Dubin W R
Philadelphia Psychiatric Center, Pennsylvania 19131.
Hosp Community Psychiatry. 1989 Dec;40(12):1280-3. doi: 10.1176/ps.40.12.1280.
Over the past decade the management of aggression on psychiatric units has generally focused on pharmacologic and physical interventions rather than on psychodynamic concerns. The author reviews the dynamics of violence and discusses how clinical staff's fantasies, countertransferences, and psychological defenses may interact to trigger patient aggression. Interventions that address these issues with staff include developing a cohesive treatment team in which clinical staff can express their feelings without the need to explore the psychodynamic underpinnings, having clinical leaders maintain a strong presence on the unit to serve as role models, and providing regular inservice training.
在过去十年里，精神病科室对攻击行为的管理通常集中在药物和身体干预上，而非心理动力学方面的考量。作者回顾了暴力行为的动态过程，并探讨了临床工作人员的幻想、反移情和心理防御如何相互作用以引发患者的攻击行为。针对工作人员解决这些问题的干预措施包括组建一个有凝聚力的治疗团队，让临床工作人员能够表达自己的感受而无需探究心理动力学基础；让临床负责人在科室中保持强大的存在感以作为榜样；以及提供定期的在职培训。
