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This was a paper with far-reaching implications. Akhtar (2014) brings psychoanalytic understanding to bear on the mental pain of minorities. In doing so, it felt as if he is giving voice to minorities in any society, as their mental pain and some sources of their mental pain are highlighted, and the reader is forewarned about the conscious and unconscious processes by which a majority can induce mental pain in a minority, the consequences of which may be ubiquitous to any society or organization.
The paper is framed primarily in the context of racial differences. I would however like to try to highlight some ways in which the paper also can be used in order to illuminate mental pain that may be experienced on many organizational levels within the current context of cuts, consultations and pending consultations within mental health services in the National Health Service. In this vein, mental health services per se may feel that they are a minority within the entire NHS, and may feel poorly acknowledged or understood. Alternatively, psychotherapy departments within multi-disciplinary teams may feel that they are perceived as a minority, be it numerically, or be it in terms of the prevailing modes of thinking within the organization. (On this point, I am drawing largely on my own experience as a child psychotherapist in training at a Child and Adolescent Mental Health Service a few years ago. At the time there was one qualified child psychotherapist who retired and was not replaced. Thus the department of psychotherapy within this team ceased to exist, and I was relocated to another service. In hindsight, it becomes clear that a psychotherapy team within a wider team can certainly endure the mental pain of a minority.)
In this context, it seems that majority/minority splits may become exacerbated at a time of crisis in the external situation, such as a time of austerity, when paranoid-schizoid anxieties (Klein, 1946) may abound. Akhtar (2014) argues that: ‘majority/mino