MacDonald D M
Department of Psychiatry, St. Luke's-Roosevelt Hospital Center, New York, NY 10025.
Gen Hosp Psychiatry. 1988 Sep;10(5):352-9. doi: 10.1016/0163-8343(88)90007-2.
The structure of a psychiatric service in an urban general hospital is complex. Varied intrainstitutional and extrainstitutional relationships create stress, which can lead to rational and irrational reactions, often in combination. Psychologic mechanisms that exist in individuals also occur as shared defense mechanisms in an institutional setting, serving to reduce anxiety and stress but often at the expense of accurate reality perception. Good communication can play a vital role in reducing reality distortions but is itself often blocked or impaired by the same defense mechanisms that led to the distortions. An awareness of how these mechanisms operate in an institutional setting can aid the psychiatric administrator in correcting distortions and maintaining good channels of communication.
城市综合医院精神科服务的结构复杂。机构内部和外部的各种关系会产生压力，这可能导致理性和非理性反应，且常常相互交织。个体中存在的心理机制在机构环境中也会作为共同防御机制出现，有助于减轻焦虑和压力，但往往以准确感知现实为代价。良好的沟通在减少现实扭曲方面可以发挥至关重要的作用，但它本身常常会被导致扭曲的相同防御机制所阻碍或损害。了解这些机制在机构环境中的运作方式，有助于精神科管理人员纠正扭曲并保持良好的沟通渠道。
