Psychoanalysis, the NHS, and Mental Health Work Today

Alison Vaspe

"This excellent book shows the ways in which the psychoanalytic work of experienced and new clinicians benefits both patient and professional. It begins with the metaphor of primitive forces in human nature being like a tiger in the room — “He who rides the tiger dare not dismount” — but notes that not to reflect on relationships in anxious times of risk is also dangerous, in a culture blindly hitting the target but missing the point. This book has a belief that inequality, injustice, and lack of care for the vulnerable in our society is bad for the mental health of us all. It offers the hope of analytic adaptation in a time of extinction anxiety. An obituary of psychoanalysis in the NHS would be premature when such life and energy is evident in an evolving discipline."— Dr James Johnston, Consultant Psychiatrist in Psychotherapy, Leeds, and author of the 2017 policy report to the Royal College of Psychiatrists 'Learning from the Cradle to the Grave: The psychotherapeutic development of doctors from the beginning to the end of their career in medicine and psychiatry'"This book is for all of us, whether we work in mental health services or are its patients. We are reminded that, essentially, we are all vulnerable. The vibrancy and applicability of psychoanalytic thinking and practice to help make sense of our different experiences of these services are at the crux of this book. In a market-driven, cost-conscious NHS, this book argues that we ignore the strain of this emotional work at our peril."— Lesley Day, psychotherapist, reflective practice and organisational consultant, and former Head of Service at Cassel Hospital"This original book is essential reading for all those concerned with mental health in the NHS. It has thought-provoking chapters on the value of psychoanalytic thinking both in outpatient and inpatient settings. The authors explore the key analytical contribution to understanding institutions. An important aspect of this is supporting staff in stressful clinical situations."— Nick Temple, President of the British Psychoanalytical Society (2012–2016) and Chief Executive of Tavistock and Portman NHS Trust (2003–2008)"The authors of this book meet their goal of illustrating the power of psychoanalysis both as an important tool for physicians and therapists in their day-to-day work with patients, and as a means for characterizing the damage that is being done by the neoliberal shift at the NHS. This shift has created an impersonal market- and metrics-driven system that is both burdensome and punitive for NHS workers, and highly deadening for the patients who are classified as consumers of healthcare."— Michael O’Loughlin, Psychoanalysis, Culture & Society"Taken as a whole, this book offers an important analysis of the state of psychoanalytic thinking and practice in the NHS and is a useful aid in making sense of the pressures that child psychotherapists and other professionals experience on a daily basis. The varied chapters help to shed light on exactly how the NHS is changing and on the place of (child) psychotherapy and psychoanalytic thinking within this organisation. This book offers a glimmer of sanity amid the turmoil of changes and increased pressure."— Georgina Taylor, Journal of Child Psychotherapy"This is a timely and thoughtfully written book that brings together psychoanalytic themes as applied to the work of mental health services in the contemporary NHS... I would recommend this excellent book to colleagues; it is rich in its contributions at a patient, team and institutional level, as it aims to be. It illustrates that applied Psychoanalytic work and thought is integral to providing caring, thoughtful and effective contemporary mental health services."— William Burbidge-James, Medical Psychotherapy Faculty Newsletter

• Statement of Confidentiality , Series Foreword , Introduction , Psychoanalytic Approaches to Working with Patients , Theory in use: perspectives on containment , Countertransference experiences as an aid to staff working with traumatised patients , Thinking psychoanalytically about mental health services for children, adolescents, and their parents , Siobhan O’Connor: two tributes , Learning from women with psychosis , Staff and Organisational Needs and Challenges , Reflective psychiatry: psychoanalytic theory in everyday clinical practice , Working with dilemmas and disappointment in difficult places: towards a psychosocial model for team-focused reflective practice , On being an observing participant in a therapeutic institution: using psychoanalytic understanding in the work in an organisation , A view from a death: understanding the impact on staff of mental health work with older adults , The organisational context for good care , General practice, mental health, and stress. Part 1: a dialogue , General practice, mental health, and stress. Part 2: organisational model and commentary on the postmodern context , Concluding remarks