Summary: Be open to what is coming. An open attitude will have a great influence on the course and success of your inpatient therapy. Openness makes sense in all directions: outward and inward, toward content and structures, in doing as well as in seeing. Even in the face of conflict, openness in the clinic is purposeful, because this is often where the therapeutic gold is buried.
The already described voluntary decision to go to an inpatient clinic is closely connected with the basic attitude with which you would go to this very clinic. You have already shown that you are open for something new. This open basic attitude is worth taking with you into the clinic.
Because successful psychotherapy has a lot to do with the extent to which you can engage with what is on offer. This starts with the principle of how psychotherapeutic clinics work, or how psychotherapy works in the first place. There, the therapy principle familiar from classical clinics is turned upside down, so to speak.
Open basic attitude means: to open up
In a normal hospital stay, the diagnosis (usually) comes from the specialists. It is not much different in psychotherapeutic clinics, because you will be given a diagnosis there too, if only because the health insurance companies have to process it for themselves. However, it can help not to get too fixated on the formal findings, as the diagnoses are often not easy to understand. The terms used to communicate in the professional psychotherapeutic context lead to confusion and irritation, especially among newcomers. Just think of terms like depression or trauma. These are both so overloaded with connotations and clichés that the conclusions you draw from them could also be wrong and that would only hinder you.
More importantly, the day-to-day life in the clinic will be less about the terms of the diagnosis and more about you as a person and your behavior, your social relationships, your feelings and what is on your mind.
In order for this to happen, access to your state of mind is necessary. Only you can provide this access by reporting about yourself as openly and honestly as possible. “Open basic attitude” in the clinic therefore means first of all to open yourself.
Don’t worry, you won’t hurt yourself with it. “The soul protects itself,” as a therapist of mine once put it. Even if you are very ruthless with yourself in terms of communicating content, you will not share anything that makes you uncomfortable. Or maybe you do? Then you were ready for it and the pain was bearable.
And if you find that it is difficult for you to talk about one thing or another, that is a gift, if you perceive that. Because then you will recognize your issues and their limits.
At the same time, there is a difference between content openness and emotional openness. Or, to put it another way, talking a lot is not the same as being honest with yourself. It is quite possible to say a lot or everything, but still be emotionally closed. For example, when you report a great event, but your audience can’t feel your excitement at all because you’re holding back your emotions.
Your contribution in the psychotherapeutic clinic is therefore disproportionately greater than in regular clinic stays. While in a normal clinic the medication is effective even if the patient does not actually want it, in a psychotherapeutic clinic “wanting it” is indispensable. There, the focus is on helping people to help themselves.
Open basic attitude with concrete offers
Even experienced patients never know what exactly they are in for unless they have been to that very clinic. It’s even stranger to newbies, and most of them really have no idea whatsoever what and how exactly everything goes on there. On the one hand, this has to do with the offerings themselves, which occur in this way in only a few other contexts in everyday life.
Those who have already experienced psychotherapeutic offers in everyday life, who at least know what it can be about in terms of content and who play improvisational theater, can perhaps engage more easily with offers such as drama therapy. But what exactly takes place there or in expressive painting, holotropic breathing or music therapy is new to most people.
This is a gift at the same time, because you can practice what it’s like to get involved with the unknown – for example, if control and over-structuring should be one of your issues. I would even advise against researching in advance exactly what the clinics’ offers mean (or can mean) in detail, because that only stirs up expectations.
For example, many local patients have very clear wishes as to which of the services they would absolutely like to take advantage of. But not everyone can do everything. A lot of things take place in parallel and a decision must be made as to what is the best fit for each patient. From your point of view, you can lean back and relax. Just here, where passivity is possible – and also advisable – most patients try to intervene in a controlling way instead.
Why, I ask myself. Have the therapists not thought about what might be suitable for you? Why waste energy now on changing this roadmap?
Accepting the offers means, first and foremost, following the clinic’s suggestions and joyfully waiting to see what happens there. Changes may also occur during the course of the stay (see below for further details). Of course, the same applies here: Get involved!
The emotional openness – to yourself
What will certainly be new for most people is the open interaction between the patients. This is unusual because we tend to be closed and “stable” in everyday life. As a rule, we reveal little about ourselves in terms of our emotional life. That’s unfortunate, because our emotions are what make us human, right?
This openness is put to the test in the clinic. Would you find it easy to walk around in drama therapy with others as a monkey one time and a tiger another? Or put another way, how easy is it for you to say how you really feel in front of others?
This requires an open attitude towards yourself. Without this, nothing – or only little – works in therapy.
This also requires courage. This is because you are entering unfamiliar territory that most people feel embarrassed about. Maybe you can try to see this as a chance to observe yourself in situations that are new. From this, many insights can usually be derived that are therapeutically valuable and can be further “utilized” or processed.
Especially if it has to do with your theme, then such moments are, as it were, treasure troves for the course of therapy. At the same time, your theme can also “change”.
Open-minded approach to changes in content
The therapists usually recognize very quickly what your acute issue is and also have a fairly clear idea of the therapeutic measures. This “issue,” however, may not coincide with what was on your mind before you checked into the clinic. You might even be very irritated about it and possibly they even work with a different diagnosis in the clinic than the one that is written on your referral.
That’s okay.
The psyche is a complex thing. We humans have many facets and our character is never one-sided. Besides, not everything can be treated in a clinic – unfortunately. In terms of time, I think it is obvious that an adult cannot be “retreaded” in three months (the current maximum period of stay). Besides, “retreading” is not the goal either. But that leads too far away from the topic now…
The focus that the clinic wants to concentrate on should be accepted because the therapists usually see more than you do. The mentioned complexity of the psyche is a blessing in disguise, because the aspect the clinic is concerned with is related to your entire personality. This then again has consequential effects on other parts of your personality. To put it another way, the clinic decides in this sense what is “up” now.
Isn’t that nice that you don’t have to decide that? You can just go into the therapies here and already have a focus to concentrate on.
A little patience is also necessary here, because the larger context will probably only become apparent to you after a few weeks. After all, a lot has been initiated, and that has to sink in first.
So I wouldn’t worry at all about “what the clinic is going to be about.” The therapists will help you to find out.
Open basic attitude to formal changes
Let’s assume you arrived well at the clinic after a week or two. You know your therapists well enough by now and have built trust, and you already know your schedule by heart.
Suddenly, an offer can no longer take place because perhaps the space for it is no longer available. Or – “even worse” – your favorite therapist is no longer there and you now have to go to someone else.
Many patients would freak out and feel confirmed in their world view: “Now I’m doing so well, and then something like this! “Of course this is happening to me!” “Everyone is against me!” “The world is bad!” “It’ll never work like this!” “Politics has ruined our health care system!”
Maybe you will find yourself in one or the other sentence. At the same time, I have only one answer: That’s life!
A psychosomatic clinic understands amazingly well how to “experience” everyday experiences even in the protected clinic context. This may sound frustrating at first, because why would anyone do this to themselves? Isn’t the primary goal to escape from this same daily routine in order to be able to heal in peace?
Yes, it is. At the same time, there is a clear difference, which has already been mentioned: the hospital provides a framework that protects, as it were.
These challenges are also opportunities, because they provide fodder for therapeutic work: Why does this frustrate you so much? What’s so bad about that? These could be questions that follow on from that.
At its core, however, is the possibility of exercising the muscle of acceptance here as well and being open to change occurring. Maybe the new therapist is even better than the old one, and maybe the new therapy I’ll be doing now because the other one has to be cancelled due to space issues is even more appropriate? Who knows? Nobody. But for the most part, little can be done about it.
I had my last hospital stay during the Corona pandemic. This was associated with many restrictions. At the same time, it has contributed to freedoms that were otherwise not possible. For example, I was able to spend a lot of time in the painting room for myself and these pictures still accompany me. Also, the groups were smaller, which led to more intensity among themselves.
…and as far as the health care system is concerned: I would even agree with that.
Openness towards conflicts
Conflicts are also part of everyday life. I have seen many patients who try to live a life where there is no conflict – myself included. But it’s nearly impossible to get through a single day – let alone: through your entire life – without experiencing conflict. Life is full of conflicts.
A therapist once said, “I get into conflicts every day. It’s not the end of the world.”
Conflicts are commonplace and they don’t always have to be full-blown crises. Even whether I like the room in the clinic can become an (inner) conflict for some. Now, this section is not intended to be about conflict in general, but what it means in everyday clinical practice and why it is good to engage in it.
Conflict is the gold of therapeutic work. These are usually the topics that concern us, that touch us, that are important. Accepting them and meeting them with an open mind means looking at what exactly is happening – internally and externally. And then to address that, perhaps first with the therapist and then probably with the people in question. This may be about resolving the conflict and clarifying it with the other person, that cannot be said in general terms.
But what can be said is that conflict is not there to be avoided, but to be openly embraced.
This can be used as a good closing to this post, as it can be applied to the hospital stay itself: Accept the inpatient therapy as openly as possible, let yourself in for what may come. Be curious about how you will react to one thing or another, and enjoy new insights that come from situations that may have initially frightened you.
And look forward to great encounters with people who will enrich your life.
This article is part of the in-depth coverage of the overview article “Inpatient therapy – why, how and where”.
