Abstract
Based on the experiences of psychiatric patients who were in the process of rehabilitation after a significant period of rest and recuperation, the author aimed at analyzing the phenomena that facilitate as well as hinder patient maladjustment, in order to identify ways for clinical psychiatry to support patients’ rehabilitation processes. Two female patients with pathological personality traits who were in the process of rehabilitation were chosen. One attended a community center that offers employment for people with mental disorders, followed by a vocational rehabilitation center for the unemployed; the other returned to an ordinary job for which she was qualified. The author first investigated the interactions between their personalities and the group mentalities in their workplaces, and then analyzed these interactions using psychodynamic theories. The dynamic interactions between these patients’ personality pathologies and the group mentalities of the workplaces they chose for their rehabilitation seemed to play a crucial role in determining whether they experienced maladjustment or not. Various phenomena experienced by an individual in a community setting should not be ascribed solely to either the person’s personality or the community group mentality, but rather to the interaction between the two. Community centers for people with mental disorders must provide support that facilitates the accomplishment of the original purposes of the group, but also helps each group member improve their self-esteem. At the end of this article, the author argues that the narcissistic need for approval cannot be dismissed simply as pathological, but should be seen as a ubiquitous phenomenon in the contemporary Japanese ethos.
Highlights
One of the most crucial tangible goals in contemporary psychiatry is to achieve patient rehabilitation in the community
Their ego seems to have been more invested in primitive narcissistic needs, which appears to determine their way of interacting with the group to which they belong
After mental breakdown and before rehabilitation, they stayed at home, and their narcissistic needs were partially satisfied within individual psychotherapy as well as by family members’ support
Summary
One of the most crucial tangible goals in contemporary psychiatry is to achieve patient rehabilitation in the community. When a patient resumes contact with the community after a significant period of recuperation, it is common for previously inconspicuous personality characteristics to manifest gradually, or in some cases, rapidly. This sometimes helps the treating psychiatrist understand the patient’s personality pathology and hypothesize ways in which it may have played a significant role in their earlier maladjustment. In psychotherapy it usually becomes clear that patients have rarely experienced happiness in creative activities, or in contributing to society, for example by way of their job Their ego seems to have been more invested in primitive narcissistic needs, which appears to determine their way of interacting with the group to which they belong. These processes are usually observed in the cases of patients with considerable narcissistic needs
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