Editorial

In my last editorial I wrote about the space that the BJP provides for ‘detailed clinical work’ that ‘can be published and debated’, and the first two articles in this issue take up the opportunity fully. Anna Bravesmith's and Jackie Gerrard's papers present the reader with a set of questions about context, modality, depth, transference and counter-transference in brief and longer-term work respectively. The detailed presentation of clinical work allows the reader to engage fully with the process in the room and, equally importantly, in the therapist's mind. Both papers offer a most open account of the therapist's deliberations.

Anna Bravesmith, in ‘Can We Be Brief?’, writes movingly about brief work with a traumatized patient in primary care. The context is one of NICE compliance and the Improving Access to Psychological Therapies programme, with known difficulties for psychodynamic approaches in maintaining their identity and availability to patients. Bravesmith's is a very full account, with discussion of the implications of manualization for psychodynamic work, of the particular techniques that may be employed in brief work, and emphasizing the interactive dialogue with the patient in arriving at an agreed focus for the work. Stressing that brief work is not ‘simply a short version of long-term work’, and against a manualized approach, Bravesmith presents her work not as a prototype but as her own way of working, and as a contribution to the development of clinical technique. In particular, she addresses the role of the brief therapist in working with the patient's defences: seeing brief work as a space in which to ‘bear with’ the defences, rather than ‘strengthen’ them, for the latter might make subsequent psychodynamic work (should the patient seek it) more difficult.

Jackie Gerrard, in ‘A Question of Absence’, takes us, directly, to the heart of the therapist's dilemma: how to maintain a therapeutic stance when the patient attends erratically, if at all. Gerrar