Silence: something we rarely hear, which does not exist.
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Biomedical subjects
Publications and source records attributed to H A Wilmer.
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A novel form of group therapy which I call the Dream Seminar was introduced on an inpatient milieu treatment unit for chronic schizophrenic patients at a Veterans Hospital. The purpose was to help patients understand and appreciate their dreams in a special group setting. It was hypothesized that the Dream Seminar would diminish insomnia and night fears, that the examination of dream experiences, no matter how bizarre or frightening, would be potentially healing, and that patients' attitudes toward dreams as well as delusions and hallucinations might change. It was also hypothesized that by limiting the focus of the Dream Seminar to the manifest dream content, the images and internal sequences of the dream, and by not allowing free association, the connective unconscious of the group would be brought into the open and balance the more conventional therapies of the rest of the program. This paper is a clinical report based on five years' experience with the Dream Seminar.
1. Vietnam veterans who still suffer from post-traumatic stress and delayed-stress disorders may respond to psychotherapy. Dreams that have recurred as often as every night for 8 to 15 years may be depotentiated. 2. In the records of the Vietnam veterans whom I have seen on my ward, almost without exception there has been no documentation of the contents, frequency and nature of their dreams and nightmares, and no precise record of their military experience in Vietnam. 3. By creating special group therapy, a Dream Seminar, and by individual analytical psychotherapy, a way has been found to work with these dreams as part of the post-traumatic stress disorder. 4. Three case histories have been presented to highlight the nature of these dreams and how they may respond to therapy. 5. In a larger perspective, the dreams of Vietnam offer a unique record of the unconscious history of Vietnam, uncontaminated by the waking ego, by conscious motivations or distortions. There cases have led to an extensive in-depth study of 125 randomly selected Vietnam combat veterans, which will be reported later. 6. Combat dreams recurring in identical form for years may change and evolve in a therapeutic drama.
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The term "therapeutic community" has been used to describe a vast array of milieu therapy techniques; thus the term has come to mean different things to different people. The author defines the therapeutic community through an examination of its historical roots in the British military hospitals of World War II and the development of the treatment concept as an ideology. He classifies therapeutic communities as left, right, or center in their therapeutic ideology. It is in the communities of the center, the least dogmatic and most flexible typology, that the author finds hope for the most effective type of therapy.
The author believes that rapid hospital turnover of psychiatric patients and heavy reliance on psychotropic drugs often interfere with recovery, especially for many psychotic patients who need a retreat where they might be helped to heal themselves. He describes the origins and operation of a Jungian-oriented therapeutic community for schizophrenic patients in a Veterans Administration hospital, the community is based parly on his earlier work with therapeutic communities and his belief that clear lines of authority must be maintained as well as his experiences with videotherapy and art therapy. The community relies heavily on art therapy in which patients are encouraged to make abstract paintings of their delusions, visions, hallucinations, dreams, and fantasies and to interpret the paintings themselves.
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