Family treatment has attracted the interest
not only of psychiatrists but also of social agencies and of the federal
government, which supports research projects in this area. Play therapy is a
form of psychotherapy adapted to children. Anyone who has tried to help an
emotionally disturbed child knows how difficult it is to get him to talk about
his problems. But often the child reveals himself, far better than he could by
talking, when he plays with toys and acts out his fantasies. The therapist
helps him get things out of his system, accepting him warmly as he is and
guiding him toward a solution of his problems. Since these are related to the
way he is treated at home, play therapy is often combined with some form of
therapy (frequently, group) for the parents. Psychoanalysis, or reconstructive
psychotherapy, has the most ambitious objective of any form of psychological
treatment. Freud was the originator but there are now many other schools of
psychoanalysis.
There are differences in the number of
sessions per week, their length, and the total period of treatment. But all try
to help the patient examine his thought and behavior patterns, uncover his
concealed problems and wounds, and rebuild his personality structure along more
healthful lines. Free association is used to help the patient bring into his
conscious mind the unconscious forces that influence him. While he is with the
analyst, the patient tries to speak freely of everything that comes into his
mind, no matter how irrelevant or shameful it may seem. The sequence of these
thoughts may reveal to the analyst the unconscious connections and help explain
the source of trouble. In the course of these sessions, transference takes
place. That is, the patient tends to react to the analyst in ways he reacted or
still reacts to important figures in his life, usually his parents. Since the
analyst is a neutral type of figure, the patient can see his own patterns of
reaction. For example, a patient might be able to rationalize his fear of a
neighbor by saying the neighbor is after his job or his wife. In analytic
sessions, unable to find a reason for a similar fear of the analyst, he may
then discover that it springs from his unconscious mind, and later may realize
that it was actually a concealed fear of his father carried over from
childhood.
Day after day, month after month, as the
patient acts and speaks in neurotic, immature ways, the analyst helps him
examine his feelings and responses. And slowly the patient becomes aware of
what is and is not rational and appropriate, and why he thinks and acts
irrationally. With this, he begins to think and talk in healthier fashion and,
fortified by little pieces of success, becomes increasingly able, over a period
of time, to function in a more mature manner. Psychoanalysis is expensive,
often exhausting. But when, after years, it works welt it can be highly
rewarding (though there is no guarantee of a completely successful result in
all cases). Medical Therapy Since 1955, when the first two tranquilizing
medicines, chlorpromazine and reserpine, were introduced in the United States
mental institutions,revolutionary changes have taken place.
