Parental Expectations as a Force in Treatment: The Identification of Unconscious Parental Projections Onto the Childrens' Psychiatric Hospital

Richard L. Cohen, Israel W. Charny, Pernilla Lembke

Research output: Contribution to journalArticlepeer-review

Abstract

This study is based on the analysis of 175 cases referred to Oakbourne Hospital's inpatient unit for the intensive treatment of severely disturbed children. The parents of these children are almost always motivated in their search for by serious help unconscious resistances which reflect and derive from the original distor-tions of the child's needs which were central to the development of his problem. The intake-diagnostic procedure cannot be considered to be complete unless some uncovering and exploration of the neurotic components of parental motivation has taken place. If this fails to occur, the institution may discover at a later date that it has unwittingly entered into a “contract” with parents which it cannot and should not honor. This study has served to identify several interrelated and overlapping attitude complexes which in our experience have characterized the major operations of parental resistance to treatment of the child. In each instance the parents are seen as attempting to enlist the hospital's support of their own narcissistic needs at the continuing expense of the child owing to their own conflicts in the following areas : ( 1 ) conflict over unresolved dependency needs; (2) conflict over the emerging impulse life of the child; (3) conflict over destructive or rejecting impulses toward the child; (4) conflict resulting from confusion of the basic identity of the child; (5) conflict over unresolved impulses toward their own parents and/or society. Early recognition of these attitudes results in a much higher percentage of treatment successes and a more efficient use of scarce hospital facilities. The study also underscores the value of involving several professional disciplines in a case as early as possible. Intake is conceptually a group problem requiring all available skills to arrive at a family diagnosis.

Original languageEnglish
Pages (from-to)471-478
Number of pages8
JournalArchives of General Psychiatry
Volume4
Issue number5
DOIs
StatePublished - May 1961
Externally publishedYes

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