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The Work of Psychoanalysts in the Public Health Sector. Edited by Mary Brownsecombe Heller & Sheena Pollet. Routledge. 2009. £22.99 (pb). 232 pp. ISBN: 9780415484299

Published online by Cambridge University Press:  02 January 2018

Jon Patrick*
Affiliation:
NHS Lothian, Psychotherapy Department, Royal Edinburgh Hospital, Tipperlinn Road, Edinburgh EH10 5HF, UK. Email: jon.patrick@nhslothian.scot.nhs.uk
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Abstract

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Columns
Copyright
Copyright © Royal College of Psychiatrists, 2010 

In the manner of great music compilation albums, the authors of this volume have managed to squeeze in virtually ‘all killer and (almost) no filler’. The book opens with a brief overture that gives the reader a chance to hear the themes that will be developed throughout – that analytic thinking adds depth and complexity to general psychiatric practice more generally and remains relevant even within the confines of a market-based health economy. The latter perhaps leading to the aptly named title of the first chapter, ‘Making a little go a long way’.

The choice of chapters and the order in which they are set gives the book a clear structure, taking the reader from working with people in the early phases of their development through to adulthood. The book then moves beyond individuals into how analytic ideas can be extended to have value and meaning within mental health work more generally, including the poignant chapter on helping ‘doctors in trouble’ wherein clinical material from analytic sessions with two different struggling doctors is given. Analytic theory can be atonal on the page but the descriptions of clinical work that illuminate this book provide a richness that keeps one hooked. They also serve to show how working in the National Health Service is a matter of engaging in applied rather than pure psychoanalysis.

The leitmotif in the work appeared to be the idea of containment, which was elegantly explained, albeit in a number of chapters. As somebody embedded within an analytic training, this duplication of content was one of the minor drawbacks of the book but to those coming afresh, repetition of these ideas may be the mother of study. The few other disharmonious moments were as a result of what might be regarded as a slightly self-satisfied view of psychoanalysis, although these were tempered by a willingness on the part of most authors to engage with the rest of psychiatry instead of feeling embattled by that contact. With this in mind, in the chapter ‘Psychoanalysis and general psychiatry’ by the late Richard Lucas, there is a quote from Freud that would best be kept in mind by practitioners who are on either side of, or indeed straddle, this imaginary divide: ‘What is opposed to psychoanalysis is not psychiatry but psychiatrists'.

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