The hospital in the mind: in-patient psychotherapy at the Cassel Hospital

Abstract

This chapter describes the setting of the Cassel and then focus on the role that the hospital takes in the mind of the patient and the ways that its different aspects are played out across the institution and how they may be integrated within the team and in psychotherapy. The setting of the Cassel Hospital has characteristics of both the bipolar and the integrated model but also additional characteristics, which are probably unique. P. Janssen, a leading practitioner and theoretician of in-patient psychotherapy in Germany, pointed out that in-patient psychotherapy was initially practised in a way that the therapeutic relationship was set completely apart from all the other things happening on a ward—in effect, “out-patient therapy in an in-patient setting”. In the bipolar setting there is a strict divide between a therapeutic space in which psychotherapy and potentially other therapies take place, and a social space in which patients are nursed and gather for social activities.