Bion, Beckett and Bob

We worked with Bob Hinshelwood for many years and begin our paper with an account of what we experienced as the essence of his approach in applying psychoanalytic understanding, especially an awareness of the ubiquitous effects of projective identification, to individual, group and organizational dynamics in mental health settings. This takes the form of a juxtaposition of some ideas and responses triggered by contact with patients expressed by Bion, Samuel Beckett and Bob himself. They all conveyed what it feels like when ‘bits of identity’ are passed around through unconscious interpersonal interactions. We then introduce the forensic psychotherapy context in which we work and try to apply what Bob helped us to see. Contact with severely mentally ill patients, who have committed catastrophic assaults, is work on the countertransference edge where patients' deficit in the capacity for symbolic communication and subsequent resort to action - sustained streams of projective identifications - evoke the maximum emotional impact in staff. We conclude with an example of a reflective practice group for beleaguered, often frightened, staff who desperately need but also attack - much as their patients do - what Bob called the attempt to build a reflective space which is so vital to survival and effective work.