The State of Mind We are in

I want, given the title of the conference, to start with the good news and that is that I feel certain that there is a future and an appetite for psychoanalytic psychotherapy and its applications. I have little doubt there will always be a cohort of clinicians, patients and academics who are drawn to psychoanalytically informed practice, treatment and scholarship. Furthermore there is, I think, an appetite for psychoanalytic ideas in the many settings that seek to engage (as opposed to avoid) the real difficulty presented by mental disturbance. This appetite, in my view, is predicated on the value that we place on thinking in a context where action, ‘competency’ and outcome are used as a defence against thinking.

So that is the good news. However, it is also true that psychoanalytic psychotherapy appears to be swimming against the tide, and it seems to me we should not underestimate the difficulties that we, as a community, face. My concern in this paper is principally with psychotherapy within the public sector and, more especially, the changed relationship between the private and the public sectors.

In my mind the question is not so much whether psychotherapy has a future. The issue is what kind of psychotherapy, informed by what kind of ideas, and located in what kind of space.

Now for the not quite such good news: it seems to me that we are in an extraordinarily different environment to the one we thought we knew. I am thinking here about the impact of globalization, technology, the impact of the lottery, the transformation of welfare, and the arrival of what Anthony Giddens, director of the LSE, describes as ‘Third Way’ politics. I, as someone who has always been interested in politics, freely admit to not knowing quite how to think in the context of the dilemma that the American sociologist Harvard Daniel famously described, namely that: ‘The nation state [has] become too small to solve the big problems, but also too big to solve the small problems’.

We face a par