players to resolve the problem. The discussion usually lasts one hour and at the end the psychiatrist sums up and attempts to bring the points of view expressed into a point of view acceptable to the group or the majority of it. The value of group activities of these types lies in the increase of group consciousness, the opportunity for overcoming neurotic difficulties and the liberation of pent-up emotion. Abreaction or narcoanalysis with sodium amytal or pentothal is still used, not only as a therapeutic measure but also as an aid in unfolding a mental state which in the surface shows a different picture from that revealed when the patient is disinhibited and talks freely. This might be classed as an aid to diagnosis so that appropriate treatment can be instituted. Ether abreaction is also employed, especially where a traumatic episode is to be unearthed. These abreactive techniques may be really classified as a combination of physical and psychological methods of treatment. Modified insulin and deep insulin therapy continue to be used, as are electro-convulsive therapy and continuous narcosis. Such well established methods of treatment require no comment. Prefrontal leucotomy is still being used in a number of states of tension and depersonalisation, which have proved resistant to other methods of treat¬ ment, with quite good results. As the effects of the operation on personality are the subject of research by Dr. Shorvon and myself, the results of which we hope to publish shortly, I will not at this stage discuss the matter further. For two years electronarcosis has been used in the hospital, mostly on schizophrenics who have failed to respond to deep insulin therapy and also on a few cases of chronic obsessional neurosis. The results are most disappointing and in no circumstances could electro¬ narcosis be advised as a substitute for deep insulin therapy in schizophrenia. Carbon dioxide inhalation therapy, which was begun by Von Meduna in America in 1946, has been used in the hospital for about twelve months. This particular form of treatment is of value in tension and hysterical states and is helpful in relieving tension and uncovering amnesias. When combined with abreactive techniques the treatment appears to be more valuable. As I have mentioned, it is essential that a balance should be retained between the psychological and physical methods of treatment, and it is safe to say that wherever physical methods are used psychotherapy must be used to reinforce such treatment. At the same time it must be realised that neurotic patients, most of whom are ambulant, are not receiving treatment all the day and it is necessary to provide forms of occupation and recreation as described below. OCCUPATIONAL THERAPY, ETC. There is a large carpenter’s shop where 60 patients attend daily and receive tuition in carpentry from Mr. Edmunds, who is in charge. This shop is the most popular among male patients and all types of articles are made, mostly for their own use at home. The cost to the patient is extremely small compared to outside prices.