The organization, culture, and atmosphere of the mental hospital unit seem contrived to accentuate the patient’s interpersonal difficulties and even their speech (
The hierarchy on the unit accentuates their sense of inferiority and marginalization
The authoritarian regimen accentuates their sense of vulnerability, being controlled, and not having an influence on what happens to them. They feel defenseless, humiliated, and helpless. The typical behavioral reactions are
The emphasis on conformity tends to diminish the
The emphasis on control leads to social incompetence, as manifested by speech disturbance.
The central problem in individuals with chronic schizophrenia is their pronounced disengagement from their environment so that they no longer entertain feasible goals for themselves. It is possible that the preoccupation of many, with grandiose delusions, serve to compensate for this loss of purpose and meaningful objective. It is quite true that many of them have grandiose delusions at the very onset of their illness, but we contend that the social atmosphere in which they are treated helps to perpetuate these delusions.7. We have noted that when the individuals are engaged in meaningful activities, such as games, dancing, singing, etc., they appear as normal as other people—they are evidently in the non-patient mode at this point.