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My first encounter with Isabel was in phantasy! I was in analysis with Oliver Lyth, and not knowing he was a widower, his ‘spouse’ was subject to intense scrutiny. There was a transformation to a more reality-focused transference when, in 1975, Oliver uprooted from North Oxford to a lovely Georgian house in Iffley, complete with this wife of formidable reputation. Following Oliver's death in 1981 I introduced myself. Somewhat to my relief, she said she knew who I was, and readily agreed to discuss how she might make a contribution to the McKnight Unit, a ward for people with severe and enduring psychoses at Littlemore Hospital, for which I held consultant psychiatric responsibility.
Littlemore was strongly involved in the Therapeutic Community approach and there was a culture of group work and staff support. Isabel encouraged a vigorous examination of role and practice, and my suggestion was that Isabel be invited to be a consultant to the weekly staff meeting. The introduction of this new style of group emphasized thinking about individual and corporate task and role to help the ward function in an optimal way. It was obligatory for all staff members, including domestic staff, to attend the group, so that ambivalence and resistance were ubiquitous. Nevertheless, the group survived, and continued for many years, even after Isabel retired, and new group consultants came. I personally found the meeting indispensable for staying engaged with the staff, and trying to understand not only the many problems they faced, but also as a source of clinical information, including seeing ‘the person inside the psychosis’ which otherwise would have been denied me.
Dr Peter Agulnik FRCPsych
formerly Consultant Psychiatrist in Rehabilitation and Counselling, Psychotherapy, Littlemore Hospital, Oxford