The Relevance of Psychoanalytic Ideas to Crisis Work

The therapeutic aim of crisis work typically has been to help the patient regain a pre-morbid state of functioning with an almost exclusive focus on the amelioration of immediate symptomatology. Drawing on our experience in a crisis team of a major metropolitan hospital with a large Hispanic and African-American population, we contend that crisis work ought not to focus myopically on symptom removal and must include, to the highest degree possible, an exploration of the multiple meanings contained in what is possibly a turning point in the patient’s life. Toward this aim, we describe three psychoanalytic principles believed to be particularly relevant to crisis work that have, nonetheless, traditionally been deemed inappropriatefor this treatment modality. These principles are historicity, neutrality, and fantasy. Discussion of the principles are presented within the context of case material.