A contemporary perspective on psychoanalytically informed hospital treatment.

Despite impressive biological advances in the treatment of hospitalized patients, many inpatients do not respond to conventional somatic therapies. For these treatment-resistant patients with axis I disorders, as well as for characterologically disturbed axis II patients, a sophisticated milieu approach employing psychoanalytic principles may be useful, if not essential, in planning effective treatment. The author presents a model based on object relations theory to assist hospital staff in conceptualizing such treatment approaches. The cornerstone is a systematic understanding of transference and counter-transference as they reflect the patient's internal object relations.