The Total Encounter Capsule

Abstract

For the last nine years, groups of patient volunteers in the Social Therapy Unit of the maximum security section of the Mental Health Centre at Penetanguishene have been making regular use of the Total Encounter Capsule. The Capsule is a specially constructed, soundproof, window-less, but continuously lighted and ventilated room, eight feet by ten feet, which provides the basic essentials — liquid food dispensers, washing and toilet facilities — and in which it is possible for a group of up to seven patients to live for many days at a time, totally removed from contact with the outside. It functions as a place of undisturbed security where a small group of voluntary patients can focus upon issues they feel important enough to warrant the exclusion of the usual physical and psychological distractions (including staff), in a setting where the risks of suicide or homicide that might attend extremely intense personal encounters are at a minimum. The many ways in which groups of patients have used this facility are reviewed and the problems of researching the effectiveness of the program are discussed. Included in the paper is an overview of the historical development of all the intensive coercive milieu therapy programs at Penetanguishene so that the purpose and function of the Capsule can be seen in context. Designed initially as an attempt to overcome the problem of the escapist role-playing of the articulate psychopath, the greatest value of the Capsule is now seen more importantly as the way in which it provides a brief, very intense, but safe experience for a patient to look forward to or back upon as a bench mark during a lengthy stay in hospital.