THE PSYCHODYNAMICS OF PSYCHIATRIC HOSPITALIZATION

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Abstract
The traditional notion of why a patient enters a psychiatric hospital is based upon existing concepts of mental illness, disease, emotional sickness and the like; the hospital is the locus of treatment. Recently, attention has been focused upon other factors which help to explain hospitalization. In accord with these trends, the thesis of the present paper is that the entire process which culminates in hospitalization may be understood as goal-directed, motivated behavior aimed toward the gratification of needs, including both positive satisfactions and the avoidance of psychological hurt and pain. Four conditions are proposed as comprising the road to hospitalization: 1) a precipitating change, either abrupt or gradual, which is related to the increased operation of needs; 2) a state of heightened or increased needs; 3) some learning or linkage between the individual''s needs and his concept of hospitalization as a major means of gratifying those needs or acheiving related goals; and 4) the emergence of personality behavior or "symptoms" directed toward the goals of achieving psychiatric hospitalization and consequent gratification of both positive satisfactions and the avoidance of psychological hurt. From such a viewpoint, this paper examines the following implied relationships: the goal-directedness of patients'' symptoms and the aims of a hospital treatment program; the suggested opposition between patients'' motivations for hospitalization and conventional treatment methods: physical complaints as goal-directed behavior: the role of psychotherapy, drugs and other pharmacological agents; the physical organization and avail-ability of the hospital to both patients and significant figures in their lives; the goals of hospital treatment: the similarities between hospital-ized and non-hospitalized persons; and procedures of diagnosis.

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