Dual diagnosis intervention on a psychiatric ward: clinical practice and research

Abstract

The authors, besides describing their therapeutic activity of dual diagnosis intervention on a psychiatric ward, discuss ideas widespread in current literature which consider the abuse and addiction of substances as an attempt at self-medication; the use of substances would work as an external regulator in the disorder of emotionality control. Starting from the assumption that abuse of substances is due to a compulsive search for sensations driven by a loss of sensibility possibly leading to some level of alteration in the capacity to perceive human relationships, the authors propose a key interpretation where the principal problem of addiction does not originate from a deficit in the development of the symbolic functions inhibiting the adaptive control, but from a lack in the development of affective dimensions due to a dynamic of annulments in the relationships with others. The principal objective of the therapeutic activity during hospitalization is therefore to stimulate in patients the recovery of a natural sensibility considered a fundamental condition for a real development of reflexive functions. With this aim the authors have introduced specific therapeutic groups of sensitization namely cinema and literature groups, whose characteristics are described in the article.