Editorial

Esther Bick's contribution to psychoanalysis is uncontested, in particular her theorizing on the notion of the skin as a container for unintegratable infantile psychic contents, on ‘adhesive identification’ as a defence, and her pioneering development of infant observation at the Tavistock Clinic. Her unpublished Membership Paper was read to the British Psychoanalytical Society in 1948. It describes the analysis of an acutely anxious woman with multiple disabling symptoms. Roger Willoughby, who discovered the paper in archives, introduces the work.

Pre-symbolic, chaotic individuals respond to the relational mode when interpretations are felt to be intolerable. Marguerite Valentine writes of how the self evolves in the treatment of regressed and borderline patients.

The victims of racial violence suffer a profound attack on their identity, precipitating often-catastrophic infantile anxieties and breakdown. Narendra Keval reports on a patient victimized by his own violent father.

Patients with physical disorder are not usually treated with psychotherapy. In an MRC-funded experimental trial with Irritable Bowel Syndrome patients, Stephanie Howlett and Else Guthrie report the benefit of farewell letters in enhancing the effect of positive change.

A pilot study for the treatment of Borderline and other Serious Personality Disorders carried out in the NHS by The Edinburgh Project is reported by Alison Cookson and her colleagues. The results of short-term (one year, once weekly) psychoanalytic psychotherapy measured improvements in impulsivity, acting out and other symptoms in this difficult to treat group of patients.

Borderline patients benefit from the structure and containment of the NHS day hospital. Jean White and her colleagues write of the long term treatment of seriously disturbed patients along psychodynamic lines by the therapeutic team.

The American psychoanalyst Stephen A. Mitchell inspired many British psychotherapists working within the relational t